A 27-year-old woman with systemic lupus erythematosus presen…

A 27-year-old woman with systemic lupus erythematosus presents for routine follow-up. She states that her joint pain has improved, but over the past month she has noticed increasing fatigue and mild swelling around her ankles. Her blood pressure today is 148/92 mm Hg, compared with her usual reading of 112/70 mm Hg. Laboratory results reveal: Hemoglobin: 11.8 g/dL Serum creatinine: 1.3 mg/dL (previously 0.8 mg/dL) ESR: Elevated Which additional test would be most important to obtain at this visit?

A 68-year-old man presents with rapid swelling over the post…

A 68-year-old man presents with rapid swelling over the posterior aspect of his elbow. He reports fever and chills beginning the previous evening. Examination reveals marked erythema, warmth, fluctuance, and pain over the olecranon bursa. What is the most appropriate next step?

A 27-year-old man presents with low back pain that has gradu…

A 27-year-old man presents with low back pain that has gradually worsened over the past 8 months. He reports morning stiffness lasting approximately 90 minutes that improves after he bikes to work but worsens after prolonged sitting. He denies any specific injury. Which feature is most suggestive of inflammatory back pain associated with ankylosing spondylitis?

A 51-year-old man presents with fatigue, weight loss, interm…

A 51-year-old man presents with fatigue, weight loss, intermittent fevers, diffuse muscle aches, and new numbness of his right foot. The nurse practitioner suspects a systemic vasculitis. Which additional findings would support this diagnosis? Select all that apply.

A 71-year-old man presents with acute onset of a swollen, pa…

A 71-year-old man presents with acute onset of a swollen, painful right knee. He denies trauma. He has known osteoarthritis of both knees and received an intra-articular corticosteroid injection 5 days ago. Temperature is 38.3°C (100.9°F).  What is the next best step?