Lupus (SLE): ABFM practice questions

10 board-style questions on lupus (sle) in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 45-year-old woman with a history of systemic lupus erythematosus presents with worsening dyspnea over 3 months. Her ECG shows right axis deviation (+120 degrees), tall R waves in V1, right atrial enlargement (peaked P waves in lead II > 2.5 mm), and T-wave inversions in the right precordial leads (V1-V4). Her prior ECG from 1 year ago showed a normal axis and no right-sided abnormalities. Which of the following is the most likely cause of these ECG findings?

  1. Development of right ventricular hypertrophy from pulmonary hypertension
  2. Acute pulmonary embolism
  3. Left posterior fascicular block
  4. Chronic obstructive pulmonary disease with hyperinflation

Sample question 2

A 35-year-old woman with a 10-year history of systemic lupus erythematosus (SLE) presents with exertional chest pain. She has no traditional cardiovascular risk factors except a mildly elevated LDL of 138 mg/dL. Her 10-year ASCVD risk score calculates to 1.8%. A coronary CT angiography reveals a non-obstructive 40% stenosis in the proximal LAD with mixed plaque. Which of the following best explains her premature atherosclerotic disease?

  1. Glucocorticoid-induced hyperlipidemia as the sole mechanism
  2. Accelerated atherosclerosis from chronic immune-mediated endothelial damage, complement activation, and dysfunctional HDL
  3. Coronary vasospasm from Raynaud phenomenon-associated endothelial dysfunction
  4. Antiphospholipid antibodies causing coronary thrombosis

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