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MRCP Part 1 Rheumatology — 25 Practice MCQs with Explanations

TL;DR

This guide offers MRCP Part 1 Rheumatology — 25 Practice MCQs with Explanations to help you strengthen core exam areas such as autoimmune serology, arthritis patterns, and vasculitis. Each question mirrors MRCP-style reasoning with concise explanations. You’ll also find a revision checklist, pitfalls to avoid, and trusted study links to build mastery efficiently.


Why this matters

Rheumatology contributes roughly 8–12 questions in each MRCP Part 1 examination. These aren’t simple recall questions—they test integrated understanding of immunology, pharmacology, and systemic disease patterns. Many candidates lose marks due to confusing antibody profiles, misinterpreting clinical clues, or skipping mock-based revision.

This post from Crack Medicine consolidates high-yield Rheumatology MCQs, real-exam style logic, and structured study advice—helping you prepare smarter, not longer.


Core areas to master

Below are the five most frequently tested Rheumatology subtopics in MRCP Part 1, with quick recall cues:

  1. Rheumatoid Arthritis (RA) — Anti-CCP is more specific than RF; look for morning stiffness >1 hour and nodules.

  2. Systemic Lupus Erythematosus (SLE) — Anti-dsDNA indicates renal involvement; anti-Sm is specific but less sensitive.

  3. Vasculitides — GPA (Wegener’s) shows c-ANCA + ENT and renal disease; Microscopic Polyangiitis shows p-ANCA.

  4. Seronegative Spondyloarthropathies — HLA-B27 +, axial involvement, dactylitis, and enthesitis.

  5. Crystal Arthropathies — Gout = negatively birefringent monosodium urate; pseudogout = positively birefringent CPPD.

High-yield quick review

  1. Methotrexate pneumonitis → restrictive defect on spirometry.

  2. ESR/CRP may remain normal in active SLE.

  3. PAN spares lungs; GPA involves sinuses and lungs.

  4. Sjögren’s → parotid swelling + anti-Ro/La.

  5. Limited cutaneous SSc = CREST variant.

  6. Gout attacks precipitated by alcohol or diuretics.

  7. Hydroxychloroquine → retinal toxicity, needs baseline eye exam.

  8. Anti-Jo-1 → polymyositis; Anti-Mi-2 → dermatomyositis.

  9. Leflunomide → hepatotoxicity, teratogenicity.

  10. HLA-B27 arthropathies include AS, reactive, psoriatic, IBD-associated.


Practical examples / mini-cases

Example 1 — Clinical clue integration

A 35-year-old woman has arthralgia, photosensitive malar rash, and proteinuria. ANA and anti-dsDNA are positive. Diagnosis: Systemic Lupus Erythematosus (SLE).

Explanation: The triad of photosensitivity, arthritis, and renal involvement with positive anti-dsDNA confirms SLE. Low C3/C4 complement levels signal flare activity. See NICE overview on Systemic lupus erythematosus management.

Example 2 — Drug mechanism trap

Question: Which DMARD inhibits dihydrofolate reductase?A) Sulfasalazine B) Leflunomide C) Methotrexate D) Hydroxychloroquine

Answer: C) Methotrexate. Explanation: Methotrexate blocks folate metabolism; co-prescribe 5 mg folic acid weekly to limit mucositis and marrow toxicity.

Example 3 — Imaging pattern

A 32-year-old man with ulcerative colitis develops chronic back stiffness. Finding: Bamboo spine due to syndesmophyte formation in Ankylosing Spondylitis.Review radiographic hallmarks via Radiopaedia: Ankylosing spondylitis.


Compact 5-day revision table

Day

Focus

Task

1

Rheumatoid arthritis

Review joints, antibodies, and DMARD ladder

2

SLE & Sjögren’s

Create antibody table, memorise organ features

3

Vasculitis

Compare c-ANCA vs p-ANCA; recall affected organs

4

Seronegative arthropathies

Revise HLA-B27 links & imaging

5

Crystal arthropathies

Practise 20 timed MCQs + error log

Medical student studying rheumatology for MRCP Part 1 with textbooks and joint diagrams on desk.

Study-tip checklist

  • Attempt 50 Rheumatology MCQs weekly using Crack Medicine’s Free MRCP QBank.

  • Use spaced repetition—revisit explanations at 2- and 7-day intervals.

  • Simulate real pressure with a full-length Mock Test.

  • Build a visual antibody chart (anti-dsDNA, anti-CCP, ANCA, anti-Jo-1).

  • Dedicate one weekend each month solely to immune & connective tissue integration.


Common pitfalls

  • Mixing up antibody patterns: Focus on function-linked antibodies, not lists.

  • Ignoring extra-articular clues: Eyes, kidneys, lungs often clinch the diagnosis.

  • Overlooking DMARD side-effects: These are frequent question stems.

  • Avoiding timed mocks: Accuracy alone won’t secure marks—speed counts.

  • Neglecting overlap syndromes: SLE–scleroderma–myositis combinations are fair game.


FAQs

1. How many Rheumatology questions appear in MRCP Part 1?

Typically 8–12 questions, often intertwined with immunology and pharmacology.

2. Which books are best for MRCP Part 1 Rheumatology?

Use Kumar & Clark, Oxford Handbook of Clinical Medicine, and Crack Medicine QBank explanations.

3. How often should I take a mock test?

Every 10–14 days; regular mocks enhance time management and diagnostic recall.

4. What’s the hardest Rheumatology topic for most candidates?Distinguishing systemic vasculitides—master ANCA patterns and organ involvement.

5. Where can I read official MRCP(UK) guidance?

On the MRCP(UK) official site.


Ready to start?

For a structured roadmap, visit the MRCP Part 1 overview hub. Practise systematically with the Free MRCP MCQs QBank and measure progress through Mock Tests. Strengthen reasoning with Crack Medicine’s in-depth Rheumatology lectures and clinical notes for sustainable retention.


Sources

 
 
 

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