MCQ answers

Rheumatology
1.

a. T Several subtypes of HLA DR4 are

associated with susceptibility to RA.
b. F The hands are commonly involved in RA.
c. T The male : female ratio is approximately 1 : 3.
d. F RA is a multisystem disorder.
e. F 10 30% of RA patients do not carry
rheumatoid factor antibodies.

2.

a. F Obesity is associated with gout.

b. T Urate deposition in the renal interstitium
and collecting tubules can cause a
nephropathy. Urate stones can cause urinary
tract obstruction.
c. F Radiological changes develop after several
years of recurrent gouty attacks.
d. F Low dose salicylate therapy reduces the
renal excretion of uric acid and predisposes to
gout.
e. T This is the commonest joint to be affected
by acute gout.

3.

4.

a. T This can complicate severe spinal diseases.

b. F Aortic regurgitation can occur.
c. T This and other types of peripheral enthesitis
are common in AS.
d. T This occurs in approximately one third of
patients with AS.
e. T This tends to be a late feature of AS.
a. F It affects approximately 10% of patients
with psoriasis.
b. T Some people with psoriatic arthritis never
develop psoriasis.
c. F There is no correlation between the severity
of the arthritis and that of the skin disease.
d. T This is a common feature of psoriatic
arthropathy.
e. F Erosions do occur.

5.

a. F It affects exocrine glands.

b. T B lymphocytes are activated, resulting in an
increase in immunoglobulin production.
c. T Rheumatoid arthritis, systemic lupus
erythematosus, systemic sclerosis and
polymyositis are all causes of secondary
Sj gren s syndrome.
d. T Neurological manifestations include
neuropathies, seizures and hemiparesis.
e. F Patients are at an increased risk of
developing lymphomas compared to the
general population.

6.

a. F The ESR can be normal.

b. F It predominantly targets people over the
age of 60 years.
c. T This is due to ischaemic optic neuritis,
caused by arteritis of the posterior ciliary artery
and branches of the ophthalmic arteries.
d. F The arteritis is patchy and it is possible to
obtain a segment of non inflamed artery on
biopsy.
e. T Approximately 50% of patients with GCA
have symptoms of PMR.

7.

a. F It is much more common in women.

b. F The joints are normal in fibromyalgia.
c. T Approximately 20% of patients with
fibromyalgia suffer with anxiety or depression.
d. T Patients usually have multiple areas of soft
tissue tenderness over the upper and lower
body.
e. F Cognitive behavioural therapy is not a cure
for fibromyalgia, but it can help patients to
cope with their symptoms.

8.

a. T The antibiotic minocycline can trigger drug

induced lupus.
b. F The arthritis of SLE is non erosive.
c. F Antinuclear antibodies are detected in more
than 95% of patients with SLE.
d. F The ESR usually rises during any flare of
SLE. The C reactive protein tends to remain
normal unless infection, serositis or synovitis is
present.
e. T SLE can involve the nervous system, causing
seizures, headaches, neuropathies or psychiatric
problems.

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