Q.1 Which of the following is the most common pediatric rheumatologic disease?
Juvenile Idiopathic Arthritis
Systemic Lupus Erythematosus
Dermatomyositis
Kawasaki Disease
Explanation - Juvenile Idiopathic Arthritis (JIA) is the most common rheumatologic disease in children.
Correct answer is: Juvenile Idiopathic Arthritis
Q.2 A 10-year-old girl presents with a malar rash that spares the nasolabial folds. What is the most likely diagnosis?
Juvenile Idiopathic Arthritis
Systemic Lupus Erythematosus
Kawasaki Disease
Dermatomyositis
Explanation - The malar rash sparing the nasolabial folds is characteristic of systemic lupus erythematosus (SLE).
Correct answer is: Systemic Lupus Erythematosus
Q.3 Which laboratory test is most specific for Systemic Lupus Erythematosus in children?
ANA
Anti-dsDNA
Rheumatoid factor
ESR
Explanation - Anti-dsDNA is highly specific for SLE, whereas ANA is sensitive but not specific.
Correct answer is: Anti-dsDNA
Q.4 A 7-year-old boy presents with fever, rash, and peeling of the skin on his hands and feet. What is the likely diagnosis?
Juvenile Idiopathic Arthritis
Kawasaki Disease
Henoch-Schönlein Purpura
Dermatomyositis
Explanation - Kawasaki disease presents with fever, rash, conjunctivitis, lymphadenopathy, and peeling of skin.
Correct answer is: Kawasaki Disease
Q.5 Which complication of Kawasaki disease is most concerning?
Renal failure
Coronary artery aneurysm
Pulmonary hypertension
Hepatitis
Explanation - The most serious complication of Kawasaki disease is the development of coronary artery aneurysms.
Correct answer is: Coronary artery aneurysm
Q.6 What is the first-line treatment for Kawasaki disease?
High-dose corticosteroids
Intravenous immunoglobulin (IVIG) and aspirin
Methotrexate
Antibiotics
Explanation - IVIG and high-dose aspirin are the standard initial treatment to reduce the risk of coronary complications.
Correct answer is: Intravenous immunoglobulin (IVIG) and aspirin
Q.7 Which subtype of Juvenile Idiopathic Arthritis (JIA) is associated with uveitis?
Systemic JIA
Oligoarticular JIA
Polyarticular RF-positive JIA
Enthesitis-related JIA
Explanation - Oligoarticular JIA is strongly associated with chronic anterior uveitis, especially in ANA-positive cases.
Correct answer is: Oligoarticular JIA
Q.8 A 9-year-old girl presents with proximal muscle weakness and heliotrope rash. What is the likely diagnosis?
Dermatomyositis
Systemic Lupus Erythematosus
Juvenile Idiopathic Arthritis
Scleroderma
Explanation - Dermatomyositis is characterized by proximal muscle weakness and characteristic rashes (heliotrope rash, Gottron papules).
Correct answer is: Dermatomyositis
Q.9 Which autoantibody is most specific for dermatomyositis?
Anti-Mi-2
Anti-dsDNA
ANA
Anti-Smith
Explanation - Anti-Mi-2 antibody is specific for dermatomyositis and often associated with a good prognosis.
Correct answer is: Anti-Mi-2
Q.10 Henoch-Schönlein Purpura (HSP) is associated with deposition of which immunoglobulin?
IgA
IgM
IgG
IgE
Explanation - HSP is an IgA-mediated small vessel vasculitis presenting with purpura, arthritis, and abdominal pain.
Correct answer is: IgA
Q.11 What is the most common initial symptom of Henoch-Schönlein Purpura?
Abdominal pain
Purpuric rash
Arthritis
Renal involvement
Explanation - The classic presenting feature of HSP is a palpable purpuric rash on the lower extremities.
Correct answer is: Purpuric rash
Q.12 Which is the most common systemic manifestation of systemic-onset JIA?
Hepatosplenomegaly
Uveitis
Skin rash
Carditis
Explanation - Systemic-onset JIA is characterized by quotidian fever and a salmon-colored rash.
