Medical Mystery: Guess the Diagnosis!

[samrusoff]

Welcome to Dungeons and Dragons: Healthcare edition. Dr Schmidt will be your dungeon master for this adventure. Listen to his scenario description and choose your action from the list below:


A. Consult Infectious Disease
B. Consult Rheumatology
C. Order vanc and zosyn
D. Ask Doc Schmidt's mom what the patient has
E. Wake up in a cold sweat and remember all at once that you abandoned pre-med for a comfortable career in IT.

[glaucomflecken]

"It's never lupus." - a handsome, tall and smart guy.

[rebeccanika]

I’m not sure but thank you for the interesting consult.

[prahamsahonooman]

Dx: Dermatomyositosis
The biopsy was a muscle biopsy.
The rashes on the knuckles were Gottron's papules

[carlie-rj]

This makes me so excited to see/hear people talk about dermatomyositis. I have the condition, but not much is ever really presented on it and it is never really talked about.

[jcortese]

I have no clue what dermatomyositis or Gottron's papules are, but I'll say that while nodding sagely because everyone else is.

[Alex-opty]

Makes me think dermatomyositis with a muscle biopsy from the affected areas. Not sure about EBV, but I know autoimmune diseases can sometimes be triggered after viral infections. (great video idea btw)

[RyanAmplification]

More of these please! This was awesome!

[kelly]

Not sure on the dx but I know one thing for certain: Jones is going to get it too 🤣

[Alia]

Its an autoimmune disease for sure but what exactly not sure

[justineglickman]

This happened to me!!! I had mono and dermatomyositis. What worse is that since then I then got Lyme, Meningitis and still have ongoing autoimmune issues 16 years later, chronic fatigue, horrible psoriasis and pain. 😖

[jimbelter]

I think it was a dermal biopsy and possible diagnosis of psoriatic arthritis. It could also be possible to be Lupus

[michelleb]

Idk but I had similar when my liver was mad at me for all the heroin. I’m clean now and no more rash or muscle fatigue

[aamirrazak]

Whoa these medical mysteries are really interesting! Idk i was going to guess maybe lupus

[DrSimonsSays.]

Definitely do more of these!!
Dx: Dermatomyositis flare diagnosed from a proximal muscle bx. or MRI, Electromyography, Violet rash= Gottron’s Papules on knuckles. Heliotrope rash on eyelids. Could have Raynauds syndrome—symptoms usually not as bad in summer. +ANA, Elevated CK.

Flare brought on by Mono (+EBV/HORRIBLE sore throat)

[Bowandarrow]

Proximal muscle weakness made me think of Polymyalgia Rheumatica

[boshrapasha]

Dermatomyositis. Diagnosis can be confirmed by muscle Bx but if the patient has typical symptoms like the one mentioned, one can make a diagnosis without a biopsy. But since dermatomyositis is often accompanied by cancer, cancer screening needs to be done too.

[liam_hurlburt]

Dx: Dermatomyositis as an autoimmune response to a stage I or II Nasopharyngeal carcinoma, which in turn may have been caused by her Epstein-Barr virus infection (especially if the nasopharyngeal carcinoma is type 2 or 3)

EBV itself covers the fatigue and myopathy, fever, and elevated WBC. Elevated ANA is because this is autoimmune

Biopsy was most likely of the carcinoma and was taken during a nasopharyngeal endoscopy (which is why Ben was involved and we're hearing about this case). Otherwise, the biopsy may have been of a lymph node

[cristianmitran]

Dermatomiositis. I'm an allergist resident and had to read about this disease this week and it matches almost all the data.

[momdalmutairi]

I’m guessing dermatomyositis with an underlying carcinoma . since she had high EBV and sore throat => that makes me think nasopharyngeal/oropharyneal carcinoma ( more so naso) . If there was LN involvement, biopsy can make the diagnose

Edit:
Ok maybe I overthought this lol 😂