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Category: Q&A Medicine--->Rheumatology
Page: 4

Question 16# Print Question

A 29-year-old man who recently completed a course of antibiotics for nongonococcal urethritis secondary to Chlamydia trachomatis presents with diffuse joint pain. The patient describes the pain as particularly bothersome in his low back and left knee. The patient is otherwise healthy and has no other complaints. Physical examination reveals an afebrile man with normal vital signs. The patient’s left knee is markedly swollen, erythematous, and exquisitely tender to palpation. Head and neck examination reveals bilateral redness in the eyes with epiphora. Joint aspiration is performed which reveals a leukocyte count of 11,000/mm3 . Synovial fluid analysis also reveals a predominance of polymorphonuclear leukocytes.

Which of the following is associated with this patient’s condition?

A. Chronic hyperuricemia
B. HLA-B27
C. Articular cartilage degradation
D. Inflammation of the synovium


Question 17# Print Question

A 39-year-old woman with a history of rheumatoid arthritis presents for routine care. The patient’s symptoms are well controlled on her current medication regimen. Routine laboratory values reveal the following:

  • Hemoglobin   9.8 g/dL
  • Mean corpuscular volume (MCV)   110 fL
  • Leukocyte count   9,500/mm3
  • Platelets   280,000/mm3

Which of the following is this patient taking for her rheumatoid arthritis?

A. Methotrexate
B. Cyclosporine
C. Corticosteroids
D. Hydroxychloroquine


Question 18# Print Question

A 4-year old boy presents with fever, swollen lymph nodes, and headache for the past 3 days. Physical examination demonstrates a fever of 38.4°C and a heart rate of 110 beats per minute. There is conjunctival injection, bilateral swelling of the anterior cervical lymph nodes, and a morbilliform rash over the upper and lower extremities. Oral examination reveals a diffusely red and enlarged tongue.

Which of the following is likely to develop if this condition goes untreated? 

A. Leukemia
B. Blindness
C. Coronary artery aneurysm
D. Pulmonary embolism


Question 19# Print Question

A 32-year-old man of Turkish descent presents with painful oral and genital ulcers. He reports two previous episodes of oral ulcers that resolved within 2 weeks. The patient also reports blurred vision, diarrhea, and a cough. Physical examination reveals nonscarring oral mucocutaneous aphthous ulcerations and several discrete ulcerations on the shaft of the penis. The rest of the dermatologic examination reveals several hyperpigmented nodules on the bilateral anterior legs that are painful to palpation.

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

A. Behçet disease
B. Herpes simplex virus (HSV) infection
C. Systemic lupus erythematosus (SLE)
D. Sarcoidosis


Question 20# Print Question

A 61-year-old man with a history of chronic alcoholism and parathyroid adenoma presents with pain in his left knee for the last 2 days. He denies fevers, chills, night sweats, or any history of trauma to the knee, but does endorse abdominal pain and constipation. Physical examination is significant for tenderness and erythematous skin overlying the left knee. There is also marked swelling of the left knee. Laboratory findings reveal an elevated calcium level (12.1 mg/dL).

If joint aspiration is performed, which of the following will be seen on synovial fluid analysis? 

A. Negatively birefringent needle-shaped crystals
B. Positively birefringent rhomboid-shaped crystals
C. Neutrophil predominance with gram-positive cocci
D. Normal synovial fluid findings




Category: Q&A Medicine--->Rheumatology
Page: 4 of 5