MRCPH/FCPS PEDIATRIC MCQS: RHEUMATOLOGY AND ORTHOPEDICS

WANTS TO LEARN PEDIATRIC RHEUMATOLOGY THROUGH MCQS: CLICK ON THE FOLLOWING:

1. What is the most accurate characteristic of the ANA test and its role in establishing the diagnosis of SLE?

2. A SLE diagnosed child with   mild renal involvement, what will be the most appropriate initial treatment regimen in this patient?

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MRCPH/FCPS PEDIATRIC MCQS: RHEUMATOLOGY AND ORTHOPEDICS

MRCPH/FCPS PEDIATRIC MCQS: Rheumatology and orthopedics

Quiz

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1. You are evaluating a 12-year-old boy in your practice who has a history of several weeks of on-and-off fatigue and joint pain. The patient also has recent weight loss. He has had 2 episodes of nonstreptococcal pharyngitis. You suspect that he may have systemic lupus
   erythematosus (SLE), and you are considering ordering an antinuclear antibody (ANA) test. Which of the following is the most accurate characteristic of the ANA test and its role in establishing the diagnosis of SLE?
   1.   A negative ANA test result helps rule out SLE.
   2.   A positive ANA test result needs no follow-up testing.
   3.   Has a high positive predictive value.
   4.   Is highly specific.
   5.   Is positive in approximately 50% of the healthy population
2. A 15-year-old adolescent girl, who is followed up in your clinic, has recently been diagnosed as having SLE with mild renal involvement based on clinical criteria and a positive ANA test result. She has no mucocutaneous features. Her complete blood cell count is normal except for mild anemia. In addition to nonsteroidal anti-inflammatory drugs for managing the fevers and arthritis, which of the following is the most appropriate initial treatment regimen in this patient?
   1.   Glucocorticoids.
   2.   Hydroxychloroquine.
   3.   Intravenous immunoglobulin.
   4.   Plasmapheresis.
   5.   Rituximab
3. A 13 years old child with juvenile idiopathic inflammatory myopathies, particularly juvenile dermatomyositis underwent a full evaluation. Serum levels of skeletal muscle enzymes, including creatine kinase, aspartate aminotransferase, lactate dehydrogenase, and aldolase, were elevated. Physical examination was significant for weakness in his upper and lower extremities and difficulty combing his hair. Electromyographic and magnetic resonance imaging findings were consistent with juvenile dermatomyositis. Which of the following is the most appropriate next step in initial management in this patient?
   1.   Cyclophosphamide.
   2.   Intravenous immunoglobulin.
   3.   Nonsteroidal anti-inflammatory drugs.
   4.   Prednisone.
   5.   Tacrolimus
4. A 14-year-old girl developed multiple large areas of waxy hyperpigmentation and hypopigmentation on her legs and back. These skin changes have been progressing over the past 12 to 18 months. Periungal capillary changes are noted along with a progressively worsening perfusion and bluish discoloration of her fingers. Scleroderma is suspected. In addition to the findings described above, which of the following clinical findings is expected to be seen in the systemic form of this disease in this patient?
   1.   Dysphagia.
   2.   Generalized lymphadenopathy.
   3.   Headaches.
   4.   Hepatosplenomegaly.
   5.   Visual changes.
5. A 5-year-old boy presents to the pediatric orthopedic surgeon’s office for evaluation of a 2-month history of intermittent right hip pain and a limp. He was seen by his primary care physician last week, who ordered hip radiographs, which demonstrated findings consistent with avascular necrosis of the femoral head. On physical examination, the patient is observed to have an asymmetrical gait and pain with internal rotation of the right hip. Which of the following is the next best step in management?
   1.   Biopsy of the femoral head.
   2.   Broad spectrum antibiotic therapy.
   3.   Nonsteroidal anti-inflammatory medications and physical therapy.
   4.   Percutaneous in situ fixation.
      .
   5.   Surgical reconstruction of the acetabulum