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RHEUMATOID ARTHRITIS

1. Which of the following statements regarding extra –articular involvements in rheumatoid arthritis is FALSE?
a. [X] Appear before articular involvements
b. [ ] Are determined by lympho-plasmocytic infiltrates and/or vasculitic processes
c. [ ] Appear in severe cases
d. [ ] Are constantly accompanied by high titers of rheumatoid factor
e. [ ] In general, the concentration of circulating immune complexes is increased
2. The following joints are usually involved in rheumatoid arthritis:
a. [ ] Distal interphalangeal joints
b. [ ] Sacroiliac joints
c. [ ] Interapophyseal joints of the lumbar column
d. [X] Atlanto-axial joint
e. [ ] Acromio – clavicular joint
3. Articular involvement in rheumatoid arthritis has the following characteristic:
a. [X] Symmetric
b. [ ] Oligoarticular
c. [ ] Migratory
d. [ ] Monoarticular
e. [ ] Stationary
4. Respiratory involvement in rheumatoid arthritis can have the following manifestation:
a. [ ] Decrease in carbon monoxide diffusion capacity
b. [ ] Pulmonary thromboembolism
c. [ ] Pneumothorax
d. [ ] Hilar adenopathy
e. [X] Pleurisy
5. Synovial fluid in rheumatoid arthritis has the following characteristic:
a. [ ] Increased level of glucose
b. [ ] Decreased concentration of immunoglobulins
c. [X] Presence of rheumatoid factor
d. [ ] Increase in complement concentration
e. [ ] Increase of LDH concentration
6. Which of the following statements regarding methotrexate treatment in rheumatoid arthritis is FALSE:
a. [ ] Clinical effects appear quicker in case of gold salts treatment
b. [ ] Is used in cases of increased immunological activity
c. [ ] Oral administration is done once a week
d. [X] The treatment is short – term
e. [ ] Hepatic toxicity demands periodic hepatic enzyme control
7. Which is the most common adverse effect of non-steroidal anti-inflammatory drug treatment?
a. [X] Gastro-intestinal tract involvement
b. [ ] Hematopoietic disorders
c. [ ] Nephrotoxic action
d. [ ] Neurotoxic action
e. [ ] Allergic reactions
8. Which DMARD drug in rheumatoid arthritis is considered the “gold standard”?
a. [ ] Sulfasalazine
b. [X] Methotrexate
c. [ ] Azathioprine
d. [ ] Hydroxychloroquine
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e. [ ] Cyclophosphamide
9. Which reno – urinary complication can be encountered in severe and prolonged cases of rheumatoid arthritis?
a. [ ] Pyelonephritis
b. [X] Renal amyloidosis
c. [ ] Micronephrolitiasis
d. [ ] Glomerulonephritis
e. [ ] Urethritis
10. The characteristic modification for rheumatoid arthritis is:
a. [ ] Decreased bone mineral density
b. [ ] The osteophyte
c. [ ] Transient inflammatory synovitis
d. [ ] Osteoarthritic changes
e. [X] Persistent inflammatory synovitis
11. The major genetic factor in rheumatoid arthritis is:
a. [ ] HLA DR5
b. [X] HLA DR4
c. [ ] HLA Dw16
d. [ ] HLA Dw15
e. [ ] HLA B27
12. An infectious agent possibly involved in the etiology of rheumatoid arthritis can be:
a. [X] Epstein – Bar virus
b. [ ] Herpes virus
c. [ ] Mycoplasma
d. [ ] Streptococcus hemolyticus
e. [ ] Chlamydia trachomatis
13. The major cellular population in rheumatoid synovitis is:
a. [ ] T lymphocytes
b. [ ] B lymphocytes
c. [ ] TCD8+ lymphocytes
d. [X] TCD4+ memory lymphocytes
e. [ ] Macrophages
14. Which of the following articular components determines pain in rheumatoid arthritis?
a. [ ] Ligaments
b. [ ] Cartilage
c. [ ] Subchondral bone
d. [X] Synovial membrane
e. [ ] Capsule
15. The characteristic radiological change in rheumatoid arthritis is:
a. [ ] Syndesmophytes
b. [ ] Joint space narrowing
c. [ ] Osteophytes
d. [X] Bony erosions
e. [ ] Bony sequestra
16. The use of methotrexate in rheumatoid arthritis presumes the supplementation with:
a. [ ] Cyanocobalamin
b. [ ] Thiamine
c. [ ] Ascorbic acid
d. [ ] Vitamin D
e. [X] Folic aid
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17. The inflammatory process in rheumatoid process begins with one of the following articular components:
a. [ ] Joint capsule
b. [X] Synovium
c. [ ] Cartilage
d. [ ] Subchondral bone
e. [ ] Ligament
18. Choose the most correct description of the articular syndrome in rheumatoid arthritis:
a. [X] Chronic, additive, peripheral, symmetric polyarthritis
b. [ ] Chronic, migratory, peripheral, symmetric oligoarthritis
c. [ ] Chronic, migratory, peripheral, symmetric polyarthritis
d. [ ] Chronic, additive, peripheral, asymmetric polyarthritis
e. [ ] Chronic, additive, peripheral, symmetric polyarthritis with axial involvement
19. The incidence of rheumatoid arthritis is:
a. [ ] Approximately 0.2/1000 in women and 0.5/1000 in men
b. [ ] Approximately 10% of the general population
c. [ ] Equal between sexes
d. [ ] Higher in male patients
e. [X] Approximately 0.5/1000 in women and 0.2/1000 in men
20. The prevalence of rheumatoid arthritis is:
a. [ ] Equal between sexes
b. [ ] Approximately 10% of the general population
c. [X] Approximately 1.7% of women and 0.7% of men
d. [ ] Higher in male patients
e. [ ] Approximately 0.7% of women and 1.7% of men

