2 Weeks in Medicine / Internal Medicine — 24yo Woman | Rheumatology | SMLE Q#11318

SMLE Question #11318

Medicine / Internal Medicine Rheumatology

Objective: OBJ-383

Last updated: February 2026
A 24-year-old woman has 3 months of symmetric pain and swelling in the hands and knees, a photosensitive malar rash sparing the nasolabial folds, and recurrent painless oral ulcers. For 2 weeks, she has developed bilateral leg swelling and frothy urine. Findings suggest active lupus nephritis. Which initial immunosuppressive regimen is most appropriate to treat her renal involvement?

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