Q.1 Which of the following is a classic feature of systemic lupus erythematosus (SLE)?
Butterfly-shaped facial rash
Scaly plaques on extensor surfaces
Thickened skin over fingers
Hyperpigmented macules on the palms
Explanation - A malar or butterfly rash over the cheeks and nose is a hallmark of SLE, often triggered by sunlight.
Correct answer is: Butterfly-shaped facial rash
Q.2 Which autoantibody is most specific for systemic sclerosis?
Anti-dsDNA
Anti-centromere
Anti-Ro/SSA
Anti-histone
Explanation - Anti-centromere antibodies are strongly associated with the limited cutaneous form of systemic sclerosis (CREST syndrome).
Correct answer is: Anti-centromere
Q.3 Which skin manifestation is most characteristic of dermatomyositis?
Gottron's papules
Erythema nodosum
Livedo reticularis
Telangiectasia on fingers
Explanation - Gottron's papules are erythematous or violaceous papules over knuckles and are pathognomonic for dermatomyositis.
Correct answer is: Gottron's papules
Q.4 Which laboratory test is most commonly elevated in active systemic lupus erythematosus?
C-reactive protein (CRP)
Erythrocyte sedimentation rate (ESR)
Creatine kinase
Rheumatoid factor
Explanation - ESR is often elevated in SLE and reflects systemic inflammation, whereas CRP may remain normal unless there is infection.
Correct answer is: Erythrocyte sedimentation rate (ESR)
Q.5 Which of the following is part of the CREST syndrome in systemic sclerosis?
Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly, Telangiectasia
Cataracts, Raynaud's phenomenon, Erythema, Scleritis, Thrombocytopenia
Cryoglobulinemia, Rash, Edema, Skin atrophy, Telangiectasia
Chilblains, Reticulated rash, Erosions, Sclerodactyly, Thrombosis
Explanation - CREST is an acronym describing features of limited cutaneous systemic sclerosis.
Correct answer is: Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly, Telangiectasia
Q.6 Which antibody is associated with a higher risk of interstitial lung disease in systemic sclerosis?
Anti-centromere
Anti-Scl-70 (Anti-topoisomerase I)
Anti-Ro/SSA
Anti-La/SSB
Explanation - Anti-Scl-70 antibodies are linked to diffuse systemic sclerosis and increased risk of lung fibrosis.
Correct answer is: Anti-Scl-70 (Anti-topoisomerase I)
Q.7 Which dermatological finding is common in mixed connective tissue disease (MCTD)?
Photosensitive rash
Mechanic’s hands
Malar rash sparing nasolabial folds
Poikiloderma
Explanation - Mechanic’s hands, thickened, cracked skin on the fingers, are often seen in MCTD, particularly with anti-U1 RNP antibodies.
Correct answer is: Mechanic’s hands
Q.8 Which is a classic laboratory marker of systemic lupus erythematosus?
Anti-Scl-70
ANA (antinuclear antibody)
Anti-centromere
Anti-mitochondrial antibody
Explanation - ANA is highly sensitive for SLE, though not specific, and is present in nearly all patients.
Correct answer is: ANA (antinuclear antibody)
Q.9 Which of the following is considered a hallmark of limited systemic sclerosis?
Rapidly progressive skin thickening of the trunk
Raynaud's phenomenon and sclerodactyly
Severe renal crisis
Diffuse joint inflammation
Explanation - Limited systemic sclerosis often presents with Raynaud’s and distal skin involvement rather than widespread organ fibrosis.
Correct answer is: Raynaud's phenomenon and sclerodactyly
Q.10 Which dermatologic feature differentiates dermatomyositis from SLE?
Photosensitive malar rash
Gottron’s papules and heliotrope rash
Alopecia
Oral ulcers
Explanation - Gottron’s papules on knuckles and violet eyelid rash (heliotrope) are specific to dermatomyositis, unlike SLE.
Correct answer is: Gottron’s papules and heliotrope rash
Q.11 Which organ is most commonly affected by fibrosis in systemic sclerosis?
Liver
Lungs
Brain
Pancreas
Explanation - Interstitial lung disease is a frequent complication in systemic sclerosis, often leading to significant morbidity.
