Term 3, CPC 6 Quiz

1. Two radiographs (below) have been taken three years apart in a 17 year old male show progression of a disease. What is the most probably diagnosis?

Ankylosing spondylitis

Osteoarthritis

Psoriatic arthritis

Tuberculous arthritis

Prolapse disc

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2. What is the most specific serological test for rheumatoid arthritis?

Anti Cyclic Citrullinated peptides (CCP) antibodies

Rheumatoid factor

Anti nuclear antibodies

Anti ds DNA antibodies

Anti neutrophhillic cytoplasmic antibodies

3. A 50 year old patient complains of aching pain in right knee, lower back and neck for the last few years. His joints feel a bit stiff in the morning but this soon passes. There is no swelling, warmth or deformity. Some joint crepitus is audible on joint moving. Normal level of serum calcium, phosphorus, alkaline phosphatase, and uric acid are seen on laboratory findings. Which of the following is the most likely diagnosis?

Gout

Rheumatoid arthritis

Osteoarthritis

Paget’s disease of bone

Multiple myeloma

4. A 70 year old male presents with acute onset pain of first metatarsophalyngeal joint of left foot. He is obese and binge drinks on the weekend. Two weeks ago he was started on thiazides by his cardiologist. Which laboratory finding would be helpful in reaching the diagnosis?

Serum urate level

RA factor

Joint aspiration cytology

Anti nuclear antibodies

Serum calcium

5. A 32 year old female complains of loss of joint motion and difficulty in walking. On examination the joint involvement is symmetrical involving hands and feet. The second and third digit in the hand show 'swan neck' deformity and there is ulnar deviation of hands. Which of the following laboratory findings would be positive in this patient?

Hyperurecimea

Calcium pyrophosphate crystal in joint aspirate

Serum positive for rheumatoid factor

Anti strreptolysin

HLA -B27