Behçet's disease — SCE Rheumatology MCQ

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EasyVasculitisBehçet's diseaseSCE Rheumatology

A 31-year-old woman has recurrent painful oral ulcers, genital ulcers, anterior uveitis, positive pathergy and venous thrombosis. What is the most appropriate management?

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Correct answer: D — Use urgent systemic immunosuppression for posterior uveitis or retinal vasculitis

Use urgent systemic immunosuppression for posterior uveitis or retinal vasculitis is the single best answer because recurrent oral and genital ulceration with uveitis and pathergy suggests Behçet's disease. The stem is testing management choice, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Migraine is less suitable because it fits a different clinical pattern or a different treatment threshold; Sarcoidosis, Aspirin monotherapy and Etanercept do not address the key discriminator in this vignette. Clinical pearl: in SCE-style rheumatology questions, autoantibodies, imaging and synovial fluid findings should be interpreted with the whole phenotype.

Reference: BSR/EULAR vasculitis recommendations; NICE technology appraisals; BNF