SYSTEMIC LUPUS ERYTHEMATOSUS

21. What is NOT characteristic for systemic lupus erythematosus?

a. [ ] Pneumonitis
b. [ ] Pericarditis
c. [ ] Endocarditis
d. [X] Eosinophilic endocarditis
e. [ ] Myocarditis
22. What hematologic abnormality is NOT characteristic for systemic lupus erythematosus?
a. [X] Leukocytosis
b. [ ] Leucopenia
c. [ ] Hemolytic anemia
d. [ ] Thrombocytopenia
e. [ ] Increased erythrocyte sedimentation rate (ESR)
23. Which heart valve is most frequently involved in systemic lupus erythematosus?
a. [X] Aortic
b. [ ] Mitral
c. [ ] Tricuspid
d. [ ] Pulmonary
e. [ ] Mitral and tricuspid
24. Which of the following is the most characteristic for systemic lupus erythematosus?
a. [ ] Mitral insufficiency
b. [ ] Mitral stenosis
c. [ ] Aortic insufficiency
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d. [X] Aortic stenosis

e. [ ] Tricuspid insufficiency
25. The main urinary sign in lupus glomerulonephritis is:
a. [ ] Hematuria
b. [ ] Leukocyturia
c. [X] Proteinuria
d. [ ] Uraturia
e. [ ] Cast – uria
26. Which variant of lupus nephritis has the worst prognosis?
a. [ ] Minimal mesangial lupus nephritis
b. [ ] Mesangio – proliferative lupus nephritis
c. [ ] Inactive focal sclerotic lupus nephritis
d. [X] Diffuse sclerotic (>90% sclerotic glomeruli) lupus nephritis
e. [ ] Membranous (proteinuria 3g/day) lupus nephritis
27. Lupus cells are:
a. [ ] Macrophages, which have phagocytosed nuclei of degraded leukocytes
b. [ ] Lymphocyte aggregates
c. [X] Mature polymorphonuclear cells which have phagocytosed nuclei of degraded leukocytes
d. [ ] Aggregates of nuclei of degraded leukocytes
e. [ ] Degraded foamy cells
28. Which statement is characteristic for systemic lupus erythematosus?
a. [ ] Serum IgG levels fall
b. [ ] Normal level of circulating immune complexes
c. [ ] ANA titer rises
d. [ ] Serum IgG levels fall
e. [X] Positive anti-CCP antibodies
29. Positive diagnosis of systemic lupus erythematosus requires the presence of no less than how many ACR criteria?
a. [ ] 3 criteria
b. [X] 4 criteria
c. [ ] 6 criteria
d. [ ] 8 criteria
e. [ ] 11 criteria
30. Select the adequate dose of corticosteroids for a patient with severe lupus nephritis:
a. [ ] 0.1 – 0.5 mg/kg/day
b. [ ] 0.75 mg/kg/day
c. [X] 1.0 – 2.0 mg/kg/day
d. [ ] 3.0 – 4.0 mg/kg/day
e. [ ] >4 mg/kg/day
31. Which statement is characteristic for systemic lupus erythematosus?
a. [ ] Activation of T-helper lymphocytes
b. [ ] Activation of T-suppressor lymphocytes
c. [X] Inhibition of B lymphocytes
d. [ ] Activation of T-suppressor lymphocytes
e. [ ] Activation of T-cytotoxic lymphocytes
32. The duration of corticosteroid treatment in systemic lupus erythematosus is:
a. [ ] 1 month
b. [ ] 3 – 6 months
c. [ ] 1 year
d. [ ] 2 years
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e. [X] Lifelong
33. The most frequent cardiac involvement in systemic lupus erythematosus is:
a. [ ] Myocarditis
b. [ ] Lupus endocarditis
c. [ ] Valvular disease
d. [X] Pericarditis
e. [ ] Cardiac arrhythmias
34. The least toxic drug used in systemic lupus erythematosus is:
a. [ ] Chlorambucil
b. [ ] Cyclophosphamide
c. [X] Azathioprine
d. [ ] Methotrexate
e. [ ] Hydroxychloroquine
35. The most efficient drug used in the treatment of systemic lupus erythematosus is:
a. [ ] Methotrexate
b. [ ] Cyclophosphamide
c. [ ] Azathioprine
d. [ ] Non-steroidal anti-inflammatory drugs
e. [X] Corticosteroids
36. The most frequent manifestation of nervous system involvement in systemic lupus erythematosus is:
a. [ ] Depression
b. [ ] Anxiety
c. [ ] Headache
d. [ ] Mild cognitive dysfunction
e. [X] Psychosis
37. Which patients carry the risk for developing lupus nephirits?
a. [ ] With persistent urinary abnormalities
b. [X] With increased titer of anti-dsDNA antibodies
c. [ ] With hypocomplementemia
d. [ ] With markedly increased ESR
e. [ ] With thrombocytopenia
38. The most frequent manifestation of cardiac lupus is:
a. [ ] Myocarditis
b. [ ] Involvement of all valves
c. [ ] Libman – Sacks endocarditis
d. [ ] Myocardial infarction
e. [X] Pericarditis
39. Which of the following antibodies has the highest incidence in systemic lupus erythematosus?
a. A. [ ] Anti – centromere
b. B. [ ] Anti – Jo1
c. C. [ ] Anti-streptolysin O or S
d. D. [ ] Anti – hyaluronidase
e. E. [X] Anti – dsDNA
40. The most characteristic skin manifestation in systemic lupus erythematosus is:
a. [X] Butterfly shaped malar rash
b. [ ] Discoid rash
c. [ ] Alopecia
d. [ ] Livedo reticularis
e. [ ] Raynaud phenomenon
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SYSTEMIC VASCULITIS

