PEDIATRIC MCQS: Rheumatology

PEDIATRIC MCQS

MCQ#01

A 3-year-old child is brought to the emergency room with fever to 39°C and refusal to bear weight for the last several hours. She is ill-appearing and on exam has a swollen, tender right knee with surrounding erythema. Radiographs of the right knee demonstrate an effusion.

Which of the following tests would most likely to ensure a definitive diagnosis?

A. Blood culture

B. Bone culture

C. MRI of the knee

D. Synovial fluid culture

E. Ultrasound of the knee

MCQ#02

A child hospitalized 2 weeks ago and suffering from Kawasaki disease presents to your office for follow-up. His father reports that the child defervesced within 24 hours of receiving intravenous immunoglobulin and the fever has not recurred. He is now back to his normal activity and disposition, with the exception of swelling of the knees bilaterally that was first noticed while he was in the hospital and is still present.

Your next step would be which of the following?

A. Readmit the patient for another dose of IVIg

B. Change the patient’s low dose (5–6 mg/kg/day) aspirin to high dose (80–100 mg/kg/day)

C. Reassure the family that the joint swelling will resolve over time

D. Perform arthrocentesis and corticosteroid injections on both knees

E. Start chronic NSAID therapy

MCQ#03

A 15-year-old girl presents to your office with complaints of painful recurrent mouth sores that have occurred 6 times in the last year. She has also had 1 episode of genital ulceration 2 months ago. She underwent culturing of both the oral and genital lesions, which was negative. You note on exam that the patient has evidence of synovitis in her ankles bilaterally, as well as a pustular rash on her arms.

Which of the following tests is likely to be helpful in ascertaining the diagnosis?

A. A skin biopsy

B. A pathergy test

C. MRI/MRA of the brain

D. C-reactive protein

E. Rheumatoid factor

MCQ#04

Of the following medications used in the treatment of systemic lupus erythematosus, which would be considered a long-term maintenance medication?

A. Hydroxychloroquine

B. Prednisone

C. Cyclophosphamide

D. Aspirin

E. Azathioprine

MCQ#05

Children with juvenile systemic sclerosis are most likely to present with which of the following physical findings?

A. Sclerodactyly

B. Tightening of the skin on the face

C. Pulmonary hypertension

D. Esophageal dysmotility

E. Raynaud phenomenon

CORRECT ANSWERS tomorrow  11/9/2019 after 10am