Uvea: HLA-B27 acute anterior uveitis: practice question

A Ophthalmology 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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Ophthalmology · Uvea: HLA-B27 acute anterior uveitis

Sample item

A 28-year-old man has recurrent episodes of unilateral acute anterior uveitis, the right and left eyes being affected at different times. He also has low back pain that is worse in the morning and improves with exercise. Which systemic disease should be sought?

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

The answer and the reasoning

B. Ankylosing spondylitis

Recurrent, alternating, non-granulomatous acute anterior uveitis in a young man, often HLA-B27 positive, is strongly associated with ankylosing spondylitis. Inflammatory back pain that eases with exercise points to the spine as the source.

Option by option

  • A. Rheumatoid arthritis

    Rheumatoid arthritis is associated with scleritis and keratoconjunctivitis sicca more than with acute anterior uveitis.

  • B. Ankylosing spondylitis (correct)

    Correct. Alternating acute anterior uveitis with inflammatory back pain suggests ankylosing spondylitis.

  • C. Sarcoidosis

    Sarcoidosis causes granulomatous uveitis with hilar lymphadenopathy, not inflammatory back pain.

  • D. Behcet disease

    Behcet disease causes oral and genital ulcers with a hypopyon uveitis and retinal vasculitis.

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 Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is B, Ankylosing spondylitis. Recurrent, alternating, non-granulomatous acute anterior uveitis in a young man, often HLA-B27 positive, is strongly associated with ankylosing spondylitis.

Why is "Rheumatoid arthritis" not the answer?

Rheumatoid arthritis is associated with scleritis and keratoconjunctivitis sicca more than with acute anterior uveitis.

Why is "Sarcoidosis" not the answer?

Sarcoidosis causes granulomatous uveitis with hilar lymphadenopathy, not inflammatory back pain.

Why is "Behcet disease" not the answer?

Behcet disease causes oral and genital ulcers with a hypopyon uveitis and retinal vasculitis.

What concept does this question test?

It tests Uvea: HLA-B27 acute anterior uveitis in Ophthalmology. Inflammatory back