41. Which of the following statements regarding vasculitides is correct?

a. [ ] The clinical picture is not determined by the caliber of involved vessels
b. [ ] Usually onsets with a process of excessive fibrosis of vessels
c. [X] Are chronic autoimmune diseases with chronic evolution
d. [ ] Have a common etiological factor
e. [ ] Are diseases with an exclusively secondary character
42. Which of the following vasculitides involve large caliber vessels?
a. [ ] Polyarteritis nodosa (PAN)
b. [X] Takayasu arteritis (TA)
c. [ ] Granulomatosis with polyangiitis (Wegener)
d. [ ] IgA vasculitis (Henoch – Schönlein)
e. [ ] Cryoglobulinemic vasculitis associated with viral hepatitis HCV
43. Which criterion is essential in the classification of vasculitides?
a. [ ] Suspected etiological factor
b. [ ] Age at the onset of the disease
c. [ ] Preferentially involved organs and systems
d. [ ] Evolutive character of the disease
e. [X] The caliber of involved vessels
44. Which of the following is an ANCA – associated vasculitis?
a. [ ] Takayasu arteritis
b. [ ] Polyarteritis nodosa
c. [X] Granulomatosis with polyangiitis (Wegener)
d. [ ] IgA vasculitis (Henoch – Schönlein)
e. [ ] Lupus vasculitis
45. Which of the following pathogenetical mechanisms is NOT characteristic for systemic vasculitides:
a. [ ] Formation of circulating immune complexes and their deposition in the vascular wall
b. [ ] Development of a chronic inflammatory process in the vessel wall
c. [ ] Ischemic changes in the adjacent tissues of the involved vessel.
d. [ ] Granuloma formation
e. [X] Progressive degeneration of the connective tissue
46. Which of the following clinical manifestations in NOT characteristic for systemic vasculitides:
a. [ ] Absence of the pulse or pulse deficit
b. [ ] Purpura or other types of eruptions
c. [ ] Mononeuritis multiplex
d. [X] Malar rash
e. [ ] Weight loss
47. Which viral infection is more frequently found in patients with polyarteritis nodosa?
a. [ ] Epstein – Bar virus
b. [ ] Cytomegalovirus
c. [ ] HCV – infection
d. [X] HBV – infection
e. [ ] Herpes – infection
48. Which of the following statements regarding the clinical picture of the small caliber vessel vasculitides is true?
a. [ ] Palpable purpura is a rarely encountered manifestation in small caliber vessel vasculitides
b. [ ] A specific clinical sign is the deficit or even the absence of pulse
c. [ ] Along the small caliber vessels nodules can be found, which represent aneurisms of the vessel wall
d. [X] Mononeuritis multiplex is frequently encountered
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e. [ ] Vessel involvement is not accompanied by an ischemic process

49. Which clinical manifestation is considered pathognomonic for polyarteritis nodosa?
a. [X] Livedo reticularis
b. [ ] Arthritis
c. [ ] Subcutaneous nodules
d. [ ] Glomerulonephritis
e. [ ] Iridocyclitis
50. Which renal manifestation is characteristic for polyarteritis nodosa?
a. [ ] Tubulo – interstitial involvement
b. [ ] IgA glomerulonephritis
c. [ ] Polycystic kidney
d. [X] Interlobar artery involvement
e. [ ] Membrano – proliferative glomerulonephritis
51. Which of the following clinical manifestations is not part of the ACR criteria for granulomatosis with
polyangiitis (Wegener)?
a. [ ] Inflammatory changes of the oral and nasal cavities (painful ulcers, purulent discharge or hemorrhage)
b. [X] Diffuse myalgia, muscle weakness, pain in the lower extremities
c. [ ] Urinary sediment changes (hematuria or red blood cell casts)
d. [ ] Radiological changes in the lungs (nodules, infiltrations, cavities)
e. [ ] Biopsy result revealing granulomas, leukocytoclastic vasculitis and necrosis
52. Which of the following immunological tests has the highest specificity for granulomatosis with
polyangiitis (Wegener)?
a. [ ] Anti-CCP antibodies
b. [X] ANCA – antibodies against proteinase 3 (c – ANCA MP3)
c. [ ] ANCA – antibodies against myeloperoxidase (p – ANCA MPO)
d. [ ] Antinuclear antibodies ANA
e. [ ] Increased titer of circulating immune complexes (CIC)
53. Which of the following immunological investigations are especially important in the diagnosis of
microscopic polyangiitis?
a. [ ] Antinuclear antibodies ANA
b. [ ] Circulating immune complexes
c. [ ] Antibodies against double stranded DNA
d. [X] ANCA – antibodies against myeloperoxidase (p – ANCA MPO)
e. [ ] ANCA – antibodies against proteinase 3 (c – ANCA MP3)
54. In the clinical picture of IgA deposit vasculitis (Henoch – Schönlein) dominates the following:
a. [ ] Bronchopulmonary manifestations
b. [ ] Renal involvement
c. [X] Skin manifestations in the form of petechial, hemorrhagic palpable purpura
d. [ ] Nasal and oral ulcers
e. [ ] Digital necrosis
55. IgA deposit vasculitis (Henoch – Schönlein) is part of:
a. [ ] Large caliber vessel vasculitides
b. [ ] Medium caliber vessel vasculitides
c. [X] Small caliber vessel vasculitides
d. [ ] Various caliber vessel vasculitides
e. [ ] ANCA – positive vasculitides
56. Skin and gastrointestinal manifestations in patients with IgA vasculitis (Henoch – Schönlein) are the consequence of:
a. [ ] Direct action of microbial toxins at tissue level
b. [X] Action of circulating immune complexes which drive the inflammatory process in the vascular wall
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c. [ ] Lesions induced by excessive exposure to ultraviolet rays

d. [ ] Lesions induced by the antibodies on the endothelial cell
e. [ ] Direct action of certain drugs, vaccines
57. Which of the following immunological abnormalities is characteristic for IgA vasculitis (Henoch – Schönlein)?
a. [ ] Presence of the HBsAg antigen
b. [X] Rise in circulating immune complexes (CIC) level
c. [ ] Positive anti – phospholipid antibodies
d. [ ] Presence of ANCA antibodies
e. [ ] Increase in IgG level
58. Which of the following drugs are not used in the treatment of IgA vasculitis (Henoch – Schönlein)?
a. [ ] Corticosteroids
b. [ ] Antibiotics
c. [ ] Antiaggregants (dipyridamole, pentoxyphilline)
d. [X] Allopurinol
e. [ ] Cyclophosphamide
59. Which change in the parameters of the complete blood count is characteristic for eosinophilic granulomatosis
with polyangiitis (Churg – Strauss)?
a. [ ] Leukocytosis
b. [ ] Thrombocytopenia
c. [ ] Lymphopenia
d. [X] Eosinophilia
e. [ ] Monocytosis
60. Which of the following clinical findings allows the differential diagnosis between eosinophilic
granulomatosis with polyangiitis (Churg – Strauss) and granulomatosis with polyangiitis (Wegener)?
a. [ ] Presence of pulmonary infiltrates
b. [ ] Constitutional symptoms (fever, weakness, myalgia)
c. [X] History of long – standing bronchial asthma, allergic rhinitis, polinosis in the patient
d. [ ] Presence of antinuclear antibodies (ANA)
e. [ ] Presence of microaneurisms in the pulmonary vessels, detected by MRI – angiography

