1. An early symptom of mixed connective tissue disease is Raynaud phenomenon. Which of the following describes the effects of Raynaud phenomenon?
2. A 30 year old women presents to the clinic complaining of dry mouth and eyes. The symptoms started gradually but now are becoming more bothersome. She has no significant past medical history and her only medication is on OCP. On physical examination, the vital signs are normal. The eyes and mouth appears normal but there is symmetric enlargement of parotid glands. Testing her serum is positive for R0/SS-A autoantibodies. Which of the following is most likely diagnosis?
3. A smoker presented with a four year history of blanching of the fingers on exposure to cold. What is the diagnosis?
4. A 40 year old woman complains of pain and swelling in both wrists and ankles for 7 weeks. She has several months of fatigue. Morning stiffness impairs her activities for 2 hours. OTC naproxen provides temporary relief. On examination, MCP joints and wrists are warm and tender; there is slight tenderness to pressure over ankles and MTP joints as well. All other joints are normal. There is no alopecia, photosensitivity, kidney disease or rash. Which of the following is correct?
5. Most common extra-articular manifestation of Ankylosing spondylitis is?
6. A 17- month old boy has a history of multiple fractures due to “brittle bones”. The child is short in stature and has a deformed skull. Physical examination is normal except for the finding of blue sclera. Which of the following is the most likely diagnosis?
7. Which of the following is associated with HLA B-27?
8. Which of the following is associated with HLA B5?
9. A 19 year old female student unwittingly eat shrimp in the dormitory dining room. Over the next 20 minutes acute lesion consisting of erythematous, elevated wheals appear. Which of the following is most characteristic of these lesion?
10. A lady presents with joint pain in both knees and low grade fever on and off. On examination she has a rash on sun exposed parts. Clinical diagnosis?
11. A 63 year old man develops pain and swelling in his knee. It appears warm, red, and swollen with decreased range of movement. A diagnostic aspiration is performed. Which of the following will most likely distinguish pseudogout from gout?
13. A 31 year old man with no past medical history presents with fever, nausea and vomiting and arthralgias for 10 days. He complains of inability to move his left foot due to weakness. He also states he has had haematuria for several hours. On physical examination, the patient has pyrexia, and he is hypertensive. He has diffuse abdominal tenderness on palpation but has no rebound tenderness. He has subcutaneous nodules and shallow ulcerations near his medial malleolus on his left leg. Neurological examination shows a left foot drop. Most likely the diagnosis is?
14. Which of the following is characteristic of muscle weakness in RA?
15. Edrophonium tets is diagnostic of?
16. A young male presents with leg swelling and recurrent apthous ulcers of his lips and tongue. He has also noticed painful genital ulcers. There is no urethritis or conjunctivitis. On examination he has evidence of deep vein thrombophlebitis. Most probable diagnosis?
17. A 74 year old woman complaining of a severe right sided headache for 1 day. She states that the vision in her right eye has diminished, and she complains of pain in the right side of her jaw when she is chewing food. On physical examination her sinuses are non tender to percussion but her right temple is tender to palpate. Most likely the diagnosis?
18. A young girl admitted with joint pains and butterfly rash and positive urine proteinuria. The best test for her diagnosis?
19. A 65 year old man is worried that he has RA because his RF serology is positive in a lower titre (1:32). He has pain in his left hand and right knee, which usually bother him in the evening. He has not noticed any inflammation or swelling and there is no history of morning stiffness. Which of the following is true?
20. A 5 year old child presents with fever, fatigue and characteristic palpable purpura scattered over the body. A biopsy of lesion revealed leukocytoclastic vasculitis. Diagnosis is?
21. Which is not autoimmune disease?
22. A 45 year old woman has pain in her fingers on exposure to cold, arthralgias and difficult swallowing food. The most useful test to make a definite diagnosis?
23. Most probable diagnosis for above condition?
24. Which one is the characteristic of sarcoidosis?
25. Strawberry tongue is seen in?
26. A 10 year old child has recurrent signs and symptoms of palpable purpura on the buttocks, arthralgias, colicky abdominal pain, diarhhoea and microscopic haematuria. Which of the following is the most likely diagnosis?
27. A 53 year old man presents with arthritis, cough, haemoptysis and bloody nasal discharge. Urinalysis reveals 4+ proteinuria, RBCs, and RBC cast. CXR shows several B/L cavitary nodules. ANCA 4+ titres are positive in a cytoplasmic pattern. Anti proteinase 3 antibodies are present, but anti MPO absent. Most likely diagnosis?
28. A patient with a 15 year history of RA develops splenomegaly and neutropenia. Most likely diagnosis?
29. Neuropathic pain are caused by 1. Syringomyelia 2. Haemochromatosis 3. Amyloidosis 4. Sarcoidosis 5. Thalmic infarct
30. Kveim siltbach test is used for diagnosis of?
31. Extra- articular manifestation of RA is?
32. A 33 year old male sex worker presents with knee pain. Examination reveals B/L conjunctivitis and a tense effusion and joint tenderness in the right knee. Most probable diagnosis?
33. Which of the following joint finding is most suggestive of an inflammatory, rather than OA cause of joint pain?
34. A patient with cutaneous vasculitis, glomerulonephritis and peripheral neuropathy. Which investigation is to be performed next that will help you to diagnose the condition?
35. The commonest cause of death in a patient with primary amyloidosis?
36. A 50 year old man comes with haemoptysis and diffuse joint pain. He states that both his father and cousin had similar symptoms and were diagnosed with microscopic polyangitis, a disease affecting medium to small sized arteries that is believed to have an autoimmune component to its pathogenesis. Antibody levels were measured to confirm the diagnosis. What other disease is most closely related with same type of autoantibodies as present in this patient?
37. In a patient with gouty arthritis, synovial fluid aspiration will show?
38. Which antibody is incriminated in causing HS purpura?
39. A 67 year old man seeks evaluation from his physician for chronic cough. He denies any sputum production or haemoptysis. He also complains of feeling more weak and fatigued than usual. He says he has lost about 4.5 kg in the past month and that he has been constipated recently. Physical examination reveals coarse breath sounds. Xray of chest showed hilar lymphadenopathy and infiltrative disease. Routine serum examination showed an isolated calcium elevation. Which of the following lab abnormalities is also likely to be present in this patient?
40. C-ANCA is associated with?
41. Small vessel vasculitis are seen in? 1. Wegner’s vasculitis 2. Microscopic polyangitis 3. Churg strauss syndrome 4. Kawasaki disease
42. A 75 year old woman presents to the emergency room for assessment of abrupt onset of soreness, and stiffness of the shoulders, upper thighs, and hips with a low grade fever. She was previously well, has no significant past medical history, and is not taking any prescription medications. Her physical examination is entirely normal but ESR is 100 mm/h. Which of the following is most likely diagnosis?
43. Woman of 30 year with Raynaud’s phenomenon, polyarthritis, dysphagia of 5 years mild sclerdactyl blood showing anti-centromere antibody present.
44. A 25 year old male presented with pigmentation of nose and pinna. After voiding urine it becomes dark. His spine is most likely to show?
45. Diagnosis of above condition?
46. A 8 year old male had non blanching rashes over the shin and swelling of knee joint with haematuria. Microscopic analysis of renal biopsy most likely to show?
47. Most common presentation of extrapulmonary TB?
48. HLA DR4 is a marker of?
49. Amyloidosis deposition most commonly occurs on
50. The bad prognostic indicator of scleroderma
