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SLE — SCE Rheumatology MCQ

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ModerateConnective tissue diseasesSLESCE Rheumatology

A 33-year-old woman has photosensitive rash, oral ulcers and migratory arthralgia. Examination shows there is synovitis without erosions. Investigations show ANA and anti-dsDNA are positive with low C3. The diagnosis is established and symptoms remain clinically important despite initial supportive measures. There is no contraindication to disease-modifying or anti-inflammatory escalation. What is the most appropriate management?

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Correct answer: C — Hydroxychloroquine

Hydroxychloroquine is the best answer because hydroxychloroquine is the most appropriate next step for sle in this clinical setting. Mycophenolate mofetil is a plausible distractor, but it does not account for the key discriminator in the stem. Urgent antibiotics and High-dose glucocorticoid therapy would be more appropriate in a different clinical pattern or at another point in the pathway, while ACE inhibitor therapy is suboptimal for this presentation. Clinical pearl: rheumatology management is generally treat-to-target, but infection risk, pregnancy plans and shared-care monitoring often determine the safest answer.

Reference: BSR SLE guideline; EULAR SLE and systemic sclerosis recommendations; BNF