Common Rheumatologic Disorders Flashcards
7 cards from real Internal Medicine Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Common Rheumatologic Disorders flashcards as text
A 35-year-old woman presents with a malar rash, arthralgias, and positive ANA with anti-dsDNA antibodies. Urinalysis shows proteinuria and RBC casts. Which class of lupus nephritis carries the worst prognosis if untreated?
Answer: Class IV (diffuse proliferative)
Class IV (diffuse proliferative) lupus nephritis is the most severe form and carries the worst renal prognosis without aggressive immunosuppressive therapy.
A 55-year-old man with long-standing rheumatoid arthritis develops new-onset wrist drop. Which extra-articular manifestation of RA is most likely responsible?
Answer: Mononeuritis multiplex due to rheumatoid vasculitis
Mononeuritis multiplex from rheumatoid vasculitis can cause focal nerve deficits such as wrist drop due to radial nerve involvement.
A patient with psoriatic arthritis has predominantly distal interphalangeal joint involvement with nail pitting and 'sausage digit.' Which HLA type is most strongly associated with this condition?
Answer: HLA-B27
HLA-B27 is the most strongly associated HLA antigen in psoriatic arthritis, particularly in patients with axial involvement.
A 68-year-old man presents with acute monoarthritis of the first MTP joint, fever, and serum urate of 9.8 mg/dL. Synovial fluid shows negatively birefringent needle-shaped crystals. Which enzyme deficiency leads to the most severe form of gout?
Answer: HGPRT deficiency (Lesch-Nyhan syndrome)
Complete deficiency of HGPRT (hypoxanthine-guanine phosphoribosyltransferase) causes Lesch-Nyhan syndrome with severe hyperuricemia and gout.
A 45-year-old woman with Sjögren syndrome presents with purpura, peripheral neuropathy, and elevated serum cryoglobulins. Which complication is she at highest risk for?
Answer: Non-Hodgkin's lymphoma
Sjögren syndrome carries a 44-fold increased risk of non-Hodgkin's lymphoma, particularly MALT lymphoma of the parotid gland.
A 30-year-old male presents with bilateral sacroiliitis, uveitis, and limited lumbar flexion. Schober test measures 2 cm expansion. Which finding on MRI would confirm active sacroiliitis?
Answer: Bone marrow edema (subchondral)
Bone marrow edema on MRI (T2/STIR sequences) is the hallmark of active inflammatory sacroiliitis in ankylosing spondylitis.
A 60-year-old woman with RA develops fever, splenomegaly, and severe neutropenia. Bone marrow biopsy shows hypercellularity. Which treatment should be avoided in this patient?
Answer: Methotrexate
Felty syndrome (RA + splenomegaly + neutropenia) is worsened by methotrexate, which further suppresses neutrophil production.