Multiple Choice Questions (MCQ)

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Category: Medicine--->Rheumatology
Page: 2

Question 6# Print Question

A 45-year-old woman with long-standing, well-controlled rheumatoid arthritis develops severe pain and swelling in the left elbow over 2 days. She is not sexually active. Arthrocentesis reveals cloudy fluid. Synovial fluid analysis reveals greater than 100,000 cells/mL; 98% of these are PMNs. What is the most likely organism to cause this scenario?

A. Streptococcus pneumoniae
B. Neisseria gonorrhoeae
C. Escherichia coli
D. Staphylococcus aureus
E. Pseudomonas aeruginosa

Question 7# Print Question

A 66-year-old man complains of a 1-year history of low back and buttock pain that worsens with walking and is relieved by sitting or bending forward. He has hypertension and takes hydrochlorothiazide but has otherwise been healthy. There is no history of back trauma, fever, or weight loss. On examination, the patient has a slightly stooped posture, pain on lumbar extension, and has a slightly wide based gait. Pedal pulses are normal and there are no femoral bruits. Examination of peripheral joints and skin is normal. What is the most likely cause for this patient’s back and buttock pain?

A. Lumbar spinal stenosis
B. Herniated nucleus pulposus
C. Atherosclerotic peripheral vascular disease
D. Facet joint arthritis
E. Prostate cancer

Question 8# Print Question

A 60-year-old man complains of pain in both knees coming on gradually over the past 2 years. The pain is relieved by rest and worsened by movement. The patient is 5 ft 9 in tall and weighs 210 lb. There is bony enlargement of the knees with mild warmth and small effusions. Crepitation is noted on motion of the knee joint bilaterally. There are no other findings except for bony enlargement at the distal interphalangeal joint. Which of the following is the best way to prevent disease progression?

A. Weight reduction
B. Calcium supplementation
C. Total knee replacement
D. Long-term nonsteroidal anti-inflammatory drug (NSAID) administration
E. Oral prednisone

Question 9# Print Question

 A 22-year-old man develops the insidious onset of low back pain improved with exercise and worsened by rest. There is no history of diarrhea, conjunctivitis, urethritis, rash, or nail changes. On examination, the patient has loss of mobility with respect to lumbar flexion and extension. He has a kyphotic posture. A plain film of the spine shows sclerosis of the sacroiliac joints. Calcification is noted in the anterior spinal ligament. Which of the following best characterizes this patient’s disease process? 

A. He is most likely to have acute lumbosacral back strain and requires bed rest
B. The patient has a spondyloarthropathy, most likely ankylosing spondylitis
C. The patient is likely to die from pulmonary fibrosis and extrathoracic restrictive lung disease
D. Rheumatoid factor is likely to be positive
E. A colonoscopy is likely to show Crohn disease

Question 10# Print Question

A 20-year-old woman has developed low-grade fever, a malar rash, and arthralgias of the hands over several months. High titers of anti-DNA antibodies are noted, and complement levels are low. The patient’s white blood cell count is 3000/µL, and platelet count is 90,000/µL. The patient is on no medications and has no signs of active infection. Which of the following statements is correct? 

A. If glomerulonephritis, severe thrombocytopenia, or hemolytic anemia develops, high-dose glucocorticoid therapy would be indicated
B. Central nervous system symptoms will occur within 10 years
C. The patient can be expected to develop Raynaud phenomenon when exposed to cold
D. Joint deformities will likely occur
E. The disease process described is an absolute contraindication to pregnancy

Category: Medicine--->Rheumatology
Page: 2 of 6