NBME lupus q

Discussion in 'Step I' started by MudPhud20XX, Sep 20, 2014.

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  1. MudPhud20XX

    MudPhud20XX 2+ Year Member

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    Nov 25, 2013
    A 25 yr old woman comes to the physician b/c of general malaise and a facial rash for 1 week. She has a 10 yr hx of episodes of pleurisy and arthritic pain in peripheral joints. Physical examination shows an erythematous malar rash that does not involve the nasolabial folds. Results of cardiolipin antibody, anti-dsDNA, and anti-Sm antibody assays are positive. Which of the following hematologic abnormalities is most likely in this patient?

    A. Hemolytic uremic syndrome
    B. Macrocytic anemia
    C. Multiple nucleated erythrocytes
    D. Rouleaux formations
    E. Thrombocytopenia

    So I am debating between D and E. I want to say E but yet you do get high ESR in lupus right? Any idea?
     
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  3. Apoplexy__

    Apoplexy__ Blood-and-thunder appearance 2+ Year Member

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    Oct 20, 2012
    Up on the Hydra's back
    E, thrombocytopenia. It's important to know that autoimmune hemolytic anemia (type 2 HS) is associated with SLE. It can cause pancytopenia, or any isolated -penia.

    You don't need to mentally associate ESR with rouleaux. I've never seen it as an answer for anything but multiple myeloma.
     
    seminoma, CodeRedDew and MudPhud20XX like this.
  4. thehundredthone

    thehundredthone 2+ Year Member

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    Aug 20, 2012
    This is NBME 15 isn't it? Why not post in that thread to keep everything together?
     
    Brain Bucket likes this.

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