53-year-old woman presents to her GP for a follow-up visit after having high BP on her last visit. She is again found to be hypeensive and was prescribed hydralazine, a b-blocker, and furosemide. The woman takes no additional prescription or over-the-counter medications. She complains of muscle aches, joint pain, and rash. Physical exam reveals a temp. of 37.7degC (100.0degF) and a scaling erythematous rash on her face. The physician orders an autoantibody panel: Antinuclear antibodies (ANA): Positive Anti-histone antibodies: Positive What is the most likely diagnosis?
53-year-old woman presents to her GP for a follow-up visit after having high BP on her last visit. She is again found to be hypeensive and was prescribed hydralazine, a b-blocker, and furosemide. The woman takes no additional prescription or over-the-counter medications. She complains of muscle aches, joint pain, and rash. Physical exam reveals a temp. of 37.7degC (100.0degF) and a scaling erythematous rash on her face. The physician orders an autoantibody panel: Antinuclear antibodies (ANA): Positive Anti-histone antibodies: Positive What is the most likely diagnosis?
💡 Explanation
**Core Concept**
The patient's symptoms and positive autoantibody panel suggest an autoimmune disorder. Specifically, the combination of hypertension, muscle aches, joint pain, rash, and positive antinuclear antibodies (ANA) points towards a systemic autoimmune disease.
**Why the Correct Answer is Right**
The patient's symptoms are consistent with Systemic Lupus Erythematosus (SLE), a chronic autoimmune disease that can affect multiple organ systems. The presence of a scaling erythematous rash, particularly on the face, is a classic symptom of SLE. The positive ANA and anti-histone antibodies further support this diagnosis, as these autoantibodies are commonly found in SLE patients. The patient's hypertension may be related to the disease process, as SLE can affect the kidneys and lead to renal hypertension.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not account for the patient's positive autoantibody panel and the systemic nature of the symptoms. While hypertension can be a risk factor for kidney disease, it does not explain the patient's rash and joint pain.
**Option B:** This option is incorrect because it does not consider the patient's age and sex. While SLE can affect anyone, it is more common in women, and the patient's age is consistent with the typical onset of SLE.
**Option C:** This option is incorrect because it does not account for the patient's positive ANA and anti-histone antibodies. While the patient's symptoms could be consistent with another autoimmune disease, the specific autoantibody profile suggests SLE.
**Option D:** This option is incorrect because it does not consider the patient's systemic symptoms and positive autoantibody panel. While the patient's hypertension could be related to another condition, the combination of symptoms and autoantibody profile suggests SLE.
**Clinical Pearl / High-Yield Fact**
The patient's symptoms and positive autoantibody panel highlight the importance of considering autoimmune disorders in patients with unexplained symptoms. A high index of suspicion and a thorough diagnostic workup, including autoantibody testing, are essential for diagnosing SLE and other autoimmune diseases.
**Correct Answer: C. Systemic Lupus Erythematosus (SLE)**
✓ Correct Answer: B. Hydralazine-induced lupus erythematosus
📤 Share this MCQ
Share Card Preview
👆 1080x1080 square card — fills the full width in WhatsApp and Telegram