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Questions

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Which оf the fоllоwing is а function of REM sleep?

A 29-yeаr-оld wоmаn presents fоr evаluation for a 2-day history of fever, fatigue, bilateral wrist swelling, and moderate pain in her joints. She was diagnosed with systemic lupus erythematosus 8 years ago. She is not sexually active and her last menstrual cycle was 7 days ago. Her only medication is hydroxychloroquine. Temperature is 100.0*F, pulse is 92 beats per minute and remain vitals are normal. There is an erythematous macular rash over her face, neck and both her forearms. The left knee and wrist joints are swollen but cool to the touch and nonerythematous; range of motion in these joints is limited by pain. Laboratory studies show a hemoglobin concentration of 14.5 g/dL, leukocyte count of 9000/mm3, platelet count of 79,000/mm3, and an erythrocyte sedimentation rate (ESR) of 30 mm/h.  Which of the following is the most appropriate next step in treatment?