Correct answer is: Skin rash
Q.13 A child with JIA is being treated with methotrexate. What supplement is commonly given alongside it?
Iron
Folic acid
Vitamin D
Calcium
Explanation - Folic acid is given with methotrexate to reduce side effects such as mucositis and bone marrow suppression.
Correct answer is: Folic acid
Q.14 Which biologic therapy targets TNF-alpha in the treatment of JIA?
Etanercept
Rituximab
Tocilizumab
Abatacept
Explanation - Etanercept is a TNF-alpha inhibitor used in treatment-resistant JIA cases.
Correct answer is: Etanercept
Q.15 What is the main difference between RF-positive and RF-negative polyarticular JIA?
Age of onset
Number of joints affected
Severity and prognosis
Presence of rash
Explanation - RF-positive polyarticular JIA resembles adult rheumatoid arthritis and has a more severe prognosis.
Correct answer is: Severity and prognosis
Q.16 In Kawasaki disease, which feature is NOT part of the diagnostic criteria?
Conjunctivitis
Cervical lymphadenopathy
Strawberry tongue
Arthritis
Explanation - Although arthritis may occur, it is not part of the classic diagnostic criteria for Kawasaki disease.
Correct answer is: Arthritis
Q.17 What is the characteristic rash in systemic JIA?
Malar rash
Salmon-pink evanescent rash
Heliotrope rash
Purpuric rash
Explanation - Systemic JIA is associated with a transient salmon-pink rash that appears with fever spikes.
Correct answer is: Salmon-pink evanescent rash
Q.18 Which pediatric rheumatologic condition is associated with macrophage activation syndrome (MAS)?
Systemic JIA
Kawasaki Disease
HSP
Scleroderma
Explanation - MAS is a severe, life-threatening complication of systemic JIA characterized by hyperinflammation.
Correct answer is: Systemic JIA
Q.19 A child presents with morning stiffness and swelling in multiple joints for over 6 weeks. What is the likely diagnosis?
Systemic Lupus Erythematosus
Rheumatic Fever
Juvenile Idiopathic Arthritis
Henoch-Schönlein Purpura
Explanation - Morning stiffness with persistent arthritis for ≥6 weeks in a child suggests JIA.
Correct answer is: Juvenile Idiopathic Arthritis
Q.20 Which laboratory finding is most commonly elevated in systemic JIA?
CRP and ESR
ANA
Anti-dsDNA
Rheumatoid factor
Explanation - Systemic JIA is characterized by elevated inflammatory markers (CRP, ESR) but often negative autoantibodies.
Correct answer is: CRP and ESR
Q.21 Which of the following is NOT a typical manifestation of dermatomyositis?
Gottron papules
Heliotrope rash
Proximal muscle weakness
Coronary aneurysm
Explanation - Coronary aneurysm is associated with Kawasaki disease, not dermatomyositis.
Correct answer is: Coronary aneurysm
Q.22 Which treatment is often considered first for mild oligoarticular JIA?
NSAIDs
Methotrexate
Corticosteroids
Biologics
Explanation - NSAIDs are first-line treatment for mild oligoarticular JIA.
Correct answer is: NSAIDs
Q.23 Which vasculitis is most common in children?
Henoch-Schönlein Purpura
Polyarteritis nodosa
Granulomatosis with polyangiitis
Takayasu arteritis
Explanation - Henoch-Schönlein Purpura is the most common childhood vasculitis, characterized by IgA deposition.
Correct answer is: Henoch-Schönlein Purpura
Q.24 Which of the following is a feature of enthesitis-related JIA?
Strong association with HLA-B27
Salmon-colored rash
Heliotrope rash
Coronary aneurysm
Explanation - Enthesitis-related JIA has a strong association with HLA-B27 and is more common in boys.
Correct answer is: Strong association with HLA-B27
Q.25 What is the primary cause of mortality in systemic JIA?
Renal failure
Macrophage activation syndrome
Coronary aneurysm
Chronic lung disease
Explanation - Macrophage activation syndrome is a life-threatening complication and major cause of mortality in systemic JIA.
Correct answer is: Macrophage activation syndrome