NSG 555 ACTUAL 2026 TEST PAPER QUESTIONS AND
SOLUTIONS GRADED A+
✔✔Antiplatelet option in treatment - ✔✔Low-dose aspirin to reduce ischemic
complications.
✔✔Raynaud Phenomenon - ✔✔Episodic vasospasm of small arteries in fingers/toes
precipitated by cold or stress.
✔✔Primary vs Secondary Raynaud Phenomenon - ✔✔Primary (idiopathic) vs
Secondary (associated with autoimmune diseases like scleroderma, SLE).
✔✔Triphasic color change in Raynaud Phenomenon - ✔✔White (ischemia) → blue
(cyanosis) → red (reperfusion).
✔✔Physical exam findings during Raynaud episodes - ✔✔Normal between attacks;
during episodes, blanching and cyanosis.
✔✔Initial diagnostics for Raynaud Phenomenon - ✔✔Nailfold capillaroscopy:
Differentiate primary vs secondary.
✔✔Management of Raynaud Phenomenon - ✔✔Nonpharmacologic (first line): Avoid
cold exposure, smoking cessation, stress management, warm clothing.
✔✔Pharmacologic treatment for Raynaud Phenomenon - ✔✔Calcium channel blockers
(CCBs) - Nifedipine, Amlodipine (first-line).
✔✔Chronic autoimmune disease causing RA - ✔✔Chronic autoimmune disease
causing symmetric inflammatory polyarthritis.
✔✔Pathophysiology of RA - ✔✔Synovial membrane inflammation → pannus formation
→ joint destruction.
✔✔Clinical presentation of RA - ✔✔Symmetric joint pain, swelling (MCP, PIP, wrist),
morning stiffness >1 hour.
✔✔Symmetric joint pain - ✔✔Joint pain that is equal on both sides of the body, often
accompanied by swelling, especially in MCP, PIP, and wrist joints.
✔✔Morning stiffness - ✔✔Stiffness in the joints that lasts for more than 1 hour after
waking up.
✔✔Extra-articular manifestations - ✔✔Symptoms that occur outside of the joints, such
as nodules, vasculitis, pericarditis, and scleritis.
, ✔✔Ulnar deviation - ✔✔A deformity where the fingers bend towards the ulnar side (the
side of the little finger).
✔✔Swan neck deformity - ✔✔A condition characterized by hyperextension of the
proximal interphalangeal joints and flexion of the distal interphalangeal joints.
✔✔Boutonnière deformity - ✔✔A deformity where the proximal interphalangeal joint is
flexed and the distal interphalangeal joint is extended.
✔✔Positive RF - ✔✔The presence of rheumatoid factor in the blood, indicating an
autoimmune response.
✔✔Anti-CCP antibodies - ✔✔Antibodies against cyclic citrullinated peptide, which have
high specificity for rheumatoid arthritis.
✔✔Elevated ESR/CRP - ✔✔Increased levels of erythrocyte sedimentation rate and C-
reactive protein, indicating inflammation.
✔✔Erosions and joint space narrowing - ✔✔Findings on X-ray that indicate damage to
the joints in rheumatoid arthritis.
✔✔Osteoarthritis (OA) - ✔✔A degenerative joint disease characterized by mechanical
wear and tear, asymmetric joint involvement, and no systemic symptoms.
✔✔Rheumatoid arthritis (RA) - ✔✔An inflammatory autoimmune disease characterized
by symmetric joint involvement and systemic findings.
✔✔First-line DMARD - ✔✔Methotrexate, a disease-modifying antirheumatic drug used
to treat rheumatoid arthritis.
✔✔Biologics - ✔✔Medications that target specific components of the immune system,
such as TNF inhibitors like Etanercept and Adalimumab.
✔✔NSAIDs - ✔✔Non-steroidal anti-inflammatory drugs used for symptom control during
flares.
✔✔Corticosteroids - ✔✔Anti-inflammatory medications like Prednisone used for short-
term management of symptoms.
✔✔Systemic Lupus Erythematosus (SLE) - ✔✔A chronic multisystem autoimmune
disease characterized by immune complex deposition leading to inflammation and
tissue damage.
