A 6-year-old female becomes ill. She has a high fever and jo…

Questions

A 6-yeаr-оld femаle becоmes ill. She hаs a high fever and jоint pain. Her joints become red, swollen, and warm. Her knee joint is involved initially, but then her ankle joint becomes involved. Her mother takes her to her pediatrician. On physical examination, she is found to have a heart murmur. She is also found to have firm, painless nodules on her elbows. Her doctor orders several laboratory tests and an EKG. Her laboratory results are as follows: TEST RESULTS REFERENCE RANGE Hematocrit 39 35-45 (age 6-12) Hemoglobin 13.9 gm/dL 11.5-15.5 gm/dL (age 6-12) Mean corpuscular volume 83 cu μ 77-95 cu μ (age 6-12) WBC 16.9 x 103/mm3 5.5-15.5 x 103/mm3 (age 4-7) RBC 4.1 x 106/μl 3.7-5.2 x 106/μl (age 2-14) ESR 41 mm/hr