View source for WBR0874

{{WBRQuestion
|QuestionAuthor={{Rim}}
|ExamType=USMLE Step 1
|MainCategory=Pathophysiology
|SubCategory=Pulmonology
|MainCategory=Pathophysiology
|SubCategory=Pulmonology
|MainCategory=Pathophysiology
|SubCategory=Pulmonology
|MainCategory=Pathophysiology
|MainCategory=Pathophysiology
|SubCategory=Pulmonology
|MainCategory=Pathophysiology
|SubCategory=Pulmonology
|MainCategory=Pathophysiology
|SubCategory=Pulmonology
|MainCategory=Pathophysiology
|SubCategory=Pulmonology
|MainCategory=Pathophysiology
|MainCategory=Pathophysiology
|SubCategory=Pulmonology
|Prompt=A 66 year old man presents to the pulmonary clinic for a cough that has been present for the past 3 months. The patient reports a constant cough that varies in intensity with recent noticeable fatigue and joint pain that has been interfering with his daily activities. He also reports significant morning stiffness lasting at least an hour and sometimes more. The patient reports that he has never smoked in his life and denies any recent sick contacts or travel. Further questioning revealed that the patient worked for several years as a coal miner but retired 2 years ago. Chest x-ray reveals 3 pulmonary nodules of approximately 1.5cm each. PPD did not show any induration. Blood analysis reveals excess IgM antibodies reactive to the Fc portion of IgG. 
|AnswerA=Systemic lupus erythematosus
|AnswerB=Asbestosis
|AnswerC=Caplan Syndrome
|AnswerD=Rheumatoid arthritis 
|AnswerE=Ankylosing Spondylitis
|Approved=No
}}