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Old 06-11-2012
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Question Rheumatology Case Presentation

A 52-year-old woman is complaining of several weeks of swelling of both hands and ankles. She notes stiffness in the
morning that subsides during the day. She has also experienced generalized weakness, cough, and intermittent low-grade fevers. The patient denies having a skin rash or dryness of the eyes. Examination reveals symmetrical swelling and warmth of the wrists, knees, and proximal interphalangeal and metacarpophalangeal joints of the hands. There are small
subcutaneous nodules palpated over the tendons of her fingers and elbows. A faint pericardial rub is auscultated. Initial
laboratory tests reveal: white cell count 11,200/mm3, hematocrit 32%, mean corpuscular volume 92 μm3, platelets 660,000/mm3, creatinine 1.2 mg/dL, and glucose 150 mg/dL.

What should be the first diagnostic test performed?

(A) X-rays of hands, wrists, and ankles
(B) Rheumatoid factor and sedimentation rate
(C) Antinuclear antibody
(D) Examine the synovial fluid
(E) Echocardiogram
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Old 06-11-2012
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Might be lupus :/
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Internal-Medicine-, Rheumatology-, Step-2-Questions

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