REACTIVE ARTHRITIS

61. Which is the most frequent extra – articular manifestation in reactive arthritis?
a. [ ] Aortic insufficiency
b. [ ] Congestive cardiac failure
c. [ ] Circinate balanitis
d. [ ] Atrioventricular conduction disorders
e. [X] Acute anterior uveitis
62. Which immunogenetic marker plays an important role in the pathogenesis of reactive arthritis?
a. [X] HLA B27
b. [ ] HLA DR3
c. [ ] HLA DR4
d. [ ] HLA B17
e. [ ] HLA B23
63. Which joint is most frequently involved in reactive arthritis?
a. [X] Sacroiliac joint
b. [ ] Ankle joint
c. [ ] Distal interphalangeal joint
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d. [ ] Proximal interphalangeal joint

e. [ ] Metacarpophalangeal
64. The Schöber test represents:
a. [ ] A method of appreciation of lumbar column extension
b. [ ] Appreciates the rotation movements of the lumbar column
c. [ ] Appreciates the extension of the dorsal column
d. [X] A method of appreciation of lumbar column flexion
e. [ ] Establishes de degree of hip mobility
65. Select the first – line treatment used in reactive arthritis:
a. [ ] Corticosteroids
b. [ ] Cytostatics
c. [X] Antibiotics
d. [ ] Antimalarial drugs
e. [ ] Gold salts
66. Reactive arthritis is more frequently found in:
a. [ ] Adults over 60 years old
b. [ ] Children under 5 years
c. [X] Adults between 18 and 40 years old
d. [ ] During puberty
e. [ ] In the 50 – 60 years decade
67. Out of the four species of Shigella, which was the most frequently involved in cases of reactive arthritis?
a. [ ] Shigella sonnei
b. [ ] Shigella boydii
c. [ ] Shigella dysenteriae
d. [X] Shighella flexneri
e. [ ] Shigella fonery
68. The following laboratory data are found in reactive arthritis, with one exception:
a. [X] Synovial fluid presents the features of specific inflammation with lymphocyte predominance
b. [ ] Moderate anemia
c. [ ] Elevated ESR in the acute phase of the disease
d. [ ] In the majority of ethnical groups 50 – 75% of patients are HLA B27 positive
e. [ ] Tendency to increased acute phase reactants
69. Which of the following statements is true regarding the treatment of reactive arthritis?
a. [X] Sulfasalazine up to 3 g/day can be benefic in patients with persistent reactive arthritis
b. [ ] Immunosuppressive agents are used in early stages
c. [ ] In severe cases Methotrexate 150 mg/week is used
d. [ ] Gold salts are useful as first line treatment options
e. [ ] Systemic glucocorticoids are used in tendinitis
70. Which is the most frequent form of articular involvement in reactive arthritis?
a. [ ] Symmetric polyarticular
b. [ ] Axial with lumbar ankyloses
c. [ ] Axial with cervical ankyloses
d. [X] Asymmetric oligoarticular
e. [ ] Mutilant
71. The most frequent manifestation of spinal column involvement in reactive arthritis is:
a. [ ] Spondylolisthesis
b. [ ] “Bamboo column”
c. [X] Spondyloarthritis
d. [ ] Osseous ankylosis
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e. [ ] Osteoporotic fracture
72. Methotrexate administered in reactive arthritis is most efficient in:
a. [ ] Sacroiliitis
b. [ ] Peripheral arthritis
c. [ ] Ocular involvement
d. [X] Renal complications
e. [ ] Pulmonary complications
73. Which of the following DMARDs is recommended in the treatment of reactive arthritis?
a. [ ] Mofetil mycophenolate
b. [ ] Cyclosporine A
c. [ ] Phenylbutazone
d. [ ] D – Penicillamine
e. [X] Methotrexate
74. Which manifestation is characteristic for reactive arthritis?
a. [ ] Diffuse vertebral ankylosis
b. [ ] Symmetrical syndesmophytes
c. [ ] Osteolysis
d. [X] Dactylitis
e. [ ] Atlanto – occipital joint involvement
75. An infectious episode precedes the symptoms of reactive arthritis by:
a. [X] 1 – 4 weeks
b. [ ] 4 – 8 weeks
c. [ ] 1 – 4 months
d. [ ] 3 – 6 weeks
e. [ ] 3 – 6 months
76. Reactive arthritis is defined as:
a. [ ] Reiter syndrome
b. [ ] The triad of: arthritis, urethritis and conjunctivitis
c. [X] A clinical syndrome in a host organism with genetic susceptibility, initiated by an etiological agent
d. [ ] Undifferentiated spondyloarthritis
e. [ ] Is mandatorily associated with HLA – B27
77. Which of the following is NOT part of the bacteria incriminated in the onset of reactive arthritis?
a. [ ] Yersinia
b. [ ] Shigella
c. [ ] Salmonella
d. [X] Staphylococcus epidermidis
e. [ ] Ureaplasma urealyticum
78. For reactive arthritis it is characteristic:
a. [ ] Positive anti – CCP antibodies
b. [ ] Positive rheumatoid factor
c. [X] Negative rheumatoid factor
d. [ ] Serum fall in IgA levels
e. [ ] Positive antinuclear antibodies (ANA)
79. The most frequent agent implicated in urogenital reactive arthritis is:
a. [ ] Shigella sonnei
b. [ ] Shigella flexneri
c. [X] Chlamydia trachomatis
d. [ ] Shigella dysenteriae
e. [ ] Ureaplasma hominis
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PSORIATIC ARTHRITIS

