AssessmentsSystemic lupus erythematosus
Systemic lupus erythematosus
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 34-year-old Caucasian woman is referred to the office for the evaluation of a heart murmur. Her medical history is relevant to recently diagnosed systemic lupus erythematosus and type I diabetes mellitus. Upon medical interrogation, the patient claims to feel easily fatigued whenever she walks a few steps and feels extremely tired all day. On physical examination the patient has a holosystolic murmur, that is heard best at the apex, as well as, scattered petechiae in her conjunctiva, oral mucosa, and legs. Her temperature is 37.1°C (98.8°F), pulse is 72/min, respirations are 17/min, and blood pressure is 120/80 mmHg. She has had multiple blood cultures drawn by her physician, and all of them are finalized and showed no growth. At this point, this patient most likely has which of the following conditions?