Rheumatology test
Dr. S. Urooj Riaz
Associate Professor Medicine
Question No 1
A 30 year old female came with complaints of pain in joints of hands
and feet along with morning stiffness of around one hour. On
examination synovitis was positive in joints of hands & feet. On
evaluation her all lab as within normal limits except raised ESR and
CRP. What is the diagnosis?
a) Rheumatoid Arthritis
b) Osteo Arthritis
c) Osteomalacia
d) Osteoporosis
Question No 2
A 30 year old female came with complaints of pain in joints of hands
and feet along with morning stiffness of around one hour. On
examination synovitis was positive in joints of hands & feet. On
evaluation her all lab as within normal limits except raised ESR and
CRP. What investigation required for confirmation of diagnosis?
a) HLA B27, MRI L/S Spine
b) RA factor, Anti CCP, Xray Hands.
c) ANA, Anti- centromere, Anti topoisomerase 1
d) Uric acid
Question No 3
A 30 year old female came with complaints of pain in joints of hands
and feet along with morning stiffness of around one hour. On
examination synovitis was positive in joints of hands & feet. On
evaluation her all lab as within normal limits except raised ESR and
CRP. How would you assess disease activity?
a) RA factor levels
b) CRP levels
c) DAS 28 score
d) ESR levels
Question No 4
A 24 years female single came in your OPD with complaints of fever,
weight loss and joint pain with morning stiffness for 6 month. On
examination temp was 100 F, she was mildly anemic and cervical lymph
nodes were palpable. She also had painful, raised erythematous rash
over her cheeks. What is your diagnosis?
a) Gout
b) Rheumatoid arthritis
c) Ankylosing Spondilitis
d)Systemic Lupus erhythematosus
Question No 5
A 24 years female single came in your OPD with complaints of fever,
weight loss and joint pain with morning stiffness for 6 month. On
examination temp was 100 F, she was mildly anemic and cervical lymph
nodes were palpable. She also had painful, raised erythematous rash
over her cheeks. Which is the most sensitive investigation?
a) Anti Ds DNA
b)ANA
c) Anti Smith antibody
d) RA factor
Question No 6
An 18-year-old man came with complaint of back pain. He had also
consulted ophthalmologist for red eye. His labs showed an Hb of 14
TLC 8 Platelets 344. ESR 40. Creatinine 0.8. What is the diagnosis?
a) Behcets Disease
b) Ankylosing spondylitis
c) Rheumatoid arthritis
d) Reactive arthritis
Question No 7
An 18-year-old man came with complaint of back pain. He had
also consulted ophthalmologist for red eye. His labs showed an
Hb of 14 TLC 8 Platelets 344. ESR 40. Creatinine 0.8. What
investigation might come positive to confirm diagnosis?
a)ANA
b) RA FACTOR
c) HLA B 27
d) CRP
Question No 8
A 50-year-old woman came to you with complaint of arthralgia and
thickening of skin. She is also having difficulty in swallowing her food.
What is the diagnosis?
a) Rheumatoid arthritis with systemic manifestations
b) Sjogren syndrome
c) Limited cutaneous scleroderma
d) Ca esophagus with paraneoplastic syndrome
Question No 9
A 50-year-old woman came to you with complaint of arthralgia and
thickening of skin. She is also having difficulty in swallowing her food.
What antibody will likely come out positive?
a) ANA
b) Anti SCL 70
c) Anti Ds DNA
d) Anti CCP
Question No 10
A 20-year-old man came to you with complaint of pain in right knee
joint. Examination reveals it to be warm red hot and tender. What
should be your next step?
a) Joint Aspiration and culture + Antibiotics
b) Blood culture + Antibiotics
c) Refer to orthopedics for joint washing
d) Treat as a case of pseudogout
Question No 11
A 22-year-old man came to you for back pain and stiffness. It has been
progressively increasing. You suspect him as a case of Ankylosing
spondylitis. What would you do?
a) Get him investigated as condition is curable
b) NSAIDs + Exercise to maintain flexibility
c) Advise him bed rest for 2 weeks before starting treatment
d) Cognitive behavioral therapy
Question No 12
A 66-year-old woman came with complaint of pain in bilateral knee
joints. Examination revealed mild swelling and crepitus. Hand
examination showed nodes in both proximal and distal interphalangeal
joints. Cause?
a) OA knees
b) Rheumatoid Arthritis
c) Psoriatic arthritis
d) Gout
Question No 13
Which of the following is not a DMARD?
a) Methotrexate
b) Sulfasalazine
c) Leflunamide
d) Indomethacin
Question No 14
A 40-year-old male presented to rheumatology OPD with pain in joints,
pain in eyes and urethral burning. On further inquiry, he had a history of
diarrhea few days back. He had also travelled to Malaysia. There was
nothing remarkable on examination. What is the diagnosis?
a) Reactive arthritis
b) Gonococcal arthritis
c) Lyme disease
d) Rheumatic fever
Question No 15
A 40-year-old male, known smoker came to you with complaint of blue
toes. On examination dorsalis pedis was palpable. ESR was 50. What is
the most probable diagnosis?
a) Peripheral arterial disease
b) Buerger’s Disease
c) SLE
d) PAN
Question No 16
A 45-year-old male came to the rheumatology OPD with pain in first
metatarsophalangeal joint. He says it’s the worst pain in his life.
Currently he is on Aspirin and a diuretic. Last uric acid checked was
normal. What is the most probable diagnosis?
a) Pseudogout
b) Gout
c) Septic arthritis
d) Psoriatic arthritis
Question No 17
A 40-year-old man presented to the OPD with complaint of pain in right
knee joint. Joint aspiration showed negatively birefringent crystals.
Which of the following is a known risk factor for this disease?
a) Vitamin C
b) High dose aspirin
c) NSAIDs
d) Alcohol
Question No 18
A 60-year-old man came to the OPD with complaint of pain in back,
neck and some other joints. X-ray was done which showed degenerative
changes and osteophytes. Which of the following joint is the most
common site of involvement of this disease?
a) Hip
b) Knee
c) Lumbosacral
d) Cervicothoracic
Question No 19
A 32-year-old patient presented to the OPD with complaint of frothy
urine. Workup showed proteinuria. On further inquiry patient also
complained of pain in hand joints and hair loss for last few years. She
was started on immunosuppressive drugs after kidney biopsy. Now
patient presented in ER with flare of the disease. Which of the following
marker is the best to identify active disease?
a) ANA profile
b) ESR
c) CRP
d)Anti Ds DNA levels
Question No 20
A 70-year-old man presented with pain in first carpometacarpal joint.
He previously had pain in knee joint and back. Xray showed loss of
joint space and osteophytes. What is the diagnosis?
a) Tenosynovitis
b) Rheumatoid arthritis
c) Pseudogout
d) Osteoarthritis
