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NBME 16 Answers

nbme16/Block 3/Question#40 (reveal difficulty score)
A 12-year-old girl is brought to the ...
Dermatomyositis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

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submitted by โˆ—cassdawg(1778)

The combination of "stairs, chairs, and hair" symtoms of proximal myopathy, dermatologic symptoms (rash) and positive antinuclear antibody (ANA) makes dermatomyositis the most likely diagnosis [FA2020 p471].

The other autoimmune conditions listed (which could be associated with ANA) are not likely to have the same muscular involvement. Myscular dystrophy does not have dermatologic involvement or ANA+.

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taylor5479  Further ruling out of muscular dystrophy is that it's X-linked recessive, making it excessively uncommon in females. +1
lovebug  FA 2019 p.463 +

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