Rheumatology and Immunology — MCQs

A 43-year-old woman presents with a year of progressive dysphagia. She notes that her hands turn white and become painful upon exposure to cold. She also observes that her face and hands lack wrinkles, despite her age. Physical examination reveals a blood pressure of 115/75 mm Hg and taut, shiny skin on her face and hands. A punch biopsy of the hand skin shows dermal collagenous fibrosis and focal calcification. She undergoes yearly esophageal dilation for 20 years, with no serious illnesses developing during this period. Which of the following serologic test results is most likely to be positive in this woman?

What is the drug of choice for an acute attack of hereditary angioneurotic edema?

A 45-year-old woman presents with pain in her fingers upon cold exposure, arthralgias, and dysphagia for solids. She has a few telangiectasias over the chest but no facial erythema or erythema of extensor surfaces. Physical examination reveals slight skin thickening of the hands, arms, and torso. What is the most appropriate diagnostic workup?

What is a cause of nail bed infarctions?

What is the pathognomonic finding in pseudogout?

A 65-year-old woman with a 12-year history of symmetrical polyarthritis presents with splenomegaly, ulcerations over the lateral malleoli, and synovitis of the wrists, shoulders, and knees. Laboratory values show a white blood cell count of 2500/uL and a rheumatoid factor titer of 1:4096. What is the likely finding on this patient's white blood cell differential count?

A patient presents with gritty pain in the eye and joint pain after a leisure trip. What is the most probable diagnosis?

Which of the following organs is typically NOT affected by granulomatosis with polyangiitis (Wegener's granulomatosis)?

Which of the following antibodies correlates with disease activity for Systemic Lupus Erythematosus?

A 30-year-old male patient presents with complaints of weakness in the right upper and both lower limbs for the last 4 months. He developed digital infarcts involving the 2nd and 3rd fingers on the right side and the 5th finger on the left side. On examination, BP was 160/140 mm Hg. All peripheral pulses were palpable, and there was asymmetrical neuropathy. Investigations showed Hb 12 gm%, TLC 12,000 per cu. mm, Platelets 4,30,000, and ESR 49 mm. Urine examination showed proteinuria and RBC 10-15/hpf with no casts. What is the most likely diagnosis?