11-13-2007, 09:00 PM
Hi everyone, I've been a longtime reader on this forum and now that I'm finally in med school (boring story), I'll try to contribute more so here's my first question post:
A 37-year-old woman with Raynaud™s phenomenon
complains of progressive weakness with inability to
arise out of a sitting position without assistance. On examination,
the patient has swollen œsausage-like fingers,
alopecia, erythematous patches on the knuckles, facial telangiectasias, and proximal muscle weakness. Laboratory
evaluation includes a normal CBC and serum chemistries,
except for creatine phosphokinase, 4.5 kat/L (270 U/L),
and aldolase, 500 nkat/L (30 U/L). The following serologic
profile is found: rheumatoid factor is positive at 1:
1600; ANA is also positive at 1:1600 with a speckled
pattern and very high titers of antibodies against the ribonuclease-sensitive ribonucleoprotein component of extractable nuclear antigen. This patient probably has
(A) early rheumatoid arthritis
(B) systemic sclerosis
© systemic lupus erythematosus
(D) dermatomyositis
(E) mixed connective-tissue disease (MCTD)
A 37-year-old woman with Raynaud™s phenomenon
complains of progressive weakness with inability to
arise out of a sitting position without assistance. On examination,
the patient has swollen œsausage-like fingers,
alopecia, erythematous patches on the knuckles, facial telangiectasias, and proximal muscle weakness. Laboratory
evaluation includes a normal CBC and serum chemistries,
except for creatine phosphokinase, 4.5 kat/L (270 U/L),
and aldolase, 500 nkat/L (30 U/L). The following serologic
profile is found: rheumatoid factor is positive at 1:
1600; ANA is also positive at 1:1600 with a speckled
pattern and very high titers of antibodies against the ribonuclease-sensitive ribonucleoprotein component of extractable nuclear antigen. This patient probably has
(A) early rheumatoid arthritis
(B) systemic sclerosis
© systemic lupus erythematosus
(D) dermatomyositis
(E) mixed connective-tissue disease (MCTD)