Q.1 Which autoimmune disease is characterized by a malar rash, often described as a 'butterfly rash'?
Dermatomyositis
Systemic lupus erythematosus
Scleroderma
Pemphigus vulgaris
Explanation - SLE often presents with a malar rash, which is erythematous and spares the nasolabial folds, distinguishing it from other conditions.
Correct answer is: Systemic lupus erythematosus
Q.2 Calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia make up which syndrome?
CREST syndrome
Marfan syndrome
Ehlers-Danlos syndrome
Antiphospholipid syndrome
Explanation - CREST syndrome is a limited form of systemic sclerosis characterized by the listed features.
Correct answer is: CREST syndrome
Q.3 Gottron’s papules are pathognomonic for which connective tissue disorder?
Scleroderma
Dermatomyositis
Lupus erythematosus
Rheumatoid arthritis
Explanation - Gottron’s papules are raised, violaceous lesions over the knuckles, classic for dermatomyositis.
Correct answer is: Dermatomyositis
Q.4 Which connective tissue disorder is associated with 'heliotrope rash' around the eyelids?
Dermatomyositis
Systemic lupus erythematosus
Scleroderma
Mixed connective tissue disease
Explanation - The heliotrope rash is a hallmark of dermatomyositis, presenting as violaceous discoloration of the eyelids.
Correct answer is: Dermatomyositis
Q.5 Which antibody is highly specific for systemic lupus erythematosus?
Anti-centromere antibody
Anti-Scl-70 antibody
Anti-dsDNA antibody
Anti-Jo-1 antibody
Explanation - Anti-dsDNA antibodies are highly specific for SLE and correlate with disease activity, especially renal involvement.
Correct answer is: Anti-dsDNA antibody
Q.6 Tightening of skin on the fingers leading to claw-like deformities is called:
Sclerodactyly
Dactylitis
Arthropathy
Dermatofibrosis
Explanation - Sclerodactyly is skin thickening and tightening of the fingers, seen in systemic sclerosis.
Correct answer is: Sclerodactyly
Q.7 Which connective tissue disease is most strongly associated with anti-centromere antibodies?
CREST syndrome
Dermatomyositis
SLE
Polymyositis
Explanation - Anti-centromere antibodies are specific for limited cutaneous systemic sclerosis (CREST).
Correct answer is: CREST syndrome
Q.8 Raynaud’s phenomenon is due to:
Arterial occlusion
Vasospasm of digital arteries
Venous thrombosis
Capillary leakage
Explanation - Raynaud’s phenomenon is episodic vasospasm of small digital arteries triggered by cold or stress.
Correct answer is: Vasospasm of digital arteries
Q.9 Which feature distinguishes dermatomyositis from polymyositis?
Proximal muscle weakness
Skin manifestations
Elevated muscle enzymes
Interstitial lung disease
Explanation - Both have muscle weakness, but dermatomyositis uniquely presents with characteristic rashes.
Correct answer is: Skin manifestations
Q.10 Which systemic sclerosis antibody is associated with diffuse cutaneous involvement?
Anti-dsDNA
Anti-Jo-1
Anti-Scl-70
Anti-centromere
Explanation - Anti-Scl-70 (anti-topoisomerase I) is associated with diffuse systemic sclerosis and lung fibrosis.
Correct answer is: Anti-Scl-70
Q.11 Which connective tissue disease often presents with photosensitivity and oral ulcers?
SLE
Dermatomyositis
Scleroderma
Ehlers-Danlos syndrome
Explanation - Photosensitivity and painless oral ulcers are diagnostic criteria for SLE.
Correct answer is: SLE
Q.12 In systemic sclerosis, pulmonary involvement usually manifests as:
Asthma
Bronchiectasis
Pulmonary fibrosis
Emphysema
Explanation - Interstitial lung disease, leading to fibrosis, is a common complication of systemic sclerosis.
Correct answer is: Pulmonary fibrosis
Q.13 Which connective tissue disease can cause 'mechanic’s hands'?