80. Which of the following statements is correct when prescribing a NSAID in patients with psoriatic arthritis:
a. [ ] Two NSAIDS can be prescribed simultaneously
b. [ ] Administering an intravenous NSAID avoids gastrointestinal toxicity
c. [ ] A NSAID can be prescribed to a patient administering oral anticoagulants
d. [X] An allergy to a NSAID class denies the possibility to prescribe a NSAID form another class
e. [ ] To avoid adverse reactions, the NSAID has to be prescribed in a minimally efficient dose and duration
81. The symptomatic treatment of psoriatic arthritis includes:
a. [ ] Clarithromycin
b. [X] Glucocorticoids
c. [ ] Benzatinbenzylpenicillin
d. [ ] D-penicilamine
e. [ ] Methotrexate
82. Arthritis mutilans is a form of what disease?
a. [ ] Systemic lupus erythematosus
b. [ ] Rheumatoid arthritis
c. [ ] Reactive arthritis
d. [X] Psoriatic arthritis
e. [ ] Gout
83. The CASPAR diagnostic criteria are used in the diagnosis of:
a. [ ] Rheumatoid arthritis
b. [X] Psoriatic arthritis
c. [ ] Systemic lupus erythematosus
d. [ ] Reactive arthritis
e. [ ] Gout
84. Osteolytic lesions of phalanges and metacarpophalangeal joints with the aspect of “telescoped” fingers,
are characteristic for:
a. [ ] Systemic lupus erythematosus
b. [ ] Rheumatoid arthritis
c. [ ] Reactive arthritis
d. [X] Psoriatic arthritis
e. [ ] Gout
85. For the axial involvement of psoriatic arthritis is characteristic:
a. [X] Sacroiliitis (frequently unilateral)
b. [ ] Sacroiliitis (frequently bilateral)
c. [ ] Atlanto-occipital involvement
d. [ ] Sacroiliac joints are not involved
e. [ ] The spinal column is uniformly involved
86. Psoriatic onichodystrophy can be manifested with:
a. [X] Pitting (punctiform erosion)
b. [ ] Solid fusion
c. [ ] Fungal infections
d. [ ] Progressive fissuration
e. [ ] Nail hemorrhages
87. Distal interphalangeal joint osteolysis, extended skin lesions and nail dystrophy suggest the diagnosis of:
a. [ ] Systemic lupus erythematosus
b. [ ] Gout
c. [X] Psoriatic arthritis
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d. [ ] Osteoarthritis
e. [ ] Rheumatoid arthritis
88. Which criterion is NOT characteristic for the diagnosis of psoriatic arthritis?
a. [ ] Negative rheumatoid factor
b. [ ] Dactylitis
c. [ ] Radiological proof of juxtaarticular new bone formation
d. [X] Positive anti-CCP antibodies
e. [ ] Personal or family history of psoriasis
89. The management and treatment of psoriatic arthritis includes:
a. [ ] Antibiotic treatment
b. [ ] Hemodialysis
c. [X] DMARD treatment
d. [ ] Continuous prolonged treatment with NSAID
e. [ ] Immunostimulatory treatment
90. Choose the correct statement referring to Schöber’s test in psoriatic spondylitis:
a. [ ] Is a test for the examination of the sacroiliac joints
b. [X] Measures lumbar stiffness
c. [ ] Measures the stiffness at the level of the dorsal segment of the spinal column
d. [ ] Is a specific test used to determine hip mobility
e. [ ] Reveals peripheral arthritis
91. Which of the following is not part of the spondyloarthritides?
a. [ ] Ankylosing spondylitis
b. [ ] Psoriatic arthritis
c. [X] Rheumatoid arthritis
d. [ ] SAPHO syndrome
e. [ ] Reactive arthritis
92. The indications for corticosteroid infiltrations in psoriatic arthritis are the following, EXCEPT:
a. [X] Synovitis
b. [ ] Arthritis mutilans
c. [ ] General lumbar radiculalgia
d. [ ] Bursitis
e. [ ] Carpal tunnel syndrome
93. The diagnosis of psoriatic arthritis is established using the following criteria:
a. [X] CASPAR
b. [ ] BASDAI
c. [ ] EULAR
d. [ ] ACR
e. [ ] CREST
94. The most frequent form of psoriatic arthritis is:
a. [X] Symmetric oligoarthritis
b. [ ] Distal interphalangeal arthritis
c. [ ] Arthritis mutilans
d. [ ] Axial involvement
e. [ ] Large joint involvement
95. The CASPAR criteria are used for the diagnosis of:
a. [ ] Rheumatoid arthritis
b. [ ] Systemic lupus erythematosus
c. [ ] Osteoarthritis
d. [X] Psoriatic arthritis
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e. [ ] Systemic sclerosis
96. The aspect of “telescoped” fingers is characteristic for:
a. [ ] Systemic lupus erythematosus
b. [ ] Gout
c. [ ] Osteoarthritis
d. [ ] Rheumatoid arthritis
e. [X] Psoriatic arthritis
97. The involvement of phalanges with the aspect of “pencil in cup” is characteristic for:
a. [ ] Systemic lupus erythematosus
b. [ ] Gout
c. [ ] Osteoarthritis
d. [ ] Rheumatoid arthritis
e. [X] Psoriatic arthritis
98. The most frequent onset of psoriatic arthritis is at the age of:
a. [X] 35 – 55 years
b. [ ] 20 – 35 years
c. [ ] 15 – 25 years
d. [ ] 55 – 70 years
e. [ ] 65 – 75 years
99. For the radiological evaluation of psoriatic arthritis the following score is used:
a. [ ] HAQ
b. [X] BASRI
c. [ ] CASPAR
d. [ ] EULAR
e. [ ] GRAPPA

OSTEOARTHRITIS

100. The region of Bouchard nodules development in osteoarthritis are:

a. [X] Proximal interphalangeal joints
b. [ ] Distal interphalangeal joints
c. [ ] Knee joint
d. [ ] Elbow joint
e. [ ] Metatarsophalangeal joints
101. What laboratory indexes are characteristic for osteoarthritis?
a. [ ] Anemia
b. [ ] Leukocytosis
c. [ ] Leukopenia
d. [ ] Thrombocytosis
e. [X] Normal indexes
102. The involvement of which joints is not characteristic for primary generalized osteoarthritis:
a. [ ] Proximal interphalangeal joints
b. [ ] Distal interphalangeal joints
c. [X] Wrist joints
d. [ ] Knee joints
e. [ ] Hip joints

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103. Choose the chondroprotective drugs used in osteoarthritis:

a. [ ] Diclofenac
b. [ ] Indomethacine
c. [X] Chondroitin and Glucosamine
d. [ ] Cyclophosphamide
e. [ ] Hydroxychloroquine
104. What drug is used for viscosupplementation in osteoarthritis?
a. [X] Hyaluronic acid
b. [ ] Ursodesoxycholic acid
c. [ ] Aminocapronic acid
d. [ ] Acidolactic acid
e. [ ] Malonic acid
105. The morning stiffness in osteoarthritis lasts:
a. [X] 5 -30 minutes
b. [ ] 30 minutes – 1 hour
c. [ ] 1 – 2 hours
d. [ ] 2 – 5 hours
e. [ ] All day long
106. What are metalloproteinases?
a. [ ] Cathepsins
b. [ ] Physiological tissue inhibitors
c. [X] Proteolytic systems produced by the chondrocyte
d. [ ] Growth factors, implicated in cartilage homeostasis
e. [ ] Cytokines with an essential role in the normal metabolism of cartilaginous tissue
107. Kellgren – Lawrence stage I of osteoarthritis has the following characteristics:
a. [X] The absence of modifications
b. [ ] Moderate joint space narrowing, multiple osteophytes
c. [ ] Uncertain changes
d. [ ] Advanced changes (practically absent joint space, massive osteophytes)
e. [ ] Minimal changes – minimal joint space narrowing, few osteophytes
108. Kellgren – Lawrence stage III of osteoarthritis has the following characteristics:
a. [ ] The absence of modifications
b. [X] Moderate joint space narrowing, multiple osteophytes
c. [ ] Uncertain changes
d. [ ] Advanced changes (practically absent joint space, massive osteophytes)
e. [ ] Minimal changes – minimal joint space narrowing, few osteophytes
109. Nodular osteoarthritis has the following characteristics:
a. [ ] Diffuse osteoporosis
b. [X] Heberden and Bouchard nodules
c. [ ] Ulnar deviation
d. [ ] Baker’s cyst
e. [ ] Genetic predisposition
110. What joint is rarely affected in osteoarthritis?
a. [ ] Ankle joint
b. [ ] Sacrococcygeal joint
c. [X] Knee joint
d. [ ] Shoulder joint
e. [ ] Hip joint

