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SLE renal activity — SCE Rheumatology MCQ

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ModerateMusculoskeletal investigationsSLE renal activitySCE Rheumatology

A 30-year-old woman with SLE has ankle swelling and foamy urine. Blood pressure is 154/96 mmHg and there is no infection. Urine dipstick shows blood and protein with low complement. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: DUrine protein:creatinine ratio and microscopy

Quantifying proteinuria and checking active urinary sediment are immediate tests for suspected lupus nephritis. The distractors investigate different diseases and would not answer the immediate diagnostic question. The most useful rheumatology investigation is the one that changes diagnosis, urgency or treatment choice.

Reference: BSR hot swollen joint guideline; NICE CKS; EULAR imaging recommendations