Hydroxychloroquine retinopathy — SCE Rheumatology MCQ

Correct answer: E — Stop hydroxychloroquine after multidisciplinary confirmation

Stop hydroxychloroquine after ophthalmology and rheumatology review if toxicity is confirmed is the single best answer because long-duration hydroxychloroquine exposure can cause retinal toxicity. The stem is testing management choice, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Start methotrexate with folic acid and monitoring is less suitable because it fits a different clinical pattern or a different treatment threshold; Begin high-dose glucocorticoids immediately, Urgent joint aspiration and culture and Use NSAID therapy and physiotherapy 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: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions