CREST syndrome

The cutaneous form of systemic scleroderma.
The five features are: CREST

• Calcinosis
• Raynaud’s phenomenon
• Esophageal dysmotility
• Sclerodactyly
• Telangectasia

Calcinosis – calcium deposits in tissue.  Most common form is dystrophic calcification and can be due to any soft tissue damage

Raynaud’s phenomenon – vasospasm of the fingers/toes

Sclerodactyly – thickening and tightness of skin around fingers or toes

Pyrexia of unknown origin causes

Infections Can Make Undergraduates Die

• Infection (20-40%)
• Tuberculosis
• Infective endocarditis
• Epstein-Barr virus (EBV)
• Cytomegalovirus (CMV)
• Connective tissue disorders (20%)
• Rheumatoid arthritis
• Systemic Lupus Erythematosus
• Adult-onset Still’s disease
• Temporal arteritis
• Malignancy (10-20%)
• Lymphoma
• Leukaemia
• Hepatocellular carcinoma
• Undiagnosed (20%)
• Drugs (e.g. phenytoin) (Rare)

* Relative percentages in brackets
Pyrexia of unknown origin (PUO) is a fever > 3 weeks with no cause found despite 7 days in hospital with investigations.