Scleroderma Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 38-year-old woman comes to the emergency department for evaluation of altered mental status that began five hours ago. She is accompanied by her husband. Past medical history is notable for asthma and diffuse scleroderma. On arrival, her temperature is 37.6°C (99.7°F) and blood pressure is 183/121 mmHg. On physical examination, the patient is oriented to self but neither time nor place. Diffuse thickening of the skin is observed, and contractures are present in the bilateral fingers. Laboratory testing is obtained, and results are as follows:  

 Laboratory value  Result  Reference Range 
 Hemoglobin  10.7 g/dL  12-16 g/dL 
 Leukocyte Count  7,300/mm3  4,500-11,000/mm3 
 Platelet Count  80,000/mm3  150,000-400,000/mm3 
 Blood Urea Nitrogen  35 mg/dL  7-18 mg/dL 
 Creatinine, Serum  2.0 mg/dL  0.6-1.2 mg/dL 
   
Which of the following is the next best step in the management of this patient’s condition?  

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