5 Days Of Severe in Medicine / Internal Medicine — 28yo Woman | Rheumatology | SMLE Q#18242
SMLE Question #18242
Medicine / Internal Medicine
Rheumatology
Objective: OBJ-383
Last updated: February 2026
A 28-year-old woman with known systemic lupus erythematosus presents with 5 days of severe headache, new-onset confusion, and a generalized tonic-clonic seizure. She has no fever and no neck stiffness. Brain MRI shows multiple small acute ischemic lesions in different vascular territories. Lumbar puncture shows inflammatory CSF with negative infectious studies, and metabolic causes are excluded. Antiphospholipid antibody testing is negative. What is the most appropriate first-line therapy?
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