Pediatric Rheumatology – ABIM Style EXAM
QUESTIONS WITH CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |INSTANT
DOWNLOAD PDF
1. A 7-year-old girl presents with fever, rash, and arthritis.
Labs show elevated ESR and CRP, and ferritin is very high.
Which diagnosis is most likely?
A. Systemic Juvenile Idiopathic Arthritis (sJIA)
B. Oligoarticular JIA
C. Kawasaki Disease
D. Acute Rheumatic Fever
Answer: A. Systemic Juvenile Idiopathic Arthritis (sJIA)
Rationale: sJIA presents with quotidian fevers, evanescent rash,
arthritis, and very high ferritin. Labs often show elevated
ESR/CRP and leukocytosis.
2. What is the most common cause of uveitis in children with
juvenile idiopathic arthritis (JIA)?
A. Oligoarticular JIA
B. Polyarticular JIA
C. Systemic JIA
D. Enthesitis-related JIA
,Answer: A. Oligoarticular JIA
Rationale: Chronic anterior uveitis is most commonly associated
with oligoarticular JIA, particularly in ANA-positive children.
3. Which laboratory test is most specific for diagnosing
systemic lupus erythematosus (SLE) in children?
A. ANA
B. Anti-dsDNA
C. ESR
D. CRP
Answer: B. Anti-dsDNA
Rationale: Anti-dsDNA antibodies are highly specific for SLE,
whereas ANA is sensitive but not specific.
4. A 10-year-old boy presents with recurrent mouth ulcers,
genital ulcers, and eye inflammation. Which condition is most
likely?
A. Henoch-Schönlein Purpura
B. Behçet Disease
C. Kawasaki Disease
D. Systemic JIA
Answer: B. Behçet Disease
Rationale: Behçet disease is characterized by recurrent
oral/genital ulcers and ocular involvement.
,5. Which of the following is the first-line therapy for
oligoarticular JIA?
A. Methotrexate
B. NSAIDs
C. TNF-alpha inhibitors
D. Corticosteroids
Answer: B. NSAIDs
Rationale: NSAIDs are first-line for symptom control in
oligoarticular JIA. DMARDs or biologics are reserved for
persistent or severe disease.
6. A child presents with palpable purpura on the lower
extremities, arthritis, abdominal pain, and hematuria. What is
the most likely diagnosis?
A. Henoch-Schönlein Purpura (IgA Vasculitis)
B. Kawasaki Disease
C. Polyarteritis Nodosa
D. Microscopic Polyangiitis
Answer: A. Henoch-Schönlein Purpura (IgA Vasculitis)
Rationale: Classic tetrad includes purpura (especially lower
extremities), arthralgia/arthritis, abdominal pain, and renal
involvement.
7. Which antibody is most commonly associated with juvenile
dermatomyositis (JDM)?
, A. ANA
B. Anti-Mi-2
C. Anti-dsDNA
D. RF
Answer: B. Anti-Mi-2
Rationale: Anti-Mi-2 antibodies are associated with classic JDM,
particularly with prominent skin involvement and good
prognosis.
8. Which clinical feature differentiates systemic JIA from other
JIA subtypes?
A. Symmetric small joint arthritis
B. High-spiking quotidian fevers
C. Chronic anterior uveitis
D. Enthesitis
Answer: B. High-spiking quotidian fevers
Rationale: sJIA is distinguished by quotidian fevers and systemic
features (rash, hepatosplenomegaly) in addition to arthritis.
9. What is the first-line treatment for Kawasaki Disease to
prevent coronary artery aneurysms?
A. NSAIDs
B. IVIG and aspirin
C. Methotrexate
D. Corticosteroids
QUESTIONS WITH CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |INSTANT
DOWNLOAD PDF
1. A 7-year-old girl presents with fever, rash, and arthritis.
Labs show elevated ESR and CRP, and ferritin is very high.
Which diagnosis is most likely?
A. Systemic Juvenile Idiopathic Arthritis (sJIA)
B. Oligoarticular JIA
C. Kawasaki Disease
D. Acute Rheumatic Fever
Answer: A. Systemic Juvenile Idiopathic Arthritis (sJIA)
Rationale: sJIA presents with quotidian fevers, evanescent rash,
arthritis, and very high ferritin. Labs often show elevated
ESR/CRP and leukocytosis.
2. What is the most common cause of uveitis in children with
juvenile idiopathic arthritis (JIA)?
A. Oligoarticular JIA
B. Polyarticular JIA
C. Systemic JIA
D. Enthesitis-related JIA
,Answer: A. Oligoarticular JIA
Rationale: Chronic anterior uveitis is most commonly associated
with oligoarticular JIA, particularly in ANA-positive children.
3. Which laboratory test is most specific for diagnosing
systemic lupus erythematosus (SLE) in children?
A. ANA
B. Anti-dsDNA
C. ESR
D. CRP
Answer: B. Anti-dsDNA
Rationale: Anti-dsDNA antibodies are highly specific for SLE,
whereas ANA is sensitive but not specific.
4. A 10-year-old boy presents with recurrent mouth ulcers,
genital ulcers, and eye inflammation. Which condition is most
likely?
A. Henoch-Schönlein Purpura
B. Behçet Disease
C. Kawasaki Disease
D. Systemic JIA
Answer: B. Behçet Disease
Rationale: Behçet disease is characterized by recurrent
oral/genital ulcers and ocular involvement.
,5. Which of the following is the first-line therapy for
oligoarticular JIA?
A. Methotrexate
B. NSAIDs
C. TNF-alpha inhibitors
D. Corticosteroids
Answer: B. NSAIDs
Rationale: NSAIDs are first-line for symptom control in
oligoarticular JIA. DMARDs or biologics are reserved for
persistent or severe disease.
6. A child presents with palpable purpura on the lower
extremities, arthritis, abdominal pain, and hematuria. What is
the most likely diagnosis?
A. Henoch-Schönlein Purpura (IgA Vasculitis)
B. Kawasaki Disease
C. Polyarteritis Nodosa
D. Microscopic Polyangiitis
Answer: A. Henoch-Schönlein Purpura (IgA Vasculitis)
Rationale: Classic tetrad includes purpura (especially lower
extremities), arthralgia/arthritis, abdominal pain, and renal
involvement.
7. Which antibody is most commonly associated with juvenile
dermatomyositis (JDM)?
, A. ANA
B. Anti-Mi-2
C. Anti-dsDNA
D. RF
Answer: B. Anti-Mi-2
Rationale: Anti-Mi-2 antibodies are associated with classic JDM,
particularly with prominent skin involvement and good
prognosis.
8. Which clinical feature differentiates systemic JIA from other
JIA subtypes?
A. Symmetric small joint arthritis
B. High-spiking quotidian fevers
C. Chronic anterior uveitis
D. Enthesitis
Answer: B. High-spiking quotidian fevers
Rationale: sJIA is distinguished by quotidian fevers and systemic
features (rash, hepatosplenomegaly) in addition to arthritis.
9. What is the first-line treatment for Kawasaki Disease to
prevent coronary artery aneurysms?
A. NSAIDs
B. IVIG and aspirin
C. Methotrexate
D. Corticosteroids
