Copy of Rheumatology Module 2

A patient with scleroderma has normal lung volumes but low DLCO <50% and minimal fibrosis on HRCT. You suspect the patient have pulmonary hypertension.

What is the investigation of choice?

Which of the following medication is helpful for scleroderma associated intersitial lung disease when FVC is <70% and HRCT extent >20%?

A patient with scleroderma undergoes a screening ECHO and is found to have a systolic pulmonary artery pressure of more than 50mmHg.

What should be the next step in management?

The following treatments are useful in pulmonary hypertension associated with Systemic sclerosis except?

The following are associated with scleroderma renal crisis except?

What is the medication of choice for the treatment of scleroderma renal crisis?

Which of the following medication is the least useful in the treatment of Raynaud’s?

The diagnostic criteria for rheumatoid arthritis has been recently revised. Which of the following feature is no longer used to define RA?

All of the following joint may be affected by rheumatoid arthritis (RA) except?

What is the typical number of WCC (In cells/mm 3) and PMNs seen in the synovial fluid taken from a patient with rheumatoid arthritis?

A 55 year old lady with a known history of rheumatoid arthritis is found to have splenomegaly on abdominal examination. Which of the following feature would most likely suggest the diagnosis of Felty’s syndrome?

A 45 year old lady with a background of Hepatitis C infection presents to the clinic with a 3 months history of joint pain on both her hands. The pain specifically involves her distal interphalangeal joints. Earlier in the month, the GP had requested a blood test for rheumatoid factor and the result came back positive with very high titres.

What would be the most likely explanation for the rheumatoid factor positivity?

Rheumatoid factor positivity is seen in the following conditions except?

Which of the following marker is the most specific for rheumatoid arthritis?

The following are poor prognostic markers in RA except?

Which of the following is the strongest marker for poor prognosis in RA?

Which of the following is not a typical radiographic feature of RA?

You are doing the annual review of a 50-year-old woman who has rheumatoid arthritis.

Which one of the following complications is most likely to occur as a result of her disease?

Which of the following marker is most predictive of subsequent death from cardiovascular disease in patients with rheumatoid arthritis?

A patient with rheumatoid arthritis still has severe joint pains despite being on 3 DMARDs(prednisone, methotrexate and sulfasalazine) and leflunomide for 6 months.

What should be the next step in management?

A patient with known RA has been well controlled on prednisone and methotrexate.However last 2 days has had a flare up of her RA.

What is the most appropriate step in management?

Which of the following DMARDs is least likely to slow the radiographic progression of RA?

You are considering to start a DMARDs on a patient with RA .He is a heavy alcohol drinker.Which would be the best treatment?

A patient with RA was started on a DMARDs for control of his RA.He then develops reduced visual acuity.

Which of the following drug is most likely to be the culprit?

A patient on leflunomide for his RA develops severe liver damage and myelosuppression .What should be the most appropriate management?

Which of the following drugs is NOT a TNF inhibitor?

Which one of the following cytokines is the most important in the pathophysiology of rheumatoid arthritis?

Which of the following drug is associated with increased risk of reactivation of latent TB?

The following are side effects of TNF inhibitors except?

What is the mechanism of action of Abatacept?