Multiple Choice Questions (MCQ)

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Category: Q&A Medicine--->Rheumatology
Page: 3

Question 11#Print Question

A 27-year-old man presents with 6 months of worsening low back pain. The pain is worse in the morning and associated with morning “stiffness” that improves with walking and exercise. The patient feels well and denies any systemic symptoms. Physical examination reveals limited range of motion on forward flexion of her lower back. X-ray reveals the presence of a “bamboo spine.

Which of the following is the most common extra-articular manifestation of this patient’s condition?

a. Aortic valve insufficiency
b. Lung fibrosis
c. Anterior uveitis
d. Oral ulcers

Question 12#Print Question

A 37-year-old woman with a history of Crohn disease presents for follow-up. She has been taking prednisone for the last 4 years at varying dosages and now has worsening left hip pain. The pain is aggravated during weight-bearing activities and is not relieved by rest. Physical examination is significant for a blood pressure of 148/82 mmHg and limited range of motion of her left hip. Dermatologic examination reveals purple striae and thinning of her skin in the lower abdominal region. Neurologic examination is within normal limits. Laboratory values (including ESR and TSH) are within normal limits.

Which of the following is the underlying mechanism of this patient’s left hip pain?

a. Cartilage erosion
b. Interruption of bone vasculature
c. Excessive fluid production from inflamed synovium
d. Peripheral nerve damage

Question 13#Print Question

A 37-year-old woman presents with progressive shortness of breath. The patient also reports painful joints over the past 5 months, especially in her fingers. She has a past medical history of GERD, which is controlled with omeprazole. On physical examination, the patient has thickened skin over the acral surfaces. Examination reveals the following figure.

Which of the following will likely be positive in this patient?

a. Anti-histone antibodies
b. RF
c. Anti-topoisomerase antibodies
d. Cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA)

Question 14#Print Question

A 47-year-old woman presents with diffuse joint pain over the past 5 days. Although the pain is diffuse, it is worst in the hand and wrist joints. The pain is at its worst in the morning and typically can take up to 20 minutes to reach the point where she can actually perform activities like walking and writing. The patient is otherwise healthy and denies fever, chills, weight loss, fatigue, or skin rashes. The patient reports that she is a third-grade teacher and has had several sick students over the past 4 months. Physical examination is unremarkable and no swelling or redness is noted over her joints. Laboratory values reveal a hemoglobin of 13.5 g/dL and an ESR of 18 mm/h.

Which of the following is the likely diagnosis in this patient?

a. Fibromyalgia
b. Rheumatoid arthritis
c. Polymyalgia rheumatica
d. Symmetric arthritis secondary to a viral infection

Question 15#Print Question

A 53-year-old man with a history of systemic lupus erythematosus (SLE) presents with hematuria. A renal biopsy demonstrates proliferative glomerulonephritis and the patient is started on cyclophosphamide.

Which of the following conditions is this patient at risk for developing with the initiation of this medication? 

a. Peripheral neuropathy
b. Hearing loss
c. Hemorrhagic cystitis
d. Thyroid abnormalities

Category: Q&A Medicine--->Rheumatology
Page: 3 of 5