Rheumatology and Immunology — MCQs

A 50-year-old man presents with fatigue and painful swelling of both hands. He experiences significant morning stiffness. Physical examination reveals symmetric erythema, swelling, and tenderness of the proximal interphalangeal and metacarpophalangeal joints. Plain hand x-rays are ordered. Which of the following x-ray findings is characteristic of this condition?

Which one of the following statements is best suited for isolated polymyalgia rheumatica?

A 30-year-old male presented with pain and swelling of the right knee and ankle joints, particularly at the insertion sites, along with burning sensation and pain during micturition, urethral discharge, and fever for two weeks. The patient also reported multiple episodes of bloody diarrhea one week prior. On examination, bilateral conjunctivitis, oral ulcers, plantar fasciitis, onycholysis, and distal yellow discoloration of nails were noted. X-ray of the pelvis with bilateral hips was normal. Lab findings revealed raised ESR and other acute phase reactants, mild anemia, and increased HLA-B27 titers. Joint aspirate was sterile. What is the most likely diagnosis?

A 32-year-old woman presents with symptoms of dry mouth and dry eyes. She feels well and reports no joint or systemic symptoms. Physical examination reveals enlarged salivary glands. Studies for autoantibodies to Ro (SS-A) are positive, and a salivary gland biopsy shows lymphocytic infiltration. Which of the following is the most likely diagnosis?

A 27-year-old man presents with low back pain and stiffness, worse at night and improving with morning stretching. He also reports hip pain. Physical examination reveals paravertebral muscle and sacroiliac joint tenderness, limited lumbar forward flexion, and a 2/6 diastolic murmur at the left sternal border radiating to the apex. Plain spine x-rays suggest sacroiliitis. Which of the following is the most likely diagnosis for the diastolic murmur?

A 25-year-old woman with a history of systemic lupus erythematosus presents with diffuse petechiae and fatigue. Physical examination demonstrates lymphadenopathy and splenomegaly. Laboratory findings include normocytic anemia (hemoglobin = 6.1 g/dL) and thrombocytopenia (30,000/mL). A peripheral blood smear shows polychromasia with 10% reticulocytes. This patient most likely has which of the following hematologic diseases?

Which of the following statements regarding gouty arthritis is FALSE?

What is true about Dermatomyositis?

Which joint is typically NOT involved in osteoarthritis?

A 30-year-old woman presents with non-specific complaints of fatigue, malaise, low-grade fever, and arthralgias. Screening serum chemistries demonstrate an elevated BUN. Urinalysis shows proteinuria. Testing for which of the following will be most helpful for making the diagnosis?