NREMT Paramedic Cognitive ExamMedicalHard
A 30-year-old female presents with generalized weakness, fatigue, and a 'butterfly rash' across her face. She also reports joint pain in her hands and wrists. She states these symptoms have been worsening over several months. Her vital signs are stable. Which of the following is the most likely underlying condition?
- ASystemic lupus erythematosus
- BFibromyalgia
- CRheumatoid arthritis
- DMultiple sclerosis
Show answer & explanationAnswer & explanation
Correct answer: A. Systemic lupus erythematosus
The constellation of symptoms, including generalized weakness, fatigue, joint pain, and specifically the 'butterfly rash' (malar rash) across the face, is highly characteristic of Systemic Lupus Erythematosus (SLE), a chronic autoimmune disease. Other options do not typically present with this specific skin manifestation.
Why the other options are wrong
- B. Fibromyalgia causes widespread musculoskeletal pain, fatigue, and sleep disturbances, but does not involve specific rashes or joint inflammation seen in SLE.
- C. Rheumatoid arthritis primarily affects joints, causing symmetrical inflammation, but does not typically present with a butterfly rash or systemic organ involvement like lupus.
- D. Multiple sclerosis is a neurological disorder affecting the central nervous system, causing motor, sensory, and cognitive deficits, but not a butterfly rash or primary joint pain.
Systemic Lupus Erythematosus (SLE)
A chronic autoimmune disease that can affect various organs, characterized by inflammation and a wide range of symptoms, including a distinctive 'butterfly rash'.
- Malar rash (butterfly rash) is a classic sign.
- Causes fatigue, joint pain, and can affect kidneys, heart, lungs, and brain.
- Diagnosis is complex; treatment involves immunosuppressants.
Memory trick: LUPUS: 'L' for Lupus, 'U' for Unexplained symptoms, 'P' for Pain (joint), 'U' for Unusual rash ('U'nique butterfly), 'S' for Systemic.