Your-Doctor Multiple Choice Questions (MCQ)

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Category: Medicine--->Rheumatology
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Question 11#Print Question

A 45-year-old woman has pain in her fingers on exposure to cold, arthralgias, and difficulty swallowing solid food. She has a few telangiectasias over the chest but no erythema of the face or extensor surfaces. There is slight thickening of the skin over the hands, arms, and torso. What is the best diagnostic test?

a. Rheumatoid factor
b. Antinuclear, anti-topoisomerase I, and anticentromere antibodies
c. ECG
d. BUN and creatinine
e. Reproduction of symptoms and findings by immersion of hands in cold water


Question 12#Print Question

A 20-year-old man complains of arthritis and eye irritation. He has a history of burning on urination. On examination, there is a joint effusion of the right knee and a rash of the glans penis. Which of the following is correct? 

a. Neisseria gonorrhoeae is likely to be cultured from the glans penis
b. The patient is likely to be rheumatoid factor-positive
c. An infectious process of the GI tract may precipitate this disease
d. An ANA is very likely to be positive
e. Creatine kinase (CK) will be elevated


Question 13#Print Question

A 22-year-old man presents to your office with complaint of right knee pain and swelling for the past 2 weeks. Although uncomfortable, it has not prevented ambulation. He denies any fevers or night sweats. He reports that he has had several similar episodes of knee and ankle pain over the past few months. He reports malaise and fatigue over the past few months as well. He has had four sexual partners over the past 6 months but denies dysuria or urethral discharge. With prompting, the patient recalls a rash on his arm accompanied by fever after a trip to upstate New York to attend a music festival. He felt the rash was interesting, and took a picture which he saved to his smart-phone (see below). Which of the following would be the most appropriate next step in the management of this disease?

 

 

a. Urethral swab and empiric treatment for Chlamydia
b. Empiric therapy with doxycycline
c. Antibody titers for Lyme disease
d. Empiric corticosteroids
e. Testing for rheumatoid factor and anti-cyclic citrullinated peptide (CCP)


Question 14#Print Question

A 75-year-old man complains of headache. On one occasion he transiently lost vision in his right eye. He also complains of aching in the shoulders and neck. There are no focal neurologic findings. Carotid pulses are normal without bruits. Laboratory data show a mild anemia. Erythrocyte sedimentation rate (ESR) is 85. Which of the following is the best approach to management?

a. Begin glucocorticoid therapy and arrange for temporal artery biopsy
b. Schedule temporal artery biopsy and begin corticosteroids based on biopsy results and clinical course
c. Schedule carotid angiography
d. Follow ESR and consider further studies if it remains elevated
e. Start aspirin and defer any invasive studies unless further symptoms develop


Question 15#Print Question

A 53-year-old woman presents with pain in the fingers bilaterally. Examination reveals inflammation of the synovium of multiple DIP and PIP joints. Larger joints are spared. Skin examination reveals the following lesion (pic). 

What is the most likely diagnosis?

 

a. Hemochromatosis
b. Rheumatoid arthritis
c. Osteoarthritis
d. Systemic lupus erythematosus
e. Psoriatic arthritis




Category: Medicine--->Rheumatology
Page: 3 of 6