ABIM Rheumatology

Question 1

Which antibody is most specific for rheumatoid arthritis?

Accepted Answer

Anti-cyclic citrullinated peptide (anti-CCP)

Answer

Antinuclear antibody (ANA)

Answer

Anti-double-stranded DNA (anti-dsDNA)

Answer

Antineutrophil cytoplasmic antibody (ANCA)

Question 2

Which antibody is most specific for systemic lupus erythematosus (SLE)?

Accepted Answer

Anti-Smith (anti-Sm)

Answer

Anti-Ro/SSA

Answer

Anti-double-stranded DNA (anti-dsDNA)

Answer

Anti-histone

Question 3

A 55-year-old man presents with sudden-onset severe pain and swelling of his right great toe with a serum uric acid of 9.2 mg/dL. What is the most appropriate first-line treatment for this acute attack?

Accepted Answer

Colchicine

Answer

Allopurinol

Answer

Probenecid

Answer

Febuxostat

Question 4

Which synovial fluid finding is most characteristic of gout?

Accepted Answer

Negatively birefringent needle-shaped crystals

Answer

Positively birefringent rhomboid crystals

Answer

WBC count >100,000/mm³ with 95% PMNs

Answer

Turbid fluid with glucose <25 mg/dL

Question 5

A 50-year-old woman presents with dry eyes, dry mouth, anti-Ro/SSA antibodies, and anti-La/SSB antibodies. Which condition is most likely?

Accepted Answer

Primary Sjögren's syndrome

Answer

Systemic lupus erythematosus

Answer

Rheumatoid arthritis

Answer

Dermatomyositis

Question 6

A 25-year-old man presents with low back pain and morning stiffness that improves with exercise, positive HLA-B27, and sacroiliitis on imaging. What is the most appropriate initial treatment?

Accepted Answer

NSAIDs

Answer

Methotrexate

Answer

Hydroxychloroquine

Answer

Rituximab

Question 7

Which feature of psoriatic arthritis most distinctly differentiates it from rheumatoid arthritis?

Accepted Answer

Dactylitis (sausage digits)

Answer

Symmetric joint involvement

Answer

Positive rheumatoid factor

Answer

Morning stiffness lasting more than 1 hour