Rhuem and ortho med

Question 1

achilles tendinopathy. patient already tried NSAIDS for a week. no relief. next step in management?

Answer 1

eccentric calf-strengthening exercises

Question 2

joint pain in several joints

now fever + diarrhea + weight loss
generalized lymphadenopathy and non deforming arthritis

small intestinal biopsy = Periodic acid schiff positive macrophage

diagnosis?

Answer 2

whipples disease!! -> caused by bacteria tropheryma whipppelii

not intestinal lymphoma -> gi symptoms but also occult blood in stool + atypiical lymphocytes on histopathology

not HIV infection as could cause symptoms if it were mycobacterium. but staining would be acid fast not acid schiff