30th July 2020

A 38 year old lady presents with acute dyspnoea as well as a 5 week history of malaise and fatigue

A 38 year old lady presents with acute dyspnoea as well as a 5 week history of malaise and fatigue. On examination, there is an erythematous, well-demarcated rash on her sun-exposed areas. She has a wide pulse pressure and a collapsing pulse.

For the patient above, please select the SINGLE most likely cause of the presentation. Select ONE option from the list above.