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Old 10-03-2012
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Question Patient with SLE

A 36 year old woman with a long history of SLE presents with speech impairment, right sided weakness and right facial droop for the past 2 hours .On physical exam, her eyes deviate to the left and a murmur is present. Labs show a normal complement level.
Which of the following is the most accurate test for this patient?

A. Chest CT
B. Echocardiogram
C. EKG
D. Holter monitor
E. Telemtery monitor
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Old 10-03-2012
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B. Echo to check for Libman-Sacks endocarditis. Murmur present is usually of valvular insufficiency.

Conrad Fischer rocks

Last edited by vaibhavmanu; 10-03-2012 at 09:44 AM. Reason: .
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Old 10-03-2012
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I think B. Echocardiogram.....may be endocarditis
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Old 10-03-2012
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I would Say B, for almost anything in cardiology ECHO is the way to go, prob libman sacks endocarditis, yet at a first glance looks like a thrombotic event also, IF a head CT would appear then I would pick that, but I think the murmur is the clue here.
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B. Echocardiogram

since she has murmur

Can't be antiphospholipid syndrome (can cause thrombotic stroke) since her complement levels are normal.
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Old 10-04-2012
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Answer B

The patient presents with a stroke .Patient with SLE have Limban sacks verrucous vegetation whihc can embolize causing a stroke .

The normal complement level in the stem is also suggestive that the episode here is not worsening of lupus resulting in cerebritis
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Cardiology-, Internal-Medicine-, Rheumatology-, Step-2-Questions

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