skip to main content

Systemic Sclerosis — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

HardConnective Tissue & VasculitisSystemic SclerosisSCE Dermatology

A patient with limited cutaneous systemic sclerosis has normal exercise tolerance but DLCO has fallen from 72% to 51% predicted over one year. FVC is stable. Which screening response is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Reassess for pulmonary arterial hypertension with echocardiography, NT-proBNP and a validated screening pathway

Explanation lettering: C = shown as A · E = shown as B · B = shown as C · A = shown as D · D = shown as E

D is correct. A disproportionate fall in DLCO can be an early clue to pulmonary arterial hypertension in systemic sclerosis, including limited cutaneous disease. Annual structured surveillance integrates symptoms, lung function, echocardiography and biomarkers such as NT-proBNP; algorithms such as DETECT are used in appropriate higher-risk patients. Echocardiography is a screening tool, while right-heart catheterisation confirms the diagnosis before disease-specific treatment. High-resolution CT evaluates interstitial lung disease but does not replace pulmonary vascular assessment, and stable FVC does not make the DLCO trend benign.

Reference: British Society for Rheumatology guideline for systemic sclerosis: https://academic.oup.com/rheumatology/article/63/11/2956/7750184