Mrs hill is a 28 year old african american with a

14. Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic lupus
erythematosus). She has noticed a raised, dark red rash on her legs. When you press on the
rash, it doesn't blanch. What would you tell her regarding her rash?
A) It is likely to be related to her lupus.
B) It is likely to be related to an exposure to a chemical.
C) It is likely to be related to an allergic reaction.
D) It should not cause any problems.
Ans:
Chapter: 06
Feedback: A “palpable purpura” is usually associated with a vasculitis. This is an
inflammatory condition of the blood vessels often associated with systemic rheumatic disease.
It can cut off circulation to any portion of the body and can mimic many other diseases in this
manner. While allergic and chemical exposures may be a possible cause of the rash, this
patient's SLE should make you consider vasculitis.
A
49
15. Jacob, a 33-year-old construction worker, complains of a “lump on his back” over his
scapula. It has been there for about a year and is getting larger. He says his wife has been able
to squeeze out a cheesy-textured substance on occasion. He worries this may be cancer. When
gently pinched from the side, a prominent dimple forms in the middle of the mass. What is most
likely?
B
16. A young man comes to you with an extremely pruritic rash over his knees and elbows
which has come and gone for several years. It seems to be worse in the winter and improves
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