ESTER Reumatologia Practice Questions - Título de Especialista em Reumatologia (Sociedade Brasileira de Reumatologia AMB) Exam - ESTER Reumatologia Practice Questions - Título de Especialista em Reumatologia (Sociedade Brasileira de Reumatologia AMB) Exam

Question 1

A 26-year-old woman presents with polyarthralgias, malar erythema, and mild proteinuria (0.6 g/24h). Indirect immunofluorescence on HEp-2 cells reveals an antinuclear antibody (ANA / FAN) titer of 1:1280 with a homogeneous nuclear pattern (ICAP AC-1). In the International Consensus on ANA Patterns (ICAP), which autoantigens are primarily associated with the AC-1 homogeneous pattern?

Double-stranded DNA (dsDNA), histones, and nucleosomes SSA/Ro60, SSA/Ro52, and SSB/La ribonucleoproteins Centromere proteins A, B, and C (CENP-A/B/C) Sm core proteins (B/B', D1, D2, D3, E, F, G) and U1-snRNP

Correct Answer:

Double-stranded DNA (dsDNA), histones, and nucleosomes

Question 2

An antinuclear antibody test performed by indirect immunofluorescence on HEp-2 cells demonstrates a fine speckled nuclear pattern designated as AC-4 by the International Consensus on ANA Patterns (ICAP). Which target autoantigen pair is most characteristically associated with this staining pattern?

Sm and U1-RNP spliceosomal proteins SSA/Ro and SSB/La ribonucleoproteins Topoisomerase I (Scl-70) and RNA Polymerase III Histidyl-tRNA synthetase (Jo-1) and SRP

Correct Answer:

SSA/Ro and SSB/La ribonucleoproteins

Question 3

A 45-year-old woman is evaluated for symmetric inflammatory polyarthritis of the wrists, metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints lasting 10 weeks. Serologic evaluation reveals high titers of anti-cyclic citrullinated peptide (anti-CCP / ACPA) antibodies and IgM rheumatoid factor (RF). Regarding the pathophysiology and clinical significance of ACPA compared to RF, which statement is most accurate?

ACPA recognizes post-translationally modified peptides where lysine is converted to citrulline by peptidylarginine deiminase (PAD) enzymes, exhibiting higher diagnostic specificity (>95%) and prognostic power for erosive disease than RF. ACPA is an IgM autoantibody directed against the Fc portion of IgG, with lower diagnostic specificity than RF in early rheumatoid arthritis. ACPA recognizes post-translationally modified arginine residues converted to citrulline by peptidylarginine deiminase (PAD) enzymes, demonstrating significantly higher specificity (>95%) and predicting radiographic progression. ACPA titers fluctuate directly with daily clinical disease activity, serving as the preferred laboratory marker over CRP to guide immediate monthly DMARD dose adjustments.

Correct Answer:

ACPA recognizes post-translationally modified arginine residues converted to citrulline by peptidylarginine deiminase (PAD) enzymes, demonstrating significantly higher specificity (>95%) and predicting radiographic progression.

Question 4

A 52-year-old woman presents with severe Raynaud phenomenon, sclerodactyly limited to the fingers and hands distal to the metacarpophalangeal joints, multiple facial telangiectasias, and subcutaneous calcinosis on the finger pads. Capillaroscopy shows enlarged giant capillaries without severe avascular areas. Which autoantibody profile is most characteristically associated with this clinical phenotype and confers a higher risk of isolated pulmonary arterial hypertension (PAH)?

Anti-Topoisomerase I antibodies (Anti-Scl-70) Anti-RNA Polymerase III antibodies Anti-U3 RNP (Anti-Fibrillarin) antibodies Anti-Centromere antibodies (ACA / CENP-B)

Correct Answer:

Anti-Centromere antibodies (ACA / CENP-B)

Question 5

A 48-year-old male with rapidly progressive diffuse cutaneous systemic sclerosis of 8 months duration undergoes routine serologic testing. Laboratory evaluation confirms high titers of anti-RNA polymerase III antibodies. Which clinical complication requires close surveillance in this patient due to its strong association with this antibody?

Scleroderma renal crisis (SRC) and synchronous internal malignancy Isolated severe pulmonary arterial hypertension without lung fibrosis Severe malabsorptive small bowel bacterial overgrowth syndrome Recurrent non-infectious pericardial tamponade

Correct Answer:

Scleroderma renal crisis (SRC) and synchronous internal malignancy

Question 1

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Prepare with the ESTER Reumatologia Practice Questions - Título de Especialista em Reumatologia (Sociedade Brasileira de Reumatologia AMB) Exam practice quiz. This question bank includes 100 questions covering year-old, arthritis, rheumatoid, woman, and clinical. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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ESTER Reumatologia Practice Questions - Título de Especialista em Reumatologia (Sociedade Brasileira de Reumatologia AMB) Exam

This practice set contains 100 questions from the matching question bank and focuses on year-old, arthritis, rheumatoid, woman, and clinical. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

This is an independent study resource intended for practice and review; it is not an official examination or an endorsement by any organization named in the title.

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ESTER Reumatologia Practice Questions - Título de Especialista em Reumatologia (Sociedade Brasileira de Reumatologia AMB) Exam

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