A 65-Year-Old Woman Comes to the Physician with a Rash

question 856

Multiple Choice

A 65-year-old woman comes to the physician with a rash on her hands for the past 2 weeks.  Two months ago she developed a rash on her face and forearms while vacationing at a beach resort.  Her review of systems is positive for recent onset weakness of the shoulders and hips.  She has no dysphagia, shortness of breath, fever, chills, or weight loss.  She is a lifetime nonsmoker.
Her temperature is 37.2 C (99 F) , blood pressure is 134/82 mm Hg, pulse is 75/min, and respirations are 14/min.  Her BMI is 21 kg/m².  Cardiopulmonary examination is within normal limits.  There is no hepatosplenomegaly.  Range of motion of the spine is normal and without pain, scoliosis, or excessive kyphosis of the back.  Upper and lower limb deep-tendon reflexes are 2+.  She has difficulty rising from a chair.  Muscle strength is 4/5 in both upper and lower extremities.
Laboratory results are as follows:

The rash is shown in the photograph.

This patient would require which of the following?

• A)Anti dsDNA antibodies testing
• B)Cancer screening
• C)Dilated funduscopic examination
• D)Liver biopsy
• E)Trial of low-dose prednisone

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Definitions:

Outgroup Homogeneity

The perception that members of an outgroup are more similar to each other than they actually are, or more similar than members of the ingroup.

Uncertainty-Identity Theory

The theory that people join and identify with groups in order to reduce negative feelings of uncertainty about themselves and others.

Entitativity

The degree to which a group is perceived as being a coherent and distinct entity, with members sharing common characteristics or a common fate.

Uncertainty-Identity Theory

A theory suggesting that individuals form or join groups in order to reduce uncertainty about themselves and their place in the world.