Systemic lupus erythematosus Quiz: Ace Your Exams
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A 24-year-old woman with a history of systemic lupus erythematosus (SLE) presents to the clinic with fatigue, joint pain, and a malar rash that has worsened over the past two weeks. She was diagnosed with SLE two years ago and takes hydroxychloroquine regularly. She has no shortness of breath or lower extremity swelling. Temperature is 37.2°C (99.0°F), heart rate is 88/min, blood pressure is 130/80 mmHg, respiratory rate is 16/min, and oxygen saturation is 98% on room air. Physical examination is significant for a pronounced malar rash and bilateral joint swelling and tenderness in her wrists, hands, knees, and elbows. Laboratory tests are shown below. Which of the following is the best next step in management?
| Laboratory test | Results |
| Hemoglobin | 10.2 g/dL |
| Hematocrit | 28% |
| White blood cell count | 5,100 cells/microL |
| Platelet count | 35,000/microL |
| Reticulocyte count | 9% |
| Mean corpuscular volume | 88 fL |
| Creatinine | 0.9 mg/dL |
| Urinalysis | |
| Specific gravity | 1.010 |
| pH | 6.0 |
| Protein | Negative |
| Blood | Negative |
| Casts | None |
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