?

development of lymphoma is complication of which of the following -1

A-raynaud's phenomenon

B- renal crisis

C- sjogren syndrome

D- TB

answer:C

?which of the following is the second most common manifestation of Scc -2

A-skin thinning

B-skin thickness

C- myositis

D- raynaud's phenomenon

answer:D

? which is indicative of malignant manifestation in sjogren syndrome -3

A- multiple lymph nodes

B- parotid gland enlargement

C- firm lymph node

D- severe eye dryness

answer:C

A 60-year-old woman complains of dry mouth and a gritty sensation in her eyes. She -4
states it is sometimes difficult to speak for

more than a few minutes. There is no history of diabetes mellitus or neurologic disease. The
patient is on no medications. On

examination, the buccal mucosa appears dry and the salivary glands are enlarged bilaterally.
Which of the following is the best

?next step in evaluation

A. Lip biopsy

B. Schirmer test and measurement of autoantibodies

C. IgG antibody to mumps virus

D. A therapeutic trial of prednisone for 1 month

E. Administration of a benzodiazepine

answer: B
A 45-year-old woman has pain in her fingers on exposure to cold, arthralgias, and -5
difficulty swallowing solid food. She has a fewtelangiectasias over the chest but no erythema
,of the face or extensor surfaces. There is slight thickening of the skin over the hands

?arms, and torso. What is the best diagnostic test

A. Rheumatoid factor

B. Antinuclear, anti-topoisomerase I, and anticentromere antibodies

C. ECG

D. BUN and creatinine

E. Reproduction of symptoms and findings by immersion of hands in cold water

answer: B

Over the last 6 weeks a 35-year-old nurse has developed progressive difficulty getting out -6
of chairs and climbing stairs. She can

no longer get in and out of the bathtub. She has no muscle pain and takes no regular
medications. She does not use alcohol and

does not smoke cigarettes. On examination she has a purplish rash that involves both
?eyelids. There is weakness of the proximal legmuscles. What is the best next diagnostic test

A. Vitamin B12 level

B. Chest x-ray

C. HLA B27

D. MRI scan of the lumbar spine

E. Creatine kinase (CK)

?What is the gene that is highly linked to pathogenesis of rheumatoid arthritis :

A. HLA-DR4

B. HLA-b27

C. HLA-DR3

D. HLA-DR5
--------------------------------------------------------------------------------------

A 40-year-old female presented with dyspnea on exertion, fatigue and palpitations. .1

Auscultation revealed an

ejection diastolic murmur in the mitral valve area. What is the best investigation to confirm
?our diagnosis

A. Echocardiography
B. ECG

C. Chest x-ray

D. CBC

A 33-year old woman presents to her primary care physician with bilateral joint pain. She .2
says that

the pain has been slowly worsening over the past 3 days. Otherwise she complains of fatigue
, subjective

fever and a sunburn on her face which she attribute to gardening, She is not aware of any
chronic

medical conditions and takes multivitamin daily , her temperature is 37.1 ,BP (125/64),pulse
,is 80

Respiratory rate 13/min, O2 sat 98% on room air. physical exam exam reveals bilateral
redness over the

?maxillary prominence. Which of the following is the most likely to be seen in this patient

A. Decreased anti-dsDNA antibodies

B. Decreased complement levels

C. Increased anti-centromere antibodies

D. Increased anti-topoisomerase antibodies

A 22-year old woman presents to her primary care provider complaining of a facial rash. .3
She says the

rash began 3 weeks ago after hiking in the white mountains of new hampshire this summer.
Since that

time she has also experienced pain in her hands and wrists that is worse in the morning and

accompanied by subjective fever. She denies any chest pain, shortness of breath,
Nausea,Vomiting. Vital

signs are (37.6 C)(BP 134/82)(RR 18/min). Examination demonstrates a rash on the patients
face that

spares the nasolabial folds along with painless oral ulcers. the metacarpophalangeal joints
are tender to

palpation and range of motion is limited by pain. CBC demonstrates normocytic anemia with

