Immunology: scleroderma antibodies: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Microbiology · Immunology: scleroderma antibodies

Sample item

A 45-year-old woman has had Raynaud phenomenon for ten years, with subcutaneous calcinosis, facial telangiectasia and sclerodactyly. Skin thickening is limited to the fingers and face. There is no interstitial lung disease or renal crisis. Which autoantibody is most likely to be found?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Anti-centromere antibody

Limited cutaneous systemic sclerosis (the CREST pattern) is strongly associated with anti-centromere antibodies and carries a risk of pulmonary arterial hypertension. Diffuse disease is linked to anti-topoisomerase I, which predicts interstitial lung disease, and to anti-RNA polymerase III, which predicts scleroderma renal crisis.

Option by option

  • A. Anti-centromere antibody (correct)

    Anti-centromere antibody is the classic marker of limited cutaneous disease with a long Raynaud history.

  • B. Anti-Jo-1 antibody

    Anti-Jo-1 is a marker of the antisynthetase syndrome with myositis and lung disease, not sclerosis.

  • C. Anti-RNA polymerase III antibody

    Anti-RNA polymerase III is associated with rapidly progressive diffuse disease and renal crisis, which are absent here.

  • D. Anti-topoisomerase I (anti-Scl-70) antibody

    Anti-Scl-70 is associated with diffuse skin involvement and pulmonary fibrosis, which are absent here.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is A, Anti-centromere antibody. Limited cutaneous systemic sclerosis (the CREST pattern) is strongly associated with anti-centromere antibodies and carries a risk of pulmonary arterial hypertension.

Why is "Anti-Jo-1 antibody" not the answer?

Anti-Jo-1 is a marker of the antisynthetase syndrome with myositis and lung disease, not sclerosis.

Why is "Anti-RNA polymerase III antibody" not the answer?

Anti-RNA polymerase III is associated with rapidly progressive diffuse disease and renal crisis, which are absent here.

Why is "Anti-topoisomerase I (anti-Scl-70) antibody" not the answer?

Anti-Scl-70 is associated with diffuse skin involvement and pulmonary fibrosis, which are absent here.

What concept does this question test?

It tests Immunology: scleroderma antibodies in Microbiology. Diffuse disease is linked to anti-topoisomerase I, which predicts interstitial lung disease, and to anti-RNA polymerase III, which predicts scleroderma renal crisis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Immunology: scleroderma antibodies?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.