Rheumatology and Immunology — MCQs

A young male presents with leg swelling and recurrent aphthous ulcers of his lips and tongue. He has also recently noted painful genital ulcers. There is no urethritis or conjunctivitis. On exam, he has evidence of deep vein thrombophlebitis. What is the most likely diagnosis?

A 25-year-old female presents with serous otitis media of the left ear, along with cough, occasional hemoptysis, hematuria, and epistaxis for one and a half months. Her hemoglobin is 7 gm. Blood pressure is > 170/100, proteinuria is +++, RA is positive, and ANCA is positive. What is the likely diagnosis?

What is the most common cause of death in rheumatoid arthritis?

Which of the following is true about antiphospholipid antibody syndrome?

p-ANCA is characteristic for which condition?

Which of the following statements is false regarding Erythema marginatum?

A 55-year-old woman presents with several weeks of fever, abdominal pain, weight loss, and fatigue. Three days prior to assessment, she developed a left foot drop. Her blood pressure is 160/90 mm Hg, and pulse is 80/min. Physical examination confirms left peroneal nerve damage and a bilateral sensory peripheral neuropathy in both legs. There are no skin rashes. Laboratory evaluation reveals ESR of 105 mm/h, WBC of 14,000/mL, and negative serologic tests for antineutrophil cytoplasmic antibody (ANCA) and ANA. The eosinophil count is normal, and urinalysis is negative for casts, protein, and red cells. Which of the following is the most likely mechanism for renal injury in this condition?

A 30-year-old woman has had gradually increased muscle weakness with myalgia for the past year. She now has difficulty getting up from a chair and climbing stairs. She does not have weakness in her hand muscles. Physical examination reveals a fine violaceous rash on her face, predominantly palpebral. Dusky, flat, red patches are present on her elbows, knees, and knuckles. Laboratory studies show serum creatine kinase of 620 U/L. A deltoid biopsy specimen is obtained, and on microscopic examination shows a mononuclear inflammatory cell infiltrate around small blood vessels and groups of atrophic myofibers at the periphery of fascicles. What mechanism is most likely responsible for her disease?

A 40-year-old man presents with a 2-week history of recurrent oral ulcers, genital ulcers, intermittent arthritic pain of the knees, and abdominal pain. Physical examination reveals shallow ulcerations of the mucosa of the glans penis, as well as oral aphthous ulcers and conjunctivitis. The Pathergy test is positive. Which of the following is the most likely diagnosis?

Which of the following joints is typically spared in acute gout?