C abhishek pre final paper 2
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36 year old female patient with Multi joint pain
January 06, 2022 36YEAR OLD FEMALE WITH JOINT PAINS, MALAR RASH, ORAL ULCERS A 36 years old female patient came with chief complaints of Multi joint pain since 2 months ,morning stifness of joints since 1 month ,Menorrhagia since 1 month HOPI Patient was apparently asymptomatic 2 months back, then she had rapid weight gain, menorrhagia, multiple joint pains, she visited a hospital and was found that her TSH was >100 mlU/L and was started on THYRONOME 100 micrograms. Her menorrhagia subsided, but she continues to have multiple joint pain (all small joints and large joints) associated with swelling of joints, morning stiffness for 30mins, on evaluation she was found to have CRP (+), Hb-10.8gm/dl, Uric acid-7.8 and was started on T. ALLOPURINOL100mg BD. Her joint pains are associated with on and off low grade fever since 2months, using T.PCM 650mg BD since 2months. On Dec 29th: ANA- 3.18(if >1.2 strongly positive) Anti CCP -1.4 UI/ml (Negative) Rh factor- Negative TSH -16.9 (