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111. The factors which influence the intensity of pain in osteoarthritis are:
a. [X] Radiological changes stage
b. [ ] Patient’s sex
c. [ ] Environmental factors
d. [ ] Infectious factors
e. [ ] Period of year
112. Synovitis in osteoarthritis occurs more frequently in:
a. [ ] Hip joints
b. [ ] Small joints of the hand
c. [X] Knee joints
d. [ ] Ankle joints
e. [ ] Shoulder joints
113. The degenerative process in osteoarthritis is characterized by:
a. [ ] Usually leads to ankyloses
b. [ ] Has a rapid evolution
c. [X] Has a slow, insidious evolution
d. [ ] The onset is usually acute, presenting with synovitis
e. [ ] Presents with progressive inflammation
114. Secondary hip osteoarthritis is characterized by:
a. [X] Is usually unilateral
b. [ ] Is usually bilateral
c. [ ] Is strictly symmetrical
d. [ ] The disease onset is usually with associated homolateral knee osteoarthritis
e. [ ] The disease onset is usually with associated spinal column osteoarthritis
115. Choose the characteristic deformity in hand osteoarthritis:
a. [ ] Boutonniere” deformity
b. [ ] Ulnar deviation of fingers
c. [ ] “Swan-neck” deformity
d. [X] Heberden and/or Bouchard nodules
e. [ ] “Camel-back” deformity
116. Bouchard nodules are localized at the level of:
a. [X] Proximal interphalangeal joints of the upper extremities
b. [ ] Proximal interphalangeal joints of the lower extremities
c. [ ] Knee joints
d. [ ] Elbow joints
e. [ ] Shoulder joints
117. In hand osteoarthritis predominantly are affected:
a. [ ] Cubitocarpal joints
b. [ ] II and III metacarpophalangeal joints
c. [ ] IV metacarpophalangeal joints
d. [ ] Radiocarpal joints
e. [X] Risomelic joint of the thumb
118. Drugs with pathogenetical action in the treatment of osteoarthritis are:
a. [ ] Slow – acting symptomatic anti – osteoarthritis drugs.
b. [ ] Short – acting symptomatic treatment
c. [ ] Analgesics
d. [ ] Non-steroidal anti-inflammatory drugs
e. [X] Bisphosphonates

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119. Which of the following non-steroidal anti-inflammatory drugs have a negative influence on the cartilage metabolism:
a. [ ] Diclofenac
b. [X] Nimesulide
c. [ ] Meloxicam
d. [ ] Etoricoxib
e. [ ] Piroxicam

OSTEOPOROSIS

120. Osteoporosis is defined as a T-score on DEXA lower than:

a. [ ] 1.0 standard deviations (SD)
b. [ ] 1.1 standard deviations (SD)
c. [ ] -1.5 standard deviations (SD)
d. [ ] -2.0 standard deviations (SD)
e. [X] -2.5 standard deviations (SD)
121. The assessment of major osteoporotic fracture risk is done using:
a. [ ] Physical examination
b. [X] FRAX tool
c. [ ] DEXA densitometry
d. [ ] Ultrasound densitometry
e. [ ] Radiological exam
122. Choose the clinical expression of osteoporosis:
a. [ ] Fever
b. [X] Fragility fractures
c. [ ] Pain during bone percussion
d. [ ] Tetany
e. [ ] Marked weakness
123. A T-score of -1.1 at DEXA densitometry in a 65-year old patient is defined as:
a. [ ] Normal values
b. [X] Osteopenia
c. [ ] Osteoporosis
d. [ ] Severe osteoporosis
e. [ ] Increased value
124. The daily necessity in Vitamin D in a person older than 50 years is:
a. [ ] 600 international units
b. [ ] 700 international units
c. [X] 800 international units
d. [ ] 900 international units
e. [ ] 1000 international units
125. The mechanism of action of denosumab is:
a. [ ] Tumor necrosis factor-α blocker
b. [ ] IL-1 antagonist
c. [ ] RANKL antagonist
d. [X] RANKL action modulator
e. [ ] Osteoprotegerin antagonist

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126. The T-score in DEXA densitometry is:

a. [ ] Total bone mass
b. [ ] The risk for fragility fracture in the next 10 years, presented in percent
c. [X] The number of standard deviations of the bone mineral density (BMD) compared with values in a
healthy young subject
d. [ ] The number of standard deviations of the bone mineral density (BMD) compared with values in a
healthy subject of the same age and sex
e. [ ] Irradiation dose used
127. The Z-score in DEXA densitometry is:
a. [ ] Total bone mass
b. [ ] The risk for fragility fracture in the next 10 years, presented in percent
c. [ ] The number of standard deviations of the bone mineral density (BMD) compared with values in a
healthy young subject
d. [X] The number of standard deviations of the bone mineral density (BMD) compared with values in a
healthy subject of the same age and sex
e. [ ] Irradiation dose used
128. Select which of the following is a localization of major osteoporotic fractures:
a. [ ] Clavicle
b. [ ] Calcaneus
c. [ ] Mandible
d. [X] Proximal third of the femur
e. [ ] Sternum
129. In premenopausal women, for the diagnosis of osteoporosis, is used the following:
a. [ ] T-score, with final values adjustment
b. [X] Z-score
c. [ ] X-score
d. [ ] FRAX tool
e. [ ] Bone mineral density
130. Select the risk factor for the development of osteoporosis:
a. [ ] Repeated exposition to the sun
b. [X] Decreased body mass index (BMI)
c. [ ] Intense physical exercise
d. [ ] Excessive ionizing radiation exposure
e. [ ] Adequate vitamin D supplementation

