Mixed connective tissue disease — SCE Rheumatology MCQ
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Correct answer: D — Mixed connective tissue disease
Mixed connective tissue disease is the single best answer because high anti-U1 RNP with overlapping connective tissue disease features supports mixed connective tissue disease. The stem is testing diagnostic synthesis, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Primary Sjögren's disease is less suitable because it fits a different clinical pattern or a different treatment threshold; Repeat ANA titre alone, Adalimumab and Rheumatoid arthritis 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