Worsening Skin Rashes in a 54 Year-Old Woman

In Episode 69 of Med School Question of the Week for USMLE, Hussain Rao, MedSchoolCoach expert tutor, answers this medical school question: A 54 year-old woman comes into the clinic due to difficulty with her profession as a home painter. She states that she has been having increased difficulty reaching above her head to paint ceilings. She reports worsening weakness in her arms and legs. She also complains of a rash that has been spreading over her cheeks and the back of her hands. Physical examination reveals difficulty lifting her arms above her head and standing up from a seated position. Examination of the patient’s hands reveal the findings below: What is this patient at greatest risk for in the future?

• Renal failure
• Spontaneous abortions
• Central retinal artery occlusion
• Depression
• Visceral malignancy