RHYME WORKSHOP

1. The following physiological changes can be seen during pregnancy except:

• A: proteinuria

• B: reduction in erythrocyte sedimentation rate (ESR)

• C: anaemia

• D: increased risk of thrombosis

2. The following statements regarding vaccinations in patients with rheumatic diseases are true except:

• A: Non-live attenuated vaccines may be given to patients taking prednisolone <20mg/day

• B: Varicella vaccine can be given for patients on Adalimumab

• C: Patients on Hydroxychloroquine do not require modifications to either dosing or vaccination timing

• D: Patients with rheumatic diseases have higher risk of COVID-19 related death regardless of age, sex, co-morbidities or disease activity

3. A 66-year-old lady complains of joint pain over the left knee, both wrists and right shoulder for the last 3 months. The least likely diagnosis is:

• A: gout

• B: osteoarthritis

• C: rheumatoid arthritis

• D: fibromyalgia

4. The following statements regarding anti-nuclear antibody (ANA) are false except:

• A: serum titre of ANA correlates with disease severity

• B: at the onset of disease, ANA is present in 94% of cases

• C: the staining pattern of ANA has no prognostic value

• D: a titre of 1:320 is present in up to 10% of healthy individuals

5. A 23-year-old lady with Systemic Lupus Erythematosus (SLE) presents to your clinic with a fever. The following manifestations warrant an urgent referral to the rheumatology unit:

• A: alopecia, chest pain and shortness of breath

• B: alopecia, joint pain and swelling

• C: rash, oral ulcers and dysuria

• D: rash, joint pain and fatigue

6. A 54-year-old gentleman who has been diagnosed with gout is unclear regarding dietary advice. The following foods are allowed except:

• A: anchovies

• B: yogurt

• C: blueberry jam

• D: soymilk

7. The following statements regarding allopurinol are TRUE except:

• A: genetic screening before starting Allopurinol for risk of allopurinol hypersensitivity syndrome is not recommended

• B: allopurinol may cause a fatal cutaneous adverse reaction

• C: allopurinol can be started even if patient only had 2 gout flares in the last 12 months

• D: allopurinol is contraindicated in patients with known renal stones

8. Which of these scenarios may warrant a referral to the rheumatologist?

• A: A 24-year-old badminton player with low back pain for the past 6 months

• B: A 43-year-old lady with low back pain which is worse at night and improves on getting up

• C: A 50-year-old mechanic with low back pain since his 20s

• D: All of the above

9. Which of the following conditions are not associated features of spondyloarthritis?

• A. uveitis

• B: interstitial lung disease

• C: psoriasis

• D: diarrhoea

10. A newly diagnosed rheumatoid arthritis patient who has been started on methotrexate presents to your clinic. The following situations require an immediate referral to the rheumatology unit except:

• A: leucopaenia noted on full blood count

• B: mild nausea and vomiting

• C: presence of multiple oral ulcers

• D: elevated liver enzymes