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Category: Q&A Medicine--->Rheumatology
Page: 5

Question 21#Print Question

A 60-year-old woman presents with vision loss in her left eye and worsening headache. The patient has had a “baseline” headache on the left side for the last 3 months, but it has worsened over the past few days. Her past medical history is significant for diabetes, hyperlipidemia, and hypertension. She has a temperature of 37°C, blood pressure of 148/76 mmHg, and heart rate of 76 beats per minute. Physical examination reveals complete loss of vision in her left eye. Laboratory values reveal an ESR of 82 mm/h.

Which of the following is the best next step in management of this patient’s condition?

a. Temporal artery biopsy
b. Low-dose corticosteroids
c. Sumatriptan and supplemental oxygen
d. High-dose corticosteroids


Question 22#Print Question

A 37-year-old man presents with low back pain. He also endorses morning stiffness of his lower back. Both the pain and the stiffness improve with exercise. The patient has also noted bloody diarrhea over the past 2 weeks, but his friend told him that since he often weight-lifts, it is most likely secondary to hemorrhoids. Physical examination reveals pain on palpation over the sacroiliac joints. Dermatologic examination confirms several discrete violaceous nodules that are painful to palpation over the bilateral shins. Fecal occult blood test is positive and laboratory values reveal a hemoglobin level of 10.1 g/dL and high p-ANCA titers.

Which of the following is the most likely underlying disease contributing to this patient’s symptoms?

a. Celiac disease
b. Reactive arthritis
c. Ulcerative colitis
d. Giardia lamblia




Category: Q&A Medicine--->Rheumatology
Page: 5 of 5