Mary

General Practice Clinic

A 28-year-old woman of mixed Caucasian and African heritage presents with a 9-month history of fatigue, bilateral symmetrical hand stiffness with morning predominance, hair thinning, recurrent oral ulcers and a photosensitive malar rash. Working diagnosis is Systemic Lupus Erythematosus (SLE); rheumatoid arthritis, drug-induced lupus, viral arthritis, dermatomyositis and mixed connective tissue disease must be considered.

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Data Gathering

Take a comprehensive history, perform examinations, and order investigations.

Clinical Reasoning

Formulate a diagnosis, consider differentials, and synthesise evidence.

Clinical Decision Making

Explain your diagnosis, recommend treatment, and arrange follow-up.

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