Question 105

Question:

A 49 year-old woman with a recent history of hypertension comes in complaining of tightening of the skin of her hands and face. BP is 142/84, and other vital signs are within normal limits. On lung exam, air entry is less than expected with deep inspiration bilaterally, with no wheezes, rales, or rhonchi. The remainder of the physical exam is within normal limits. In addition to the skin and lungs, what organ is often affected by this disease?

Correct Answer: A.  Esophagus

This patient has progressive systemic sclerosis (PSS), or scleroderma. PSS can affect much of the GI tract, with the esophagus being the most common portion affected, frequently resulting in dysphagia. Findings on lung exam may represent an early finding of interstitial pulmonary fibrosis, a complication of PSS that can be fatal.