Rheumatology Prometric Style Questions – 50 Cases with Answers

What this deck covers

Rheumatology Prometric Style Questions – 50 Cases with Answers in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. One swollen knee at three
2. Fever spikes and a fleeting rash
3. A bad back at fourteen
4. Both hands, both wrists
5. A sausage-shaped toe
6. Suddenly much worse
7. Starting the weekly tablet
8. A knee that will not settle
9. A fever on two drugs
10. Growing sideways not upwards
11. A rash across the cheeks
12. Protein in the urine, feeling fine
13. A very slow newborn heart
14. Clots despite a long clotting time
15. Lupus from a tablet
16. Purple spots you can feel
17. Better now, what next
18. Belly pain with the rash
19. Protein three months later
20. A frightening rash in a well toddler
21. Eight days of fever in an infant
22. No pulse on one side
23. Nose, lungs and kidneys
24. Ulcers in two places
25. Nodules along an artery
26. Purple eyelids and weak legs
27. Confirming it without a biopsy
28. Chalky lumps under the skin
29. Choking on her food
30. Starting treatment for the muscles
31. Fingers that change colour
32. A hard band down the leg
33. White fingers in winter
34. Tight skin and breathlessness
35. Blood pressure through the roof
36. Fever like clockwork
37. Belly pain that comes and goes
38. A rash since babyhood
39. Eleven fevers in a year
40. Fevers lasting two weeks
41. Refusing to stand on one leg
42. Sore legs at bedtime
43. Pain everywhere, tests all normal
44. Bendy joints that ache
45. A limp with a low platelet count
46. Reading the antibody test
47. Before the first biologic dose
48. Chickenpox in his class
49. How to take the anti-inflammatory
50. Moving to adult clinic

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Regular echocardiography for valvular involvement, It usually remits spontaneously within two years, Renal ultrasound every six months while on treatment, Anti-double stranded DNA antibodies, Meningococcal septicaemia, Reassurance, as the vasculitis has resolved, Takayasu arteritis, Systemic juvenile idiopathic arthritis, Subcutaneous abscess formation, Primary Raynaud phenomenon needing no investigation, Interstitial lung disease and pulmonary hypertension, Corticosteroid at the onset of each attack, X-linked recessive, A trial of long-term opioid analgesia.

Clinical pearls from this deck

• The eye that goes blind in this disease never hurts and never looks red. Only the slit lamp finds it, and only if somebody books it.
• Chart the temperature rather than describing it. A fever that touches normal every day is a different disease from one that never does.
• Back pain that improves with movement is inflammatory; back pain that worsens with movement is mechanical. That one question sorts most adolescent back pain.
• The two positive results three months apart are not padding. One transient positive rheumatoid factor means nothing, and the subtype requires two.
• A whole swollen toe is not a joint problem, it is a digit problem, and that single observation names the subtype.
• A falling sedimentation rate in a child who is getting worse is one of the most dangerous results in paediatrics. It reads like improvement and it is the opposite.

This deck is open to everyone with no sign-in. Work through it once for recognition, then again a week later to test yourself.

More from this system: all Rheumatology case decks · pediatric reference values.