?thrombocytopenia, Which of the following is the best next step in diagnosis

A. Anti-cardiolipin antibodies

B. Anti-DsDNA antibodies

C. Anti-histone antibodies
D. Anti-nuclear antibodies

A 25-year-old female gives birth to a baby with complete heart block who subsequently )4
requires

pacemaker insertion. Which of the following antibodies is most likely to be detected in the
maternal

?serum

A) Anti-double-stranded deoxyribonucleic acid (dsDNA) antibodies

B) Anti-endomysial antibodies

C) Anti-Ro/SSA antibodies

D) Anti-SCL70 antibodies

?Which of the following genes are linked to SLE )5

A) HLA-B27

B) HLA-DR4

C) HLA-DR2

D) HLA-B51

?Which of the following is the most common first manifestation in SLE patients )6

A) Arthritis

B) Malar rash

C) Glomerulonephritis

D) Discoid rash

?Which of the following antibodies is used to diagnose drug induced lupus )7

A) Anti-DsDNA

B) Anti-SSA

C) Anti-nuclear

D) Anti-histones

Answers: 1)A , 2)B , 3)D, 4)C, 5)C,6)A,7)D

Questions

A kid found himself to be clumsy, as he has just turned 5. His mother decided to bring him .1
to a clinic and

explained how her son couldn’t keep up with his peers which made her worry. Which of the
following could be the

? disease
.A. Becker muscle dystrophy

.B. Inclusion Body Myositis

.C. Duchenne muscle dystrophy

.D. Myotonic dystrophy

?Which of the following do we need to screen for cardiac diseases .2

.A. Dystrophinopathy carriers

.B. FSHD carriers

.C. Myotonic dystrophy carriers

D. A and C

A patient complains of a history of generalized muscle weakness. On examination, his .3

facial muscles show marked

atrophy, and when you ask him to shake your hand, he appears to be unable to relax his grip
.for an extended period

?What is the likely diagnosis

.A. Myotonic Dystrophy

.B. Becker's dystrophy

.C. Inclusion body myositis

D. Myasthenia Gravis

?Everyone with dystrophic myopathies should be screened for cardiomyopathy -5

A. True

B. False

? Any patient with asymptomatic FSHD should do EKG, Echo and PFT -6

A. True

B. False

.Inherited myopathies are always symmetrical -7

A. True

B. False

.We need to screen asymptomatic Myotonic dystrophy patients for cardiac disease -8

A. True

B. False

Answers: 1. C /2. D /3. A /4. A / 5. A / 6. B / 7. B / 8. A / 9. C / 10. B /11. B

:Questions

?Q1: The most common extra-articular manifestation of Ankylosing Spondylitis

A. Anterior Uveitis

B. Psoriasis

C. IBD

D. Aortic Regurgitation

Answer: A

?Q2: Which of the following joints is affected the most in Ankylosing Spondylitis

A. Knees

B. Ankles

C. SI joint

D. DIP joint

Answer: C

Q3: Which of the following is the minimum duration characteristic of Inflammatory back
?pain

A. 10 minutes

B. 30 minutes

C. 1 hour

D. 4 hours

Answer: B

Q4: In Spondyloarthropathies, which of the following sites is affected the most with
?enthesitis

A. Achilles tendons

B. Plantar fascia

C. Lateral epicondyles

D. Medial malleolus

Answer: A

?Q5: What gene is responsible for SpA diseases

A. HLA B27

B. HLA DR4

C. HLA DR3

D. HLA B24
Answer: A

Q6: It is said that Reiter’s disease has been related to Chlamydia trachomatis infection. Is this

?correct

A. True

B. False

Answer: A

?Q7: Which of the following is a radiological sign of advanced Ankylosing Spondylitis

A. Syndesmophytes

B. Blurring of the upper or lower vertebral rims at the thoracolumbar junction

C. Bamboo spine

D. None of the above

Answer: C