session 11

Question 1

A50-year-old female with a history of rheumatoid presents with a suspected
septic knee joint. A diagnostic aspiration is performed and sent to
microbiology. Which of the following organisms is most likely to be
responsible?
A. Staphylococcus aureus
B. Staphylococcus epidermidis
C. Escherichia coli
D. Neisseria gonorrhoeae
E. Streptococcus pneumonia

Question 2

Reactive arthritis is associated with which one of the following HLA antigens?
A. HLA-B27
B. HLA-A3
C. HLA-DR4
D. HLA-B5
E. HLA-DR3


Question 3
A47-year-old man with a history of chronic sinusitis presents with shortness of breath to
the Emergency Department. Initial investigations reveal:
Hb 10.4g/dl
Platelets 477 * 109/l
WCC 14.3 * 109/l
ESR 92 mm/h
Urea 20 mmol/l
Creatinine 198 µmol/l
Urine dipstick blood +++
What is the most likely diagnosis?ia
A. Mixed cryoglobulinaemia
B. Churg-Strauss syndrome
C. Wegener's granulomatosis
D. Haemolytic uraemic syndrome
E. Henoch-Schonlein purpura

Question 4

Which one of the following is not a risk factor for developing osteoporosis?
A. Smoking
B. Obesity
C. Sedentary lifestyle
D. Premature menopause
E. Female sex


Question 5
Which one of the following features is least commonly seen in drug-induced
lupus?
A. Glomerulonephritis
B. Arthralgia
C. Myalgia
D. Malar rash
E. Pleurisy

Question 6

A45-year-old man presents with a painful swelling on the posterior aspect of his elbow. There is
no history of trauma. On examination an erythematous tender swelling is noted. What is the most
likely diagnosis?
A. Synovial cyst
B. Haemarthrosis
C. Septic arthritis
D. Gout
E. Olecranon bursitis

Question 7

A45-year-old female with a history of rheumatoid arthritis presents to the
Emergency Department with a two day history of a hot, painful, swollen
right elbow joint. What is the most appropriate management?
A. Joint aspiration
B. Start infliximab
C. Oral high-dose prednisolone
D. Short course of methotrexate
E. Depomederone injection


Question 8
Perinuclear antineutrophil cytoplasmic antibodies (pANCA) are most
strongly associated with which condition?
A. Goodpasture's syndrome
B. Churg-Strauss syndrome
C. Polyarteritis nodosa
D. Wegener's granulomatosis
E. Autoimmune hepatitis

Question 9

Which of the following is associated with a good prognosis in rheumatoid
arthritis?
A. Rheumatoid factor negative
B. HLA DR4
C. Anti-CCP antibodies
D. Rheumatoid nodules
E. Insidious onset

Question 10

The presence of anti-cyclic citrullinated peptide antibody is suggestive of
which one of the following conditions?
A. Systemic lupus erythematous
B. Rheumatoid arthritis
C. Type 1 diabetes mellitus
D. Addison's disease
E. Dermatomyositis