Rheumatology – Exam Review Set 1

What this deck covers

Rheumatology – Exam Review Set 1 in 51 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 paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 51 cases, in order

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

Diagnoses and management options tested

Across the 51 cases you are asked to choose between options such as: Gangrene of the fingertips, Oligoarticular juvenile idiopathic arthritis, Macrophage activation syndrome, Reassure and review only if he becomes more unwell, Start a diuretic and restrict dietary salt, Systemic lupus erythematosus of new onset, Intussusception, Bone marrow examination for malignancy, Recurrent aphthous stomatitis alone, Antinuclear antibody with rheumatoid factor titre, Hydroxychloroquine as a single agent for two years, Immediate referral for immunosuppressive treatment, Periodic fever with aphthous stomatitis, Recurrent common viral infections.

Clinical pearls from this deck

• In scleroderma the artery is narrowed for good, so every cold snap costs a little more tissue.
• 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.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

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