Rheumatology Questions in MRCP

MRCP Rheumatology Questions

Let's us take a break and look at some of common rheumatology questions in MRCP,

1) A 30 year gentleman was admitted to ward due to history of backpain for 3 months. He denied small joints pain and history of family members having the same problem. There was no history of dysuria and red eye.Below is his X-ray. What is the diagnosis?



1) Ankylosing Spondylitis
2) Riter’s syndrome
3) Psoriatic arthropathy
4) Enteropathic spondylitis
5) Seronegative Rheumatoid arthritis

2) This gentleman presents with swollen joint and fever.

What is likely to be found on microscopy of aspirated synovial fluid?

1 )Bipyramidal crystals that exhibit strong positive birefringence under polarised light
2 )Gram positive cocci in clusters
3 )Needle-shaped crystals that exhibit strong negative birefringence under polarised light
4 )Rhomboid crystals that exhibit weak positive birefringence under polarised light
5 )Small, non-birefringent crystals visible only under electron microscopy

3) A 30 year-old man is admitted to casualty with a 24 hour history of a painful and swollen right knee. He denies any previous history of joint problems. Over the last two days, he has also noticed redness and soreness in both eyes. He has returned from a business trip to Kuala Lumpur a fortnight ago.
On examination, his temperature is 38.5°C. His eyes are red. His right knee is hot, swollen and tender to palpate. No other joint appears to be affected.
Investigations:
Hb 12.9 g/dl
WBC 14.0 x 109/l
Platelets 200 x 109/l
ESR 75 mm/h

Blood cultures
No growth after 48 hours

Urinalysis
No blood, glucose or protein detected

Knee x-ray
Soft tissue swelling around left knee
What is the most likely diagnosis?

1 )Gout
2 )Gonococcal arthritis
3 )Reiter's syndrome
4 )Rheumatoid arthritis
5 )Viral arthritis

4) Which of the following statements are correct regarding this patient's condition?

1 )It occurs more commonly in men
2 )Rheumatoid factor is positive in >90% of cases
3 )It is associated with an erosive arthritis
4 )Raynaud's phenomenon is a feature in ~10%
5 )It is associated with a reduced transfer factor

5) A 22 year old lady presents with typical erythema nodosum. She has a low grade fever and bilateral ankle arthritis but no other symptoms and has no medical history. There is no history of travel abroad and she is on no medication. Which of the following would be the most appropriate investigation for this patient?

1 )Barium enema
2 )Chest x-ray
3 )ESR
4 )Upper GI endoscopy
5 )Viral titres

Get your answers here!