40-year-old woman comes to the office due to pain in her right hip for the past 4 weeks. The pain increases with weight bearing
She has no morning stiffness, warmth, or erythema, and no pain in other joints. The patient has no history of significant trauma to the
hip and has not had similar pain before. She was diagnosed with systemic lupus erythematosus 7 years ago Her current
medications include low-dose prednisone, hydroxychloroquine, and lansoprazole. The patient does not use tobacco, alcohol, or illicit
drugs She is afebrile, and vital signs are normal. There is no local tenderness over any joints, and range of motion of the right hip is
normal. Plain film radiograph of the hip is normal. Which of the following is the best next step in management of this patient?
- QA Bone densitometry
- 0 B. Increasing the dose of prednisone
- 0 C. Joint aspiration
- 0 D. MRI of the hip
- 0 E. Naproxen and reassurance
0 voters
29-year-old woman comes to the office due painful sores on her labia. The patient first noticed the sores 3 days ago and has not
had these symptoms before. She has also had a headache and intermittent fever for the past 5 days that temporarily resolved with
acetaminophen The patient recently became sexually active with a new male partner and uses a progestin-containing intrauterine
device for contraception She has no chronic medical conditions and takes no medications. Temperature is 38.4 C (101.2 F}, blood
pressure is 110/70 mm Hg, and pulse is 88/min. Physical examination shows several clusters of multiple small, vesicular lesions on
the right labium minora and tender, right inguinal lymphadenopathy. Speculum examination is normal. Urine pregnancy test is
negative If left untreated, this patient’s clinical course would most likely result in which of the following?
29-year-old woman comes to the office due painful sores on her labia. The patient first noticed the sores 3 days ago and has not
had these symptoms before. She has also had a headache and intermittent fever for the past 5 days that temporarily resolved with
acetaminophen The patient recently became sexually active with a new male partner and uses a progestin-containing intrauterine
device for contraception She has no chronic medical conditions and takes no medications. Temperature is 38.4 C (101.2 F}, blood
pressure is 110/70 mm Hg, and pulse is 88/min. Physical examination shows several clusters of multiple small, vesicular lesions on
the right labium minora and tender, right inguinal lymphadenopathy. Speculum examination is normal. Urine pregnancy test is
negative If left untreated, this patient’s clinical course would most likely result in which of the following?
- Q A Development of maculopapular rash that includes the palms and soles
- Q B. Inflammation of the liver capsule and resultant perihepatitis
- Q C. Persistent lesions with no additional sequelae
- Q D. Progression to CNS infection
- Q E. Spontaneous resolution within the next week
- Q F Suppuration of inguinal lymph nodes and formati:on of buboes
0 voters