Dermatomyositis — SCE Rheumatology MCQ

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EasyConnective Tissue DiseasesDermatomyositisSCE Rheumatology

A 28-year-old woman has proximal muscle weakness, dysphagia, heliotrope rash, Gottron papules and CK 4200 IU/L. What is the most appropriate biologic?

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Correct answer: A — Rituximab for refractory inflammatory myopathy

Rituximab for refractory inflammatory myopathy is the single best answer because pathognomonic skin signs with true proximal weakness and high CK indicate dermatomyositis. The stem is testing biologic selection, 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