Rheumatology: anti-RNA polymerase III antibody: 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: anti-RNA polymerase III antibody

Sample item

A 50-year-old man with diffuse cutaneous systemic sclerosis has skin thickening that is spreading quickly. He is counselled to check his blood pressure at home daily. Which antibody makes this advice most important?

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

The answer and the reasoning

B. Anti-RNA polymerase III

Anti-RNA polymerase III antibodies identify patients with rapidly progressive diffuse skin disease who carry the highest risk of scleroderma renal crisis. Home blood pressure monitoring allows early ACE inhibitor treatment.

Option by option

  • A. Anti-U1 RNP

    Anti-U1 RNP defines mixed connective tissue disease and is not the main marker of renal crisis risk.

  • B. Anti-RNA polymerase III (correct)

    Correct. This antibody predicts fast skin progression and a high risk of renal crisis.

  • C. Anti-centromere

    Anti-centromere antibody is associated with limited disease and a low risk of renal crisis.

  • D. Anti-histone

    Anti-histone antibody is typical of drug-induced lupus, which does not cause scleroderma kidney.

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 B, Anti-RNA polymerase III. Anti-RNA polymerase III antibodies identify patients with rapidly progressive diffuse skin disease who carry the highest risk of scleroderma renal crisis.

Why is "Anti-U1 RNP" not the answer?

Anti-U1 RNP defines mixed connective tissue disease and is not the main marker of renal crisis risk.

Why is "Anti-centromere" not the answer?

Anti-centromere antibody is associated with limited disease and a low risk of renal crisis.

Why is "Anti-histone" not the answer?

Anti-histone antibody is typical of drug-induced lupus, which does not cause scleroderma kidney.

What concept does this question test?

It tests Rheumatology: anti-RNA polymerase III antibody in General Medicine. Home blood pressure monitoring allows early ACE inhibitor treatment.

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 Rheumatology: anti-RNA polymerase III antibody?

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.