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Antiphospholipid syndrome — SCE Rheumatology MCQ

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ModerateConnective Tissue DiseasesAntiphospholipid syndromeSCE Rheumatology

A 32-year-old woman has recurrent miscarriages, an unprovoked proximal DVT and persistent lupus anticoagulant with high anticardiolipin IgG 14 weeks apart. What is the most appropriate management?

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Correct answer: CUse vitamin K antagonist anticoagulation for thrombotic high-risk APS

Use vitamin K antagonist anticoagulation for thrombotic high-risk APS is the single best answer because thrombosis plus persistent antiphospholipid antibodies establishes APS. The stem is testing management choice, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Mixed connective tissue disease is less suitable because it fits a different clinical pattern or a different treatment threshold; Primary Sjögren's disease, Repeat ANA titre alone and Adalimumab 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 connective tissue disease recommendations; BNF