Free Specialty Certificate Examination in Rheumatology Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Specialty Certificate Examination in Rheumatology practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A patient with newly diagnosed rheumatoid arthritis asks which conventional DMARD is usually the first medicine used. Which is it?

   1. A.Hydroxychloroquine
   2. B.Sulfasalazine
   3. C.MethotrexateCorrect answer: C
   4. D.Leflunomide

   Explanation: The NHS states: "Methotrexate is usually the first medicine given for rheumatoid arthritis, often with another DMARD and a short course of steroids (corticosteroids) to relieve any pain." Methotrexate is the usual initial drug; the other choices are alternative conventional DMARDs.

   Reference: NHS: Rheumatoid arthritis treatment — Disease-modifying anti-rheumatic drugs

2. 2A young child with JIA has normal vision and no eye discomfort. Why are scheduled uveitis screening visits still needed?

   1. A.Uveitis can be present without noticeable symptomsCorrect answer: A
   2. B.Uveitis reliably begins with painful red eyes
   3. C.Normal visual acuity excludes intraocular inflammation
   4. D.Control of joint symptoms excludes ocular inflammation

   Explanation: The NHS states: "There are usually no symptoms of uveitis in young children," Symptoms are an unreliable screening strategy in young children with JIA.

   Reference: Royal Wolverhampton NHS Trust: Uveitis screening in children with JIA — printed page 1, What are the symptoms of uveitis?

3. 3A woman has fatigue, joint pain and a rash over the cheeks and nose after sun exposure. Which connective tissue disease is most consistent?

   1. A.Systemic sclerosis
   2. B.Sjögren disease
   3. C.Systemic lupus erythematosusCorrect answer: C
   4. D.Polymyalgia rheumatica

   Explanation: The NHS states: "rashes that usually come on after being in the sun – the rash is often over the nose and cheeks" The photosensitive facial rash with joint symptoms supports SLE.

   Reference: NHS: Lupus — Symptoms of lupus

4. 4A postmenopausal woman's DEXA scan reports a T score of -2.8. Which bone-density category does this indicate?

   1. A.Normal bone density
   2. B.Osteopenia
   3. C.OsteoporosisCorrect answer: C
   4. D.Osteomalacia

   Explanation: The NHS states: "below -2.5 shows bone loss and is defined as osteoporosis" A T score of -2.8 is below -2.5; DEXA classification does not diagnose osteomalacia.

   Reference: NHS: Osteoporosis — Bone density scan (DEXA scan)

5. 5Hand osteoarthritis makes it difficult for a patient to rotate the handles controlling water flow at the sink. Which assistive device directly addresses this task?

   1. A.Tap turnerCorrect answer: A
   2. B.Key turner
   3. C.Jar opener
   4. D.Button hook

   Explanation: The NHS states: "Special devices, such as tap turners, can make performing these tasks more manageable." A tap turner improves leverage for this particular hand-operated task.

   Reference: NHS: Osteoarthritis treatment and support — Assistive devices

6. 6An adult is prescribed methotrexate for rheumatoid arthritis. What is the usual dosing frequency for this indication?

   1. A.Once every day
   2. B.Twice every day
   3. C.Once every weekCorrect answer: C
   4. D.Once every month

   Explanation: The NHS states: "For rheumatoid arthritis, the usual starting dose for adults is 7.5mg, taken once a week." Low-dose methotrexate for RA is weekly; schedules for other indications must not be substituted.

   Reference: NHS: Methotrexate — Dosage for inflammatory conditions

7. 7An immunosuppressed adult has an acutely painful, hot swollen knee but a normal temperature. How should absence of fever affect concern about septic arthritis?

   1. A.It excludes a bacterial joint infection
   2. B.It establishes a sterile inflammatory flare
   3. C.It does not exclude septic arthritisCorrect answer: C
   4. D.It establishes a crystal-induced arthritis

   Explanation: The NHS states: "a high temperature (fever) – although not everyone has one." Septic arthritis can occur without fever, so temperature alone cannot exclude it.

   Reference: NHS: Septic arthritis — Symptoms of septic arthritis

8. 8A physiotherapist recommends a TENS machine for painful rheumatoid arthritis joints. What does this device apply to help relieve pain?

   1. A.Small pulses of electrical currentCorrect answer: A
   2. B.Focused waves of ultrasound energy
   3. C.Conductive heat from a heated surface
   4. D.Pulsed fields of magnetic energy

   Explanation: The NHS states: "A TENS machine applies a small pulse of electricity to the affected joint, which numbs the nerve endings and can help ease the pain of rheumatoid arthritis." TENS uses electrical pulses. Therapeutic ultrasound, surface heat and magnetic-field treatments use different physical modalities.

   Reference: NHS: Rheumatoid arthritis treatment — Physiotherapy

9. 9A child with JIA attends screening for intraocular inflammation. Which instrument is used to examine the eye under magnification?

   1. A.Ophthalmoscope
   2. B.Slit lampCorrect answer: B
   3. C.Retinoscope
   4. D.Keratometer

   Explanation: The NHS states: "Your child will be examined using a large magnification lens called a slit lamp" Slit-lamp examination permits screening for uveitis; the other instruments have different ophthalmic uses.

   Reference: Royal Wolverhampton NHS Trust: Uveitis screening in children with JIA — printed page 3, screening appointment

10. 10During routine SLE follow-up, which investigation is used to screen for kidney involvement?

    1. A.ESR
    2. B.Anti-CCP testing
    3. C.ANA testing
    4. D.UrinalysisCorrect answer: D

    Explanation: The NHS recommends "urine tests to check for kidney problems". Urinalysis screens for renal involvement; ESR assesses inflammation and ANA/anti-CCP tests detect antibodies rather than testing urinary abnormalities.

    Reference: NHS: Lupus — Tests for lupus