A 53-year-old website developer complained of pain and discoloration of fingertips after cold exposure. Upon his arrival nurse notice a sharp demarcated color change in 2nd, 3rd, and 4th fingers on both hands as shown in the image. On physical examination, both hands were cold, radial pulse 85 bpm, and 3+ bilateral. No numbness, tingling, burning sensation, or any skin abnormality. He had chronic systemic lupus erythematosus that was diagnosed eight years ago and denies drinking alcohol, cigarette smoking, or a history of a heart condition. His lab result reveals the presence of proteinuria and hematuria in urinalysis, antinuclear antibody titer of 1:2,560, and normal creatinine level. Renal biopsy indicated stage V membrane lupus nephritis, which was conducted due to proteinuria. Based on the patient’s history and physical examination findings,

Which of the following is the most likely diagnosis?

Real-Life cases to ensure you are ready for your MCCQE1 Exam!

Ace Qbank Clinical Edge


Ace Qbank Clinical Edge

Making the proper diagnosis is one of the most important aspects of any medical student’s or junior doctor’s clinical training and hence we created Clinical Edge Cases.

Ace Qbank Clinical Edge helps our students put their knowledge of symptoms and physical findings to test by applying clinical reasoning and assessment concepts to a series of common clinical vignettes. Problem-based learning is being used to focus on the cause behind the presentation of a simulated clinical case.

Each simulated Clinical Edge case contains a list of common causes of the presented condition, offers abundant references to the presented case, making additional information easy to find

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