Items 337339

For each patient with rheuma-tologic complaints, choose the most likely diagnosis.

337. A 75-year-old woman presents with malaise and myalgias for the last several months. She is chronically tired and has 1 h of morning stiffness in the cervical, shoulder, and hip areas. She often has a low-grade temperature and has lost approximately 8 lb during this period. Neurologic exam reveals normal sensation, strength, and reflexes. (CHOOSE 1 DIAGNOSIS)

338. A 53-year-old woman presents with a 2-mo history of difficulty climbing stairs and arising from the seated position. On physical examination, she has a purplish discoloration of the skin over the forehead, eyelids, and cheeks. She has tenderness on palpation of the quadriceps muscles. (CHOOSE 1 DIAGNOSIS)

339. A patient with a 15-year history of rheumatoid arthritis develops splenomegaly and neutropenia.

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