SYSTEMIC SCLEROSIS

131. Which of the following factors DOES NOT promote de development of systemic sclerosis:
a. [ ] Vynil polychloride
b. [ ] Aromatic carbohydrates
c. [ ] Toxic oils
d. [ ] Bleomycin
e. [X] Prostacyclin
132. CREST syndrome is a variant of:
a. [X] Systemic sclerosis
b. [ ] Rheumatoid arthritis
c. [ ] Systemic lupus erythematosus
d. [ ] Ankylosing spondylitis
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e. [ ] Polymyositis
133. The following are diagnostic criteria for systemic sclerosis, with the exception of:
a. [ ] Raynaud syndrome
b. [ ] “Indurative edema”, thickening of skin
c. [ ] Pneumofibrosis
d. [ ] Digital ulcers
e. [X] Dysphagia
134. Renal involvement in systemic sclerosis is clinically manifested with:
a. [X] Malignant arterial hypertension
b. [ ] Renal calculi
c. [ ] Acute pyelonephritis
d. [ ] Renal polycystosis
e. [ ] Nephroptosis

GOUT

135. Which of the following risk factors are incriminated in the etiology of gout?
a. [ ] Female gender
b. [ ] Males
c. [X] Hyperuricemia
d. [ ] Environmental factors such as climate and urbanization
e. [ ] Physical inactivity
136. Specify which are characteristic hand deformities that occur during the development of gout:
a. [ ] Deformation in "buttonhole"
b. [X] Deformation "hand pseudorheumatoid"
c. [ ] Ulnar deviation of the fingers
d. [ ] Deformation in "gooseneck"
e. [ ] Ankylosis of distal interphalangeal joints
137. The common eye disease in patients with gout:
a. [ ] Scleritis
b. [ ] Episcleritis
c. [ ] Glaucoma
d. [X] Not characteristic
e. [ ] Cataracts
138. What are the manifestations of renal damage in gout?
a. [ ] Mesangial glomerulonephritis
b. [ ] Focal proliferative glomerulonephritis
c. [ ] Renal cystic dysplasia
d. [X] Nephrolithiasis
e. [ ] Nephrotic syndrome
139. Which of the following are most commonly affected joints in gout?
a. [ ] Distal interphalangeal
b. [ ] Proximal interphalangeal
c. [ ] Metacarpophalangeal
d. [ ] Knees
e. [X] MTF I

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140. The muscle manifestations of gout are:

a. [ ] Spontaneous muscle pain
b. [X] No characteristic
c. [ ] Muscular atrophy
d. [ ] Calcinosis
e. [ ] intramuscular phlegmon
141. Mechanism of gout identifies the following processes:
a. [ ] Initially affect endothelial cell
b. [X] The penetration of urate in synovial fluid
c. [ ] Fibroblasts secrete more fibronectin
d. [ ] Inhibits fibroblasts, mast cells
e. [ ] Monokines hinder the development of fibrosis
142. What aspects in chest radiograph may be present in patients with gout?
a. [ ] Diffuse interstitial fibrosis
b. [X] No characteristic
c. [ ] Crosslinking of the strip towards the base hilum
d. [ ] Honeycomb lung
e. [ ] Large opacities round
143. Patients with gout may show evolving radiological changes in the spine:
a. [ ] Vertebrae squares
b. [ ] Widening interlining articular space
c. [ ] Sindesmofites
d. [ ] Clamping of interlining articular joints facet
e. [ ] Appearance of column "bamboo cane"
144. In what damage glucorticosteroids are used in gout:
a. [ ] Pulmonary
b. [ ] Pericardium
c. [X] Joints refractory to NSAIDs and colchicine
d. [ ] Muscle
e. [ ] Stomach
145. Gout morphological criteria are considered:
a. [ ] Nodules Aschoft
b. [ ] Nodules Osler
c. [ ] Rheumatoid nodules
d. [ ] Nodules Geberden
e. [X] Nodules tofacee
146. The following preparations are used to treat gout, except:
a. [ ] Anti-inflammatory steroids
b. [ ] NSAIDs
c. [X] Immunosuppressive
d. [ ] Colchicine
e. [ ] Allopurinol
147. Gout nodules (tophi) are formations containing cell debris, leukocites and:
a. [ ] Collagen
b. [ ] Hydroxyapatite
c. [X] Uric acid
d. [ ] Lipoproteide
e. [ ] Charcot- Leyden crystals

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148. Gout inducing preparations are criminalized following except:

a. [ ] Furosemide
b. [X] Methylprednisolone
c. [ ] Warfarin
d. [ ] Low-dose aspirin
e. [ ] Vitamin B12
149. Injury of gout tofus may be reflected in the high level of:
a. [ ] Factor Fon Willenbrant
b. [ ] Rheumatoid factor
c. [ ] Hageman factor
d. [ ] Cholesterol
e. [X] Uric acid in the blood
150. Arthralgia in gout can be explained by:
a. [ ] Colagenusis of synovium
b. [ ] The degeneration of proteoglycans of articular cartilage
c. [X] Submission of uric acid crystals in joints
d. [ ] Submission of apatite crystals in joints
e. [ ] Subchondral osteoporosis
151. Gout is a disease caused by inborn or acquired abnormality of metabolism:
a. [ ] Carbohydrates
b. [X] Purine
c. [ ] Hydrate
d. [ ] Electrolyte
e. [ ] Energy
152. What is the favourite affected joint (the debut) in gout?
a. [ ] Radio-Carp
b. [X] MTF I
c. [ ] Knees
d. [ ] Shoulders
e. [ ] Bend
153. Bone erosions "punched-out", radiographically confirmed is essential criteria for:
a. [ ] Ankylosing Spondylitis
b. [ ] Systemic Lupus Erythematosus
c. [ ] Rheumatoid arthritis
d. [ ] Rheumatic fever
e. [X] Gout
154. What is usually the first manifestation of gout?
a. [X] MTF I joint arthritis
b. [ ] Asthma
c. [ ] Nephritis
d. [ ] Pneumonitis
e. [ ] Recurrent oral and genital ulcers

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POLYMYOSITIS / DERMATOMYOSITIS

