Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Review of Clinical Signs Review Questions

Answer 1
  1. Biopsy of the small intestine. This patient has Whipple’s disease, which is characterized by joint pains, diarrhea, weight loss, and lymphadenopathy. The disease typically affects men in their fourth to sixth decade. Duodenal biopsy will likely reveal the causative organism Tropheryma whippelii, a gram-positive bacillus. Treatment is trimethoprim-sulfamethoxazole (1 double-strength tablet twice daily) for 1 year. Radiographs of the hands are helpful in rheumatoid arthritis but not in Whipple’s disease. Anti-dsDNA titer would be helpful in systemic lupus erythematosus. CT scan of the abdomen would lead to nonspecific findings. Biopsy of the small intestine is more likely to reveal the organism than a lymph node biopsy.

Click here to return to the questions

Click here to read more about Extraintestinal Manifestations
of Hepatogastrointestinal Diseases

(Requires Adobe Acrobat Reader)

Review of Clinical Signs main page

Check our archives to test your knowledge in other clinical signs:

Review of Clinical Signs Archives

If you do not already have Acrobat Reader, simply click on the icon below, scroll down to the "Get the Free Acrobat Reader" heading and follow the instructions to install the program. Acrobat enables you to convert any document into an Adobe Portable Document Format (PDF) file for easy viewing.

Download Adobe Acrobat Reader


Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj