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På Akutmottagningen träffar du 56‐åriga Annelie som står på steroider för en svårbehandlad RA (reumatoid artrit). Nu söker hon med trötthet, feber och viss viktnedgång sedan sex veckor. Hon har sökt vårdcentralen för detta och fått prova en doxycyklinkur, utan effekt. Hon har inte varit utomlands och ingen i omgivningen är sjuk. I status framkommer:AT: Trött men opåverkad. Temp 38,5oC. Sat 97% på luft, AF 20/min. Hjärta: Regelbunden rytm, frekvens runt 105/minut, diastoliskt lågfrekvent blåsljud med PM I2dx. (Patienten känner inte till att hon har något blåsljud). Blodtryck: 135/65 mmHg. Lungor: Normala andningsljud bilateralt. Ledstatus ua. Lokalstatus hud: litet sår på höger underben, ej vätskande, ser kroniskt ut.A. Vad misstänker du ger upphov till blåsljudet? Endast ett svar ska markeras.- Aortainsufficiens- Mitralisstenos- Bikuspid aortaklaff- Mitralisinsufficiens- Aortastenos1 pB. Vilken sjukdom misstänker du i första hand att Annelie har drabbats av? 1 p

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