Rheumatology and Immunology — MCQs

A 48-year-old man presents with 3 weeks of fever, fatigue, and shortness of breath. He has a history of nasal allergies and asthma, which have been poorly controlled in the past month. Two days prior to presentation, he developed weakness in his left foot and it now drags when he walks. On examination, his blood pressure is 165/90 mm Hg, pulse 100/min, respirations 20/min, and lungs have bilateral expiratory wheezes. There is left foot drop, and the rest of the neurologic examination is normal. Laboratory evaluation reveals ESR of 90 mm/h, WBC of 14,000/mL with 10% eosinophils, and 1+ proteinuria. A CXR shows bilateral pulmonary infiltrates. For the above patient with a vasculitis syndrome, what is the most likely diagnosis?

A 17-year-old boy presents with chronic low back pain and stiffness for the past 8 months. He denies any gastrointestinal or genital infections. His temperature is 98.6 F. Laboratory investigations show normal ESR and negative RA factor. X-ray films of the vertebral column show flattening of the lumbar curve and subchondral bone erosion involving the sacroiliac joints. What is the most likely diagnosis?

A patient with rheumatoid arthritis presents with progressive quadriplegia and weakness. The patient has a positive Babinski sign, increased muscle tone in the limbs with exaggerated tendon jerks, and worsening gait. There is no sensory or sphincter involvement. What is the best initial investigation?

Which is the best treatment for an over-producer in chronic gout with kidney impairment?

A 35-year-old man presents with loss of appetite, nausea, vomiting, and fatigue. Laboratory examination confirms the diagnosis of hepatitis B, and the man becomes icteric 2 weeks later. This patient is particularly vulnerable to the development of which of the following disorders?

Which of the following urine findings are characteristic of Systemic Lupus Erythematosus (SLE)?

What is the treatment for the lesions seen in Behcet syndrome?

Multiple cavitary lesions in the lungs, hematuria, and renal insufficiency are features in a patient with:

Extreme widening of the periodontal ligament space on dental radiograph is the characteristic feature of which condition?

A 72-year-old man injures his right knee, which is now swollen and extremely painful to bend. X-rays of the knee rule out a fracture, and joint fluid aspiration reveals an opaque-colored fluid containing rhomboid crystals with weak-positive birefringence. Which of the following is the most appropriate next step in management?