155. The diagnosis of dermatomyositis is established based on the following criteria, with the exception of:
a. [ ] General weakness
b. [ ] Serum elevation of muscular enzymes
c. [X] Bone destruction
d. [ ] Electromyographic abnormalities
e. [ ] Muscular necrosis
156. The majority of patients with polymyositis and anti-Jo1 antibodies belong to the following phenotype:
a. [X] Myositis associated with interstitial pulmonary fibrosis
b. [ ] Mixed connective tissue disease
c. [ ] Systemic lupus erythematosus
d. [ ] Sjögren syndrome
e. [ ] CREST syndrome
157. Symptoms of gastroesophageal reflux in dermatomyositis are caused by:
a. [ ] Involvement of pharyngeal striated muscle
b. [X] Inferior esophageal sphincter dysfunction
c. [ ] Cholecystitis
d. [ ] Superior esophageal sphincter dysfunction
e. [ ] Enzymopathies
158. For the diagnosis of polymyositis the essential exploration is:
a. [ ] Magnetic resonance imaging
b. [ ] Skeletal scintigraphy
c. [X] Muscle biopsy
d. [ ] Computer tomography
e. [ ] Pancreatic enzymes assessment

MIXED CONNECTIVE TISSUE DISEASE

159. Mixed connective tissue disease is defined as:

a. [ ] The association of 2 or more diffuse connective tissue diseases
b. [ ] The association of 2 or more diffuse connective tissue diseases and the presence of anti-U1RNP antibodies
c. [ ] The association of symptoms of 2 or more diffuse connective tissue diseases
d. [X] The association of symptoms of 2 or more diffuse connective tissue diseases ant the presence of
anti-U1RNP antibodies
e. [ ] Any association of autoimmune diseases and the presence of anti-U1RNP antibodies
160. The criteria of mixed connective tissue disease include the following, except:
a. [ ] Raynaud phenomenon
b. [ ] Digital ulcers
c. [X] Synovitis
d. [ ] Sclerodactily
e. [ ] The presence of anti-U1RNP antibodies
161. The presence of anti-U1RNP antibodies is associated with:
a. [ ] Severe renal involvement
b. [X] Interstitial lung disease
c. [ ] Relatively good prognosis for organ involvement
d. [ ] Poor prognosis for organ involvement
e. [ ] The prognosis depends on patients’ age
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162. Choose the specific clinical manifestation for mixed connective tissue disease:
a. [ ] Malar rash
b. [X] Raynaud phenomenon
c. [ ] Gottron papules
d. [ ] Subcutaneous nodules
e. [ ] Jaccoud arthropathy

SJÖGREN SYNDROME

163. Secondary Sjögren syndrome can be found in the following diseases, except:
a. A. [ ] Chronic viral hepatitis
b. B. [ ] Chronic pancreatitis
c. C. [ ] HIV infection
d. D. [X] Sarcoidosis
e. E. [ ] Primary biliary cirrhosis
164. The specific ocular manifestation in Sjögren syndrome is:
a. A. [ ] Optic nerve neuritis
b. B. [ ] Retinopathy
c. C. [ ] Lacrimal duct abnormalities
d. D. [X] Xerophtalmia
e. E. [ ] Anterior uveitis
165. The specific oral manifestation in Sjögren syndrome is:
a. A. [ ] Lingual deposits
b. B. [ ] Parodontopathy
c. C. [X] Xerostomia
d. D. [ ] Gingivitis
e. E. [ ] Hard palate ulcers
166. The skin involvement found in Sjögren syndrome is:
a. A. [ ] Subcutaneous nodules
b. B. [ ] Malar rash
c. C. [ ] Nodular erythema
d. D. [X] Palpable purpura
e. E. [ ] Panniculitis
167. The systemic manifestations found in Sjögren syndrome are the following, except:
a. A. [ ] Non-erosive arthritis
b. B. [ ] Interstitial lung disease
c. C. [ ] Renal tubular acidosis
d. D. [ ] Palpable purpura
e. E. [X] Non-infectious endocarditis

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ACUTE RHEUMATIC FEVER

168. Select the specific morphological abnormality in acute rheumatic fever:

a. [ ] Rheumatoid nodules
b. [X] Aschoff nodules
c. [ ] Osler nodules
d. [ ] Heberden nodules
e. [ ] Tophaceous nodules
169. Select the duration of the latent period in acute rheumatic fever:
a. [ ] 1 – 2 months
b. [ ] 1 – 2 weeks
c. [X] 2 – 3 weeks
d. [ ] 2 – 4 months
e. [ ] 2 – 4 days
170. Select the age group most frequently affected by acute rheumatic fever:
a. [ ] 5 – 10 years
b. [ ] 7 – 12 years
c. [ ] 7 – 18 years
d. [X] 7 – 15 years
e. [ ] 5 -20 years
171. Select the main pathogenetical theory approved in the development of acute rheumatic fever:
a. [ ] infectious
b. [ ] toxic
c. [X] autoimmune
d. [ ] infectious – allergic
e. [ ] via circulating immune complexes
172. Select the most frequent cause of heart failure in acute rheumatic fever:
a. [ ] Fibrinous pericarditis
b. [ ] Exudative pericarditis
c. [ ] Parceled myocarditis
d. [X] Diffuse myocarditis
e. [ ] Endocarditis
173. Select the most sensitive index of the rheumatic process:
a. [ ] C-reactive protein
b. [X] Erythrocyte sedimentation rate
c. [ ] Leukocytosis
d. [ ] Fibrinogen elevation
e. [ ] Inflammatory dysproteinemia
174. Select the first-line group of antibacterial drugs in the treatment of acute rheumatic fever:
a. [ ] Macrolides
b. [ ] Tetracyclins
c. [X] Penicillins
d. [ ] Cephazolins
e. [ ] Aminoglycosides
175. Select the average duration of anti-inflammatory treatment in acute rheumatic fever:
a. [ ] 1 – 2 weeks
b. [X] 1.5 – 2 months
c. [ ] 2 – 3 months
d. [ ] 3 - 4 weeks
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e. [ ] 3 – 4 months
176. Select the drugs for secondary prophylaxis in acute rheumatic fever:
a. [X] Benzatinbenzylpenicillin G
b. [ ] Lincomycin
c. [ ] Trimethoprim
d. [ ] Nitrofurantoin
e. [ ] Norfloxacin
177. The duration of secondary prophylaxis in acute rheumatic fever without carditis is:
a. [ ] 3 years
b. [X] 5 years
c. [ ] 10 years
d. [ ] Until the age of 21
e. [ ] Lifelong

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