Dermatomyositis
Polymyositis
Systemic sclerosis
SLE
Explanation - Rough, cracked hands resembling those of mechanics are seen in dermatomyositis with anti-synthetase syndrome.
Correct answer is: Dermatomyositis
Q.14 Which histological finding is typical in lupus erythematosus skin lesions?
Basement membrane thickening
Granulomas
Spongiosis
Ballooning degeneration
Explanation - Lupus skin lesions show deposition at the dermoepidermal junction leading to thickened basement membrane.
Correct answer is: Basement membrane thickening
Q.15 A patient with systemic sclerosis presents with dysphagia. The most likely cause is:
Achalasia
Stricture formation
Esophageal dysmotility
GERD
Explanation - Systemic sclerosis causes smooth muscle atrophy and fibrosis, leading to esophageal dysmotility.
Correct answer is: Esophageal dysmotility
Q.16 Which lab test best monitors lupus nephritis activity?
Anti-Scl-70
Complement levels and anti-dsDNA
ESR
Rheumatoid factor
Explanation - Falling complement and rising anti-dsDNA levels indicate active lupus nephritis.
Correct answer is: Complement levels and anti-dsDNA
Q.17 Which connective tissue disease is strongly linked with an increased risk of malignancy?
Dermatomyositis
Scleroderma
SLE
Rheumatoid arthritis
Explanation - Dermatomyositis has a well-established association with underlying malignancies.
Correct answer is: Dermatomyositis
Q.18 The 'shawl sign' rash over the shoulders is seen in:
Dermatomyositis
Scleroderma
Lupus erythematosus
Ehlers-Danlos syndrome
Explanation - The shawl sign is a photosensitive rash distributed over the shoulders and upper chest.
Correct answer is: Dermatomyositis
Q.19 Which connective tissue disorder is associated with hyperextensible skin and joint hypermobility?
Marfan syndrome
Ehlers-Danlos syndrome
Scleroderma
CREST syndrome
Explanation - Ehlers-Danlos syndrome presents with defective collagen leading to skin hyperextensibility and joint hypermobility.
Correct answer is: Ehlers-Danlos syndrome
Q.20 Which systemic condition is associated with 'salt-and-pepper' skin pigmentation?
Systemic sclerosis
SLE
Dermatomyositis
Ehlers-Danlos syndrome
Explanation - Skin hypopigmentation and hyperpigmentation, giving a salt-and-pepper appearance, are seen in systemic sclerosis.
Correct answer is: Systemic sclerosis
Q.21 Which organ is most commonly affected in systemic lupus erythematosus?
Lungs
Kidneys
Heart
Brain
Explanation - Renal involvement is the most frequent and severe organ complication of SLE.
Correct answer is: Kidneys
Q.22 Which nailfold finding is characteristic of systemic sclerosis?
Splinter hemorrhages
Capillary dropouts and dilatations
Onycholysis
Leukonychia
Explanation - Nailfold capillaroscopy shows dilated and absent capillaries in systemic sclerosis.
Correct answer is: Capillary dropouts and dilatations
Q.23 Which cutaneous manifestation is most specific for lupus erythematosus?
Discoid lesions
Malar rash
Photosensitivity
Oral ulcers
Explanation - Discoid lupus lesions are chronic scaly plaques, considered highly specific for lupus.
Correct answer is: Discoid lesions
Q.24 Which connective tissue disorder can cause microstomia (small mouth)?
Systemic sclerosis
Ehlers-Danlos syndrome
SLE
Marfan syndrome
Explanation - Skin tightening around the mouth in systemic sclerosis leads to reduced oral aperture (microstomia).
Correct answer is: Systemic sclerosis
Q.25 Which antibody is associated with dermatomyositis and interstitial lung disease?
Anti-Jo-1
Anti-dsDNA
Anti-centromere
Anti-Scl-70
Explanation - Anti-Jo-1 antibodies are part of the antisynthetase syndrome in dermatomyositis, linked with lung disease.
Correct answer is: Anti-Jo-1