Clinical Signs of Systemic Sclerosis Bernard M. Karnath, MD Questions 1 through 5 are based on the following case: A 53-year-old man with a past medical history of hypertension and coronary artery disease presents to the emergency department complaining of chest pain and shortness of breath that started about 1 hour ago. Four weeks ago, he was admitted to the hospital after having a myocardial infarction (MI). Cardiac enzymes, chest radiograph, and an electrocardiogram (ECG) are ordered. The ECG (above) shows the following: 1. Which of the following complications is least likely to develop in this patient? Interstitial lung disease Glomerular nephritis Renal crisis Pulmonary hypertension Esophageal reflux Click here to compare your answer. 2. Which of the following findings is seen prior to or at the time of diagnosis of scleroderma? Arthritis Interstitial lung disease Pulmonary hypertension Raynaud’s phenomenon Renal crisis Click here to compare your answer. 3. This patient is likely to test positive for which of the following antibodies? Anti-CCP (cyclic citrullinated peptide) Anti-Jo1 Anti-SCL-70 Anti-Smith Click here to compare your answer. 4. The case patient was diagnosed with scleroderma after the first visit. Which of the following medications is least likely to be beneficial as chronic medication? Angiotensin-converting enzyme (ACE) inhibitors Calcium channel blockers High-dose corticosteroids Proton pump inhibitors Click here to compare your answer. 5. The patient presents again after 2 years with dry cough and dyspnea on exertion. Which of the following lung diseases is most likely? Diaphragmatic weakness Interstitial lung diseases Lung nodule Shrinking lung syndrome Click here to compare your answer. Click here to read more about Clinical Features of Systemic Sclerosis (Requires Adobe Acrobat Reader) Check our archives to test your knowledge in other clinical signs: If you do not already have Acrobat Reader, simply click on the icon below, scroll down to the "Get the Free Acrobat Reader" heading and follow the instructions to install the program. Acrobat enables you to convert any document into an Adobe Portable Document Format (PDF) file for easy viewing. Download Adobe Acrobat Reader   Hospital Physician     JCOM     Seminars in Medical Practice Hospital Physician Board Review Manuals About TWC    Subscribe    Contact TWC    Home    Search   Site Map Copyright © 2009, Turner White Communications Updated 1/31/08 • kkj