SOLUTIONS GRADED A+
✔✔Antiplatelet option in treatment - ✔✔Low-dose aspirin to reduce ischemic
complications.
✔✔Raynaud Phenomenon - ✔✔Episodic vasospasm of small arteries in fingers/toes
precipitated by cold or stress.
✔✔Primary vs Secondary Raynaud Phenomenon - ✔✔Primary (idiopathic) vs
Secondary (associated with autoimmune diseases like scleroderma, SLE).
✔✔Triphasic color change in Raynaud Phenomenon - ✔✔White (ischemia) → blue
(cyanosis) → red (reperfusion).
✔✔Physical exam findings during Raynaud episodes - ✔✔Normal between attacks;
during episodes, blanching and cyanosis.
✔✔Initial diagnostics for Raynaud Phenomenon - ✔✔Nailfold capillaroscopy:
Differentiate primary vs secondary.
✔✔Management of Raynaud Phenomenon - ✔✔Nonpharmacologic (first line): Avoid
cold exposure, smoking cessation, stress management, warm clothing.
✔✔Pharmacologic treatment for Raynaud Phenomenon - ✔✔Calcium channel blockers
(CCBs) - Nifedipine, Amlodipine (first-line).
✔✔Chronic autoimmune disease causing RA - ✔✔Chronic autoimmune disease
causing symmetric inflammatory polyarthritis.
✔✔Pathophysiology of RA - ✔✔Synovial membrane inflammation → pannus formation
→ joint destruction.
✔✔Clinical presentation of RA - ✔✔Symmetric joint pain, swelling (MCP, PIP, wrist),
morning stiffness >1 hour.
✔✔Symmetric joint pain - ✔✔Joint pain that is equal on both sides of the body, often
accompanied by swelling, especially in MCP, PIP, and wrist joints.
✔✔Morning stiffness - ✔✔Stiffness in the joints that lasts for more than 1 hour after
waking up.
✔✔Extra-articular manifestations - ✔✔Symptoms that occur outside of the joints, such
as nodules, vasculitis, pericarditis, and scleritis.
, ✔✔Ulnar deviation - ✔✔A deformity where the fingers bend towards the ulnar side (the
side of the little finger).
✔✔Swan neck deformity - ✔✔A condition characterized by hyperextension of the
proximal interphalangeal joints and flexion of the distal interphalangeal joints.
✔✔Boutonnière deformity - ✔✔A deformity where the proximal interphalangeal joint is
flexed and the distal interphalangeal joint is extended.
✔✔Positive RF - ✔✔The presence of rheumatoid factor in the blood, indicating an
autoimmune response.
✔✔Anti-CCP antibodies - ✔✔Antibodies against cyclic citrullinated peptide, which have
high specificity for rheumatoid arthritis.
✔✔Elevated ESR/CRP - ✔✔Increased levels of erythrocyte sedimentation rate and C-
reactive protein, indicating inflammation.
✔✔Erosions and joint space narrowing - ✔✔Findings on X-ray that indicate damage to
the joints in rheumatoid arthritis.
✔✔Osteoarthritis (OA) - ✔✔A degenerative joint disease characterized by mechanical
wear and tear, asymmetric joint involvement, and no systemic symptoms.
✔✔Rheumatoid arthritis (RA) - ✔✔An inflammatory autoimmune disease characterized
by symmetric joint involvement and systemic findings.
✔✔First-line DMARD - ✔✔Methotrexate, a disease-modifying antirheumatic drug used
to treat rheumatoid arthritis.
✔✔Biologics - ✔✔Medications that target specific components of the immune system,
such as TNF inhibitors like Etanercept and Adalimumab.
✔✔NSAIDs - ✔✔Non-steroidal anti-inflammatory drugs used for symptom control during
flares.
✔✔Corticosteroids - ✔✔Anti-inflammatory medications like Prednisone used for short-
term management of symptoms.
✔✔Systemic Lupus Erythematosus (SLE) - ✔✔A chronic multisystem autoimmune
disease characterized by immune complex deposition leading to inflammation and
tissue damage.
