Immunology Questions & Answers for USMLE NBDE FMGE NEET PDF Free Download
1) A patient with rheumatoid arthritis presents to her physician and mentions
that after many years without teeth problems, she has recently developed
seven caries. This is a clue to her clinician that she should be evaluated for
which of the following diseases?
A. Oral squamous cell carcinoma
B. Polyarteritis nodosa
C. Sjögren’s syndrome
D. Systemic lupus erythematosus
The correct answer is C. Rheumatoid arthritis can coexist with a variety of
autoimmune diseases (including those listed in the answers),
but is most frequently associated with Sjögren’s syndrome.
Sjögren’s syndrome is due to autoimmune involvement with subsequent scarring of
the salivary and lacrimal glands, leading to dry eyes and dry mouth. Secondary
effects include parotid gland enlargement, dental caries, and recurrent
Squamous cell carcinoma of the mouth (choice A) is not associated with
dryness of the mouth.
Polyarteritis nodosa (choice B) is a systemic necrotizing vasculitis. Patients
present with lowgrade
fever,weakness, and weight loss. They may also have
abdominal pain, hematuria, renal failure, hypertension, and leukocytosis.
Systemic lupus erythematosus (choice D) is an autoimmune disease
characterized by vasculitis (which may produce a variety of symptoms depending
on the site of the lesion), rash, renal disease, hemolytic anemia, and neurologic
Thyrotoxicosis (choice E) produces insomnia, weight loss, tremors, heat
intolerance, excessive sweating, and frequent bowel movements or diarrhea.