Rheumatology: haemochromatosis arthropathy: practice question

A General Medicine 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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General Medicine · Rheumatology: haemochromatosis arthropathy

Sample item

A 52-year-old man with diabetes and bronze skin has pain in the second and third metacarpophalangeal joints. Radiographs show hook-like osteophytes and chondrocalcinosis of the knees. Which test is the best next step?

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

The answer and the reasoning

C. Transferrin saturation with serum ferritin

Arthropathy of the second and third MCP joints with hook osteophytes and chondrocalcinosis in a diabetic with bronze skin suggests haemochromatosis. Raised transferrin saturation and ferritin are the first tests, followed by HFE genotyping.

Option by option

  • A. Serum uric acid

    Serum uric acid would assess gout, which does not explain this radiograph.

  • B. HLA-B27 typing

    HLA-B27 testing is relevant to spondyloarthritis rather than this pattern.

  • C. Transferrin saturation with serum ferritin (correct)

    Correct. Iron studies confirm the suspected iron overload.

  • D. Anti-CCP antibody

    Anti-CCP antibody supports rheumatoid arthritis, which spares these hook changes.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Transferrin saturation with serum ferritin. Arthropathy of the second and third MCP joints with hook osteophytes and chondrocalcinosis in a diabetic with bronze skin suggests haemochromatosis.

Why is "Serum uric acid" not the answer?

Serum uric acid would assess gout, which does not explain this radiograph.

Why is "HLA-B27 typing" not the answer?

HLA-B27 testing is relevant to spondyloarthritis rather than this pattern.

Why is "Anti-CCP antibody" not the answer?

Anti-CCP antibody supports rheumatoid arthritis, which spares these hook changes.

What concept does this question test?

It tests Rheumatology: haemochromatosis arthropathy in General Medicine. Raised transferrin saturation and ferritin are the first tests, followed by HFE genotyping.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Rheumatology: haemochromatosis arthropathy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.