This week’s free board review question…
A 35-year-old woman with no known long-term medical conditions presents to you for her annual physical examination. She does not have any symptoms. She denies smoking, alcohol use, or using illicit drugs. She does not have a family history of coronary artery disease at a young age.
Her vital signs are: blood pressure 125/80 mm Hg, pulse 75 beats/minute, respiratory rate 14 breaths/minute, oxygen saturation on room air 100%, and temperature 99 °F. Her body mass index is 25 kg/m2.
Findings on general physical examination are within normal limits, except that you notice this on her thighs (Figure).
Results of a complete blood count, serum chemistries, and liver function tests are within normal limits. Urine pregnancy test is negative.
What is the best next step in the management of this patient’s condition?
Check her lipid profile.
Check her erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level.
Check her rheumatoid factor and anti-cyclic citrullinated peptide levels.
Check her antinuclear antibodies, anti-Smith ab, anti-dsDNA antibodies, rheumatoid factor, C3, and C4 levels.
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