Correct answer is: Lungs
Q.12 Which is the most sensitive diagnostic test for detecting renal involvement in SLE?
Serum creatinine
Urinalysis for proteinuria
Renal ultrasound
Serum BUN
Explanation - Proteinuria and hematuria in urinalysis are early indicators of lupus nephritis, even before creatinine rises.
Correct answer is: Urinalysis for proteinuria
Q.13 Which of the following is a common vascular manifestation of systemic lupus erythematosus?
Raynaud's phenomenon
Erythema nodosum
Livedo reticularis
Telangiectasia
Explanation - Livedo reticularis is a net-like purplish discoloration of the skin due to vascular involvement in SLE.
Correct answer is: Livedo reticularis
Q.14 Which antibody is characteristic of neonatal lupus?
Anti-Ro/SSA
Anti-dsDNA
Anti-Scl-70
Anti-centromere
Explanation - Maternal anti-Ro/SSA antibodies can cross the placenta, causing neonatal lupus with skin lesions and congenital heart block.
Correct answer is: Anti-Ro/SSA
Q.15 Which clinical feature is highly suggestive of scleromyositis?
Mechanic's hands and proximal muscle weakness
Butterfly rash and arthritis
Telangiectasia and calcinosis
Photosensitivity and alopecia
Explanation - Scleromyositis presents with features of both systemic sclerosis (scleroderma) and inflammatory myopathy.
Correct answer is: Mechanic's hands and proximal muscle weakness
Q.16 Which of the following is a typical first symptom of systemic sclerosis?
Skin thickening of fingers
Diffuse alopecia
Oral ulcers
Fever and malaise
Explanation - Sclerodactyly or thickening of the skin on the fingers is often the earliest manifestation of systemic sclerosis.
Correct answer is: Skin thickening of fingers
Q.17 Which of the following lab findings is common in dermatomyositis?
Elevated creatine kinase (CK)
Low ESR
Hypercalcemia
Positive rheumatoid factor
Explanation - Muscle inflammation in dermatomyositis leads to elevated CK levels in the blood.
Correct answer is: Elevated creatine kinase (CK)
Q.18 Which skin manifestation is associated with lupus nephritis?
Malar rash
Discoid lesions
Alopecia
All of the above
Explanation - Cutaneous signs like malar rash, discoid lesions, and alopecia can all occur in patients with SLE, including those with renal involvement.
Correct answer is: All of the above
Q.19 Which of the following is a risk factor for developing Raynaud's phenomenon in connective tissue diseases?
Cold exposure
Stress
Female sex
All of the above
Explanation - Raynaud's phenomenon is precipitated by cold, emotional stress, and is more common in females, especially in autoimmune disorders.
Correct answer is: All of the above
Q.20 Which systemic complication is most serious in diffuse systemic sclerosis?
Pulmonary hypertension
Skin rash
Alopecia
Oral ulcers
Explanation - Diffuse systemic sclerosis can lead to severe internal organ involvement, including life-threatening pulmonary hypertension.
Correct answer is: Pulmonary hypertension
Q.21 Which antibody is most strongly associated with overlap syndrome between scleroderma and myositis?
Anti-U1 RNP
Anti-Ro
Anti-dsDNA
Anti-Scl-70
Explanation - Anti-U1 RNP antibodies are characteristic of mixed connective tissue disease, an overlap syndrome involving features of scleroderma and myositis.
Correct answer is: Anti-U1 RNP
Q.22 Which cutaneous finding is indicative of calcinosis in systemic sclerosis?
Firm subcutaneous nodules on fingers
Erythematous plaques on face
Vesicles on trunk
Hyperpigmented macules on legs
Explanation - Calcinosis refers to calcium deposits under the skin, often seen in fingers of systemic sclerosis patients.
Correct answer is: Firm subcutaneous nodules on fingers
Q.23 Which type of lupus is typically limited to the skin without major organ involvement?
Systemic lupus erythematosus
Discoid lupus erythematosus
Subacute cutaneous lupus erythematosus
Neonatal lupus
Explanation - Discoid lupus causes chronic, scarring skin lesions but usually does not affect internal organs.
Correct answer is: Discoid lupus erythematosus