Medicine
Rheumatology
A violaceous discoloration around the eyelids in dermatomyositis is called:
A. Erythema nodosum
B. Livedo reticularis
C. Heliotrope rash
D. Malar rash
Correct Answer: C
A heliotrope rash is a violaceous periorbital eruption associated with dermatomyositis.
Medicine
Rheumatology
Which skin finding is characteristic of dermatomyositis?
A. Heberden nodes
B. Tophi
C. Erythema migrans
D. Gottron papules
Correct Answer: D
Gottron papules are violaceous papules over extensor surfaces of the MCP and IP joints.
Medicine
Rheumatology
Which enzyme is commonly elevated in active inflammatory myositis?
A. Creatine kinase
B. Amylase only
C. Troponin in every patient
D. Alkaline phosphatase only
Correct Answer: A
Creatine kinase is commonly elevated when skeletal muscle inflammation and injury are active.
Medicine
Rheumatology
Which muscle pattern is typical of inflammatory myopathy?
A. Pain without objective weakness in every case
B. Symmetric proximal muscle weakness
C. Isolated sensory loss
D. Distal weakness only after trauma
Correct Answer: B
Inflammatory myopathies classically cause symmetric proximal weakness affecting activities such as climbing stairs or rising from a chair.
Medicine
Rheumatology
Which vascular event can occur in Behçet disease?
A. No vascular involvement
B. Aortic coarctation as a defining feature
C. Venous thrombosis
D. Only capillary bleeding
Correct Answer: C
Behçet disease can cause venous and arterial thrombosis as well as aneurysmal disease.
Medicine
Rheumatology
Behçet disease is classically characterized by recurrent oral ulcers, genital ulcers and:
A. Podagra
B. Sclerodactyly
C. Heberden nodes
D. Uveitis
Correct Answer: D
Behçet disease is a multisystem vasculitic disorder known for recurrent oral and genital ulceration and ocular inflammation.
Medicine
Rheumatology
Which complement abnormality is often seen in mixed cryoglobulinemia?
A. Low C4
B. High C4 in every case
C. Absent C3 only with normal C4 always
D. Complement levels are never affected
Correct Answer: A
Mixed cryoglobulinemia often causes complement consumption, particularly low C4.
Medicine
Rheumatology
Cryoglobulinemic vasculitis has a well-known association with which chronic infection?
A. Rabies
B. Hepatitis C
C. Measles
D. Tetanus
Correct Answer: B
Mixed cryoglobulinemic vasculitis is strongly associated with chronic hepatitis C infection.
Medicine
Rheumatology
IgA vasculitis is classically associated with palpable purpura, abdominal pain, arthritis and:
A. Tophi
B. Bamboo spine
C. Renal involvement
D. Sclerodactyly
Correct Answer: C
IgA vasculitis can involve skin, joints, gastrointestinal tract and kidneys.
Medicine
Rheumatology
Palpable purpura most strongly suggests inflammation of which vessel category?
A. Aorta only
B. Large pulmonary arteries only
C. Deep veins only
D. Small vessels
Correct Answer: D
Small-vessel vasculitis commonly presents with non-blanching palpable purpura, especially on dependent areas.
Medicine
Rheumatology
A young woman has limb claudication, unequal arm blood pressures and diminished pulses. Which diagnosis is most likely?
A. Takayasu arteritis
B. Gout
C. Sjögren syndrome
D. CPPD
Correct Answer: A
Large-vessel stenosis in a young woman with pulse and blood-pressure asymmetry is classic for Takayasu arteritis.
Medicine
Rheumatology
Takayasu arteritis most commonly affects:
A. Only coronary microvessels
B. The aorta and its major branches
C. Only small dermal capillaries
D. Only veins
Correct Answer: B
Takayasu arteritis is a granulomatous large-vessel vasculitis of the aorta and major branches.
Medicine
Rheumatology
Which renal finding is more characteristic of polyarteritis nodosa than ANCA-associated glomerulonephritis?
A. Nephrotic syndrome only
B. Polycystic kidneys
C. Renal ischemia and hypertension without glomerulonephritis
D. RBC casts from pauci-immune GN in every patient
Correct Answer: C
PAN affects medium arteries and can cause renal ischemia and hypertension but typically spares glomerular capillaries.
Medicine
Rheumatology
Which infection has a classic association with polyarteritis nodosa?
A. Influenza only
B. Epstein-Barr virus in every case
C. Tetanus
D. Hepatitis B
Correct Answer: D
A subset of PAN is associated with hepatitis B virus infection.
Medicine
Rheumatology
Polyarteritis nodosa primarily affects which vessels?
A. Medium-sized muscular arteries
B. Capillaries only
C. Large elastic arteries only
D. Veins only
Correct Answer: A
PAN is a necrotizing vasculitis of medium-sized arteries.
Medicine
Rheumatology
Which neuropathic pattern is a classic clue to systemic vasculitis?
A. No neuropathy ever occurs
B. Mononeuritis multiplex
C. Symmetric carpal tunnel only
D. Meralgia paresthetica only
Correct Answer: B
Vasculitic ischemia of individual peripheral nerves can produce painful asymmetric mononeuritis multiplex.
Medicine
Rheumatology
Eosinophilic granulomatosis with polyangiitis is characteristically associated with:
A. Sclerodactyly
B. Bamboo spine
C. Asthma and eosinophilia
D. Tophi and hyperuricemia
Correct Answer: C
EGPA classically occurs in patients with asthma, eosinophilia and systemic small-vessel vasculitis.
Medicine
Rheumatology
Which feature distinguishes microscopic polyangiitis from granulomatosis with polyangiitis?
A. No renal involvement can occur
B. Only large arteries are affected
C. It always causes asthma
D. Absence of granulomatous upper-airway disease
Correct Answer: D
MPA is a necrotizing small-vessel vasculitis without the granulomatous ENT disease typical of GPA.
Medicine
Rheumatology
Microscopic polyangiitis is most commonly associated with which ANCA antigen?
A. Myeloperoxidase (MPO)
B. Proteinase 3 exclusively
C. Anti-dsDNA
D. Anti-centromere
Correct Answer: A
MPO-ANCA is commonly associated with microscopic polyangiitis, although ANCA patterns are not absolutely disease-specific.
Medicine
Rheumatology
A patient has chronic sinusitis, hemoptysis and rapidly progressive glomerulonephritis. Which diagnosis is most likely?
A. Gout
B. Granulomatosis with polyangiitis
C. Osteoarthritis
D. Polymyalgia rheumatica
Correct Answer: B
The ENT-lung-kidney pattern strongly suggests GPA.