Rheumatology and Immunology — MCQs

A 29-year-old man presents with a 3-day history of burning pain on urination and urethral discharge. ELISA testing of the urethral exudate is positive for Chlamydia trachomatis. Three weeks later, he develops increasing stiffness of his knees and ankles and lower back pain. Radiographs of his lumbar spine reveal narrowing and sclerosis of the sacroiliac joints. One month later, he experiences painful erythema of the glans penis, and his conjunctivae become red. A follow-up examination reveals a slightly irregular heart rate and a murmur suggestive of aortic regurgitation. The back pain recurs intermittently for 5 more months. Which of the following test results is most likely to be positive in this man?

Which of the following statements is FALSE about reactive arthritis?

HLA-B27 antigen is associated with all of the following conditions except?

A 42-year-old man presents with a history of recurrent sinus and ear infections over the past year, associated with headaches and pollen allergy. He now complains of blood-tinged sputum and cough. Chest X-ray reveals bilateral nodular and cavitary infiltrates. A CT scan is planned, and a CT-guided biopsy is to be performed from a mass seen on the X-ray. Laboratory investigations show elevated ESR and c-ANCA positivity. Which of the following is the least likely diagnosis?

Antiphospholipid syndrome is associated with all of the following except:

In a case of undifferentiated arthritis, the presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies strongly indicates the possibility of which of the following conditions?

All of the following statements regarding systemic sclerosis are TRUE, EXCEPT:

A 33-year-old woman presents with a 2-month history of fever and increasing fatigue. Over the past year, she has experienced muscle and joint soreness and a 4-kg weight loss. On physical examination, her temperature is 37.5°C, pulse is 80/min, respirations are 15/min, and blood pressure is 145/95 mm Hg. She has pleuritic chest pain, and a friction rub is heard on auscultation. Laboratory findings include glucose, 73 mg/dL; total protein, 5.2 g/dL; albumin, 2.9 g/dL; and creatinine, 2.4 mg/dL. Serum complement levels are decreased. CBC shows hemoglobin of 9.7 g/dL, platelet count of 85,000/mm³, and WBC count of 3560/mm³. A renal biopsy specimen shows diffuse proliferative glomerulonephritis with extensive granular immune deposits of IgG and C1q in capillary loops and mesangium. After treatment with immunosuppressive therapy, her condition improves. Which of the following serologic studies is most likely to be positive in this patient?

Enthesopathy is commonly found in which of the following conditions?

A young male develops serous otitis media of the left ear with cough, occasional hemoptysis, hematuria, and epistaxis for 2 months. His Hb is 7.5 g% with heavy proteinuria, BP 170/100 mmHg, RA negative, and ANCA positive. What is the most probable diagnosis?