skip to main content

Systemic sclerosis — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

HardConnective tissue diseasesSystemic sclerosisSCE Rheumatology

A 58-year-old woman has limited cutaneous systemic sclerosis with anticentromere antibodies, Raynaud phenomenon and a falling transfer factor despite preserved FVC. Which complication should annual surveillance particularly target?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Pulmonary arterial hypertension, within a rheumatology pathway

The best answer is “Pulmonary arterial hypertension, within a rheumatology pathway”. Pulmonary arterial hypertension is a major late complication of limited anticentromere-positive systemic sclerosis; annual screening uses symptoms, lung function, echocardiography and biomarkers within a structured pathway. The remaining choices—“Scleroderma renal crisis, with clinical reassessment”, “Inflammatory myopathy, after safety review, within a rheumatology pathway”, “Autoimmune hepatitis, after specialist assessment, after safety review”, “Atlantoaxial subluxation, with clinical reassessment, after specialist assessment”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.

Reference: BSR 2024 systemic sclerosis guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC11534099/