WBR0690

Author	[[PageAuthor::Twinkle Singh, M.B.B.S. [1]]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Immunology, MainCategory::Pharmacology
Sub Category	SubCategory::Musculoskeletal/Rheumatology
Prompt	[[Prompt::A 65 year old female comes with complaints of breathlessness and a sharp chest pain on right side which increases on deep inspiration and cough from one week. She is also suffering from joint pain, generalized muscle ache and mild on and off fever from few weeks. On examination, there is a pleural rub at 4th intercostal space on right side. Her vital signs are blood pressure 130/100, pulse 90/min and respiratory rate 22/min. She is on a medication for irregular heart beat from one year. Her other medications include lisinopril, simvastatin and over the counter analgesics. Which of the following is the most common lab finding in this patient?]]
Answer A	AnswerA::Anti ds-DNA antibodies
Answer A Explanation	AnswerAExp::Anti ds-DNA antibodies are more specific to idiopathic SLE
Answer B	AnswerB::Anti nuclear antibodies
Answer B Explanation	AnswerBExp::Anti nuclear antibodies are the non specific antibodies present in SLE.
Answer C	AnswerC::Anti- mitochondrial antibodies
Answer C Explanation	AnswerCExp::Anti mitochondrial antibodies are found in primary billiary cirrhosis
Answer D	AnswerD::Anti-histone antibodies
Answer D Explanation	AnswerDExp::Anti-histone antibodies are present in 90% of patients with drug induced lupus
Answer E	AnswerE::Anti smooth muscle antibodies
Answer E Explanation	AnswerEExp::Anti smooth muscle antibodies are present autoimmune hepatitis
Right Answer	RightAnswer::D
Explanation	[[Explanation::Drug-induced lupus erythematosus is a side-effect of long-term use of certain medications. The most commom medications that cause drug-induced lupus erythematosus are procainamide, hydralazine, isoniazid and quinidine. Symptoms of drug-induced lupus erythematosus are similar to systemic lupus erythematosus. It presents commonly with non inflammatory arthritis, myalgia, fever and serositis. Cutaneous manifestations are less common. After stopping the medication that caused the condition, most patients may recover. Educational Objective: References: ]]
Approved	Approved::No
Keyword	WBRKeyword::Drug Induced Lupus Erythematosus, WBRKeyword::Anti histone antibodies, WBRKeyword::Anti smooth muscle antibodies
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::