This page is dedicated to organizing various examples of standardized exam questions whose answer is systemic lupus erythematosus (SLE). While this may seem a odd practice, it is useful to see multiple examples of how SLE will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)
When it comes to standardized exams, each topic has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for SLE.
- Malar fashial rash: this is a very classic piece of the physical exam for a patient with this condition.
- Joint pains/swelling
- Serum findings:
- Low compliment levels
- Positive ANA antibodies
- Positive anti-dsDNA antibodies
Question # 1
A 11 year old girl is brought to the hospital after she has a generalized tonic clonic seizure. She has a 1 month history of behavior disturbances, and also a 2 week history of a fever, weakness, and painful swelling of her right knee. Labs are ordered and this patient’s hemoglobin concentration is 9.1 g/dL, leukocyte count is 3700/mm³. A direct Coombs test is positive. A urinalysis shows the presence of both protein and microscopic blood. What is the likely diagnosis in this patient?
Explanation # 1
Joint pain/swelling + positive Coombs test (antibodies in serum) + proteinuria + hematuria = SLE
Question # 2
A 20-year-old African American female comes to the clinic because she has been experiencing diffuse joint pain in her hips and knees for the past 5 months. She also has noticed a rash on her nose and cheeks during this time. Her past medical history is unremarkable and she has no allergies. Her temperature is currently 100.5°F. A physical exam is notable for warmth and swelling in both of the patient’s knees. Lab studies are performed and shown below:
- Hemoglobin: 10.7 g/dL
- ESR: 43 mm/h
- Serum urean nitrogen: 31 mg/dL
- Creatinine: 1.9 mg/dL
What is a possible diagnosis in this patient?
Explanation # 2
Joint pains + facial rash involving nose (malar rash) = SLE
Question # 3
Explanation # 3
TESTABLE FACTS ABOUT THIS TOPIC (BEYOND ITS IDENTIFICATION)
Many questions on standardized exams go beyond simply recognizing the underlying topic. Often there are specific testable facts regarding some aspect of the topic’s pathophysiology/management/clinical implications that are commonly asked. Some of these are listed below:
Page Updated: 02.20.2017