A 27-Year-Old African American Woman Comes to the Office Due

question 832

Multiple Choice

A 27-year-old African American woman comes to the office due to 6 weeks of pain and swelling of her hands and wrists.  The pain worsens in the morning and is associated with stiffness for 10-15 minutes.  She also has had easy fatigability and muscle aches.  The patient has no significant medical history and does not take any medications.  She has been sexually active with a new partner.  Temperature is 37.9 C (100.2 F) , blood pressure is 140/90 mm Hg, and pulse is 76/min.  Physical examination shows slightly swollen, tender metacarpophalangeal and proximal interphalangeal joints.  There is a nontender ulcer on the buccal mucosa.  Mild cervical and axillary lymphadenopathy are present.  Cardiopulmonary auscultation is normal.  The abdomen is soft and nontender.  Laboratory results are as follows: X-ray of the hands and wrists reveals no bony erosions.  Urinalysis shows 2+ protein and 20-30 red blood cells/hpf.  Which of the following is the most likely diagnosis?

• A)Behçet disease
• B)Disseminated gonococcal infection
• C)Felty syndrome
• D)Hodgkin disease
• E)Parvovirus B19 infection
• F)Sarcoidosis
• G)Systemic lupus erythematosus

---

Definitions:

Wallerstein's Theory

Refers to the world-systems theory, which analyzes the world economy as a complex system structured by capitalist exploitation and nation-state competition.

Cultural Domination

The imposition of the customs, behaviors, practices, and beliefs of one culture over another, often resulting in the suppression of the dominated culture's values.

Colonization

The action or process of settling among and establishing control over the indigenous people of an area.

Legal Domination

Legal domination is a concept in sociology referring to a form of authority where individuals or groups exert control through a system of laws and regulations that are formally established and often enforced by a state.