WBR0690

Author	[[PageAuthor::Twinkle Singh, M.B.B.S. [1] (Reviewed by Serge Korjian)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Immunology, MainCategory::Pharmacology
Sub Category	SubCategory::Musculoskeletal/Rheumatology
Prompt	[[Prompt::A 65-year-old woman presents to emergency department with complaints of breathlessness, sharp pleuritic chest pain, and cough for the past week. She also reports mild joint pain and intermittent fever. On physical examination, a right-sided pleural rub is appreciated. Her blood pressure is 110/60 mm Hg, heart rate is 92/min, respiratory rate is 21/min, and temperature is 36.7 ᵒC (98 ᵒF). Upon further questioning, the patient explains that she has been receiving a medication for an irregular heart beat for the past 3 months whose name she cannot recall. Which of the following antibodies are likely to be present 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::