Dermatomyositis is usually associated with?
(most Common)
- A. Rheumatoid arthritis
- B. SLE
- C. Systemic sclerosis
- D. Underlying Malignancy
- E. Polymyalgia Rheumatica
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A 40-year-old white woman presents to the ED with 3 hours of cramping abdominal pain and multiple episodes of vomiting after which the pain was temporarily relieved. She says the vomit is greenish. Her last bowel movement was 2 days prior to presentation, but she continues to pass flatus. Her vital signs are normal, except for a pulse of 115/min. On examination, she is in mild distress, and her abdomen is somewhat distended and diffusely tender with high-pitched bowel sounds and multiple old surgical scars. She does not have rebound tenderness. Complete blood cell count, urinalysis, and electrolytes are unremarkable. Flat and upright x-rays of the abdomen reveal multiple air-fluid levels and residual air in the colon. Which of the following is the most appropriate management of this patient?
- (A) Admit to hospital, administer intravenous fluids, and perform endoscopic retrograde cholangiopancreatography
- (B) Admit to hospital, make “nothing by mouth,” place nasogastric tube, and give intravenous fluids
- © Admit to hospital, place rectal tube, administer enemas, and disimpact bowels
- (D) Emergency laparotomy
- (E) Make “nothing by mouth” and observe in ED
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