ABIM & Internal Medicine Shelf Exam Review Question of the Week: Mastering the Labs associated with SLE Flare-Up
As we begin #RheumWeek in our preparation of the ABIM and Internal Medicine Shelf exam review, here is a question directly out of the Knowmedge QVault. Give it your best shot and then see below for the answer.
42-year-old female has a history of systemic lupus erythematosus (SLE) and now feels like she is having a flare-up. Which of the following set of labs would confirm an SLE flare-up?
A. Increased complement level, increased anti-dsDNA level, increased ESR level B. Decreased complement level, increased anti-dsDNA level, increased ESR level C. Decreased complement level, decreased anti-dsDNA level, increased ESR level D. Increased complement level, decreased anti-dsDNA level, increased ESR level E. Decreased complement level, decreased anti-dsDNA level, decreased ESR level
ABIM Exam Practice Question Explanation
Laboratory studies can provide a clue to the diagnosis of systemic lupus erythematosus (SLE) flare-up. Let’s go through the lab results you would expect to see:
● Complement level: You would expect to see low complement levels in a patient with a SLE flare-up. Low complement levels mean a high level of lupus activity.
● Anti-dsDNA: Increased anti-dsDNA levels are typically seen before and during the period of SLE flare-up.
● ESR: This is a blood test that measures the amount of inflammation in the body – during a flare-up, you would expect to see the ESR level go up.
We would expect to see Choice B (Decreased complement level, increased anti-dsDNA level, and increased ESR level). A mnemonic to assist in remembering which of the tests in a SLE flare-up is decreased is to think that lupus does not deserve complements when it flares up.
You can view all the previous ABIM Exam Review Questions of the Week at the Knowmedge Blog. You can also find additional topics and questions directly from the Knowmedge Internal Medicine ABIM Board Exam Review Questions QVault.