#august2020mccqe1
A 65-year-old woman consults a physician with complaints of severe pain and stiffness of the neck, shoulders, and hips. These symptoms are worst in the morning and after inactivity. The woman has also been experiencing a variety of systemic symptoms, including malaise, low grade fever, depression, and some weight loss. On physical examination, there is no evidence of erosive or destructive joint disease, no point tenderness when pressure is applied to small joints, no selective muscle weakness or muscle atrophy, and no rheumatoid nodules. Blood studies demonstrate a mild normochromic normocytic anemia, dramatically elevated erythrocyte sedimentation rate, and elevated c-reactive protein. Thyroid-stimulating hormone (TSH) is 0.75 mIU/mL. Rheumatoid factor is negative. Electromyography and muscle biopsy fail to demonstrate conclusive evidence of muscle disease. This patient’s most likely condition has the strongest association with which of the following?
(A) Crohn disease
(B) Dermatomyositis
(C) Discoid lupus erythematosus
(D) Sjögren syndrome
(E) Temporal arteritis
A 65-year-old woman consults a physician with complaints of severe pain and stiffness of the neck, shoulders, and hips. These symptoms are worst in the morning and after inactivity. The woman has also been experiencing a variety of systemic symptoms, including malaise, low grade fever, depression, and some weight loss. On physical examination, there is no evidence of erosive or destructive joint disease, no point tenderness when pressure is applied to small joints, no selective muscle weakness or muscle atrophy, and no rheumatoid nodules. Blood studies demonstrate a mild normochromic normocytic anemia, dramatically elevated erythrocyte sedimentation rate, and elevated c-reactive protein. Thyroid-stimulating hormone (TSH) is 0.75 mIU/mL. Rheumatoid factor is negative. Electromyography and muscle biopsy fail to demonstrate conclusive evidence of muscle disease. This patient’s most likely condition has the strongest association with which of the following?
(A) Crohn disease
(B) Dermatomyositis
(C) Discoid lupus erythematosus
(D) Sjögren syndrome
(E) Temporal arteritis
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