Rheumatology

Topics in this chapter

• Autoimmune Connective Tissue Diseases
• Systemic Vasculitides
• Spondyloarthropathies
• Crystal Arthropathies
• Inflammatory Myopathies
• Geriatric Rheumatology
• Rheumatology Pharmacology

Practice questions

1. Question 1Q-B939F4

   A 32-year-old woman presents with polyarthralgia, malar rash, and generalized fatigue. Laboratory investigations reveal positive antinuclear antibodies (ANA) in a homogeneous pattern and high titer anti-double-stranded DNA (anti-dsDNA) antibodies. Which of the following complement profiles is most characteristic of active disease flares in this condition?

   1. A.Elevated C3 and C4 levels
   2. B.Normal C3 and C4 levels
   3. C.Decreased C3 and C4 levels
   4. D.Elevated C3 with decreased C4 levels
   See the answer and solution
2. Question 2Q-7BE860

   A 45-year-old man presents with inflammatory low back pain and morning stiffness that improves with exercise, lasting for over 3 years. He also develops asymmetric oligoarthritis of the lower limbs. Radiography of the pelvis reveals bilateral sacroiliitis. Which of the following human leukocyte antigens (HLA) is most strongly associated with this condition?

   1. A.HLA-B27
   2. B.HLA-DR4
   3. C.HLA-DQ2
   4. D.HLA-B51
   See the answer and solution
3. Question 3Q-A03ECB

   A 55-year-old woman complains of severe dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia) for the past year. She also has bilateral parotid gland enlargement. Serological tests are positive for anti-SSA (Ro) and anti-SSB (La) antibodies. Which of the following is the most appropriate diagnostic test to confirm the diagnosis by evaluating minor salivary gland involvement?

   1. A.Parotid sialography
   2. B.Lower lip labial salivary gland biopsy
   3. C.Fine-needle aspiration cytology of the parotid gland
   4. D.Schirmer's test
   See the answer and solution
4. Question 4Q-41FAA7

   A 60-year-old man presents with sudden onset of excruciating pain, swelling, and erythema of the first metatarsophalangeal joint. Arthrocentesis of the joint reveals negatively birefringent needle-shaped crystals under polarized light microscopy. Which of the following is the primary pathophysiological abnormality responsible for this condition?

   1. A.Deposition of calcium pyrophosphate crystals
   2. B.Deposition of monosodium urate crystals
   3. C.Deposition of basic calcium phosphate crystals
   4. D.Deposition of cholesterol crystals
   See the answer and solution
5. Question 5Q-E28569

   A 28-year-old woman presents with recurrent painful oral aphthous ulcers, genital ulcers, and painful erythematous lesions on her shins. She also develops anterior uveitis. Pathergy test is positive. Which of the following conditions is the most likely diagnosis?

   1. A.Systemic Lupus Erythematosus
   2. B.Behçet disease
   3. C.Takayasu arteritis
   4. D.Polyarteritis nodosa
   See the answer and solution