Billy Step 1 Questions # 51 - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 10-28-2012
billy's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 444
Threads: 109
Thanked 370 Times in 208 Posts
Reputation: 380
Arrow Billy Step 1 Questions # 51

A 17-year-old girl comes to the physician complaining of a painful, swollen left elbow and fever. She notes that in the previous few days her right knee was also swollen and slightly painful. Upon physical examination, the physician notices an edematous and tender left elbow. He also notices that the patient’s cheeks are slightly red but do not appear tender to the
touch. Laboratory tests are negative for antidouble- stranded DNA antibodies but positive for antibodies against Smith nuclear antigen and antinuclear antibodies. Also, results of Venereal Disease Research Laboratory testing are positive. The patient is shocked when informed of her positive result for syphilis, stating that she has no past sexual history. Which of the following is the most likely diagnosis?


(A) Polyarteritis nodosa
(B) Rheumatoid arthritis
(C) Secondary syphilis
(D) Systemic lupus erythematosus
(E) Tertiary syphilis
Reply With Quote Quick reply to this message



  #2  
Old 10-28-2012
venky2600's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,186
Threads: 119
Thanked 821 Times in 434 Posts
Reputation: 831
Send a message via Yahoo to venky2600
Post

D) SLE------APLA also show VDRL positive(react with treponemal antigens)

thanks
Reply With Quote Quick reply to this message
  #3  
Old 10-28-2012
koolkiller88's Avatar
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 864
Threads: 62
Thanked 374 Times in 225 Posts
Reputation: 384
Default (D) Systemic lupus erythematosus

Quote:
Originally Posted by billy View Post
A 17-year-old girl comes to the physician complaining of a painful, swollen left elbow and fever. She notes that in the previous few days her right knee was also swollen and slightly painful. Upon physical examination, the physician notices an edematous and tender left elbow. He also notices that the patient’s cheeks are slightly red but do not appear tender to the
touch. Laboratory tests are negative for antidouble- stranded DNA antibodies but positive for antibodies against Smith nuclear antigen and antinuclear antibodies. Also, results of Venereal Disease Research Laboratory testing are positive. The patient is shocked when informed of her positive result for syphilis, stating that she has no past sexual history. Which of the following is the most likely diagnosis?


(A) Polyarteritis nodosa
(B) Rheumatoid arthritis
(C) Secondary syphilis
(D) Systemic lupus erythematosus
(E) Tertiary syphilis
anti smith antibody
anti-cardiolipin antibody (reason of positive SLE- as it uses cardiolipin)
ANA
__________________
One day i will infect these microbes and they will search for "Anti-MEbiotic"....
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
 
  #4  
Old 10-28-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,039
Threads: 189
Thanked 570 Times in 323 Posts
Reputation: 580
Default my answer :)

(D) Systemic lupus erythematosus
Reply With Quote Quick reply to this message
  #5  
Old 10-28-2012
freebielady's Avatar
USMLE Forums Scout
 
Steps History: 1 + CS
Posts: 82
Threads: 10
Thanked 76 Times in 31 Posts
Reputation: 86
Default SLE

All signs point to D SLE: + ANA, + Anti-smith, False + VDRL, Malar rash, joint pain.
Reply With Quote Quick reply to this message
  #6  
Old 10-28-2012
rupesh's Avatar
USMLE Forums Guru
 
Steps History: 1 + CS
Posts: 386
Threads: 71
Thanked 193 Times in 109 Posts
Reputation: 203
Send a message via AIM to rupesh
Default

my ans is SLE>>>False positive VDRL
Reply With Quote Quick reply to this message
  #7  
Old 10-28-2012
USMLE Forums Addict
 
Steps History: Not yet
Posts: 126
Threads: 6
Thanked 43 Times in 22 Posts
Reputation: 53
Default my asnwer D

----CLASSIC Qs
Reply With Quote Quick reply to this message
  #8  
Old 10-29-2012
billy's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 444
Threads: 109
Thanked 370 Times in 208 Posts
Reputation: 380
Correct Answer D is correct

This patient has systemic lupus erythematosus (SLE), which is diagnosed by the presence of 4 of the following 11 fi ndings designated by the American Rheumatism Association, and summarized by the mnemonic “BRAIN SOAP, MD”: Blood dyscrasias (such as hemolytic anemia or thrombocytopenia), Renal disorder, Arthritis (in two or more peripheral joints), Immunologic disorder (such as anti-DNA antibody and anti-Smith antibody), Neurologic disorder, Serositis (such as pleuritis or pericarditis), Oral ulcers, Antinuclear antibody (elevated titers in the absence of
drugs associated with drug-induced lupus syndrome), Photosensitivity, Malar rash, and Discoid rash. Many patients with SLE have antiphospholipid
antibodies, which are actually believed to be antibodies against proteins that complex to phospholipids. Since these antibodies also bind to the cardiolipin antigen used in syphilis serology, patients with SLE may test false-positive for syphilis.
Reply With Quote Quick reply to this message
  #9  
Old 10-29-2012
koolkiller88's Avatar
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 864
Threads: 62
Thanked 374 Times in 225 Posts
Reputation: 384
Default

Quote:
Originally Posted by billy View Post
This patient has systemic lupus erythematosus (SLE), which is diagnosed by the presence of 4 of the following 11 fi ndings designated by the American Rheumatism Association, and summarized by the mnemonic “BRAIN SOAP, MD”: Blood dyscrasias (such as hemolytic anemia or thrombocytopenia), Renal disorder, Arthritis (in two or more peripheral joints), Immunologic disorder (such as anti-DNA antibody and anti-Smith antibody), Neurologic disorder, Serositis (such as pleuritis or pericarditis), Oral ulcers, Antinuclear antibody (elevated titers in the absence of
drugs associated with drug-induced lupus syndrome), Photosensitivity, Malar rash, and Discoid rash. Many patients with SLE have antiphospholipid
antibodies, which are actually believed to be antibodies against proteins that complex to phospholipids. Since these antibodies also bind to the cardiolipin antigen used in syphilis serology, patients with SLE may test false-positive for syphilis.
Today i read in FA
VDRL is also positive in some other cases (never paid attention to anyone except SLE)
V- virus (hep, mono)
D- drugs
R- RA
L- lupus, leprosy
__________________
One day i will infect these microbes and they will search for "Anti-MEbiotic"....
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message



Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Billy Step 1 Questions # 42 billy USMLE Step 1 Forum 8 10-21-2012 09:50 AM
Billy Step 1 Questions # 37 billy USMLE Step 1 Forum 5 10-20-2012 05:47 AM
Billy Step 1 Questions # 33 billy USMLE Step 1 Forum 6 10-18-2012 10:17 AM
Billy Step 1 Questions # 18 billy USMLE Step 1 Forum 11 10-10-2012 08:29 AM
Billy Step 1 Questions #3 billy USMLE Step 1 Forum 14 10-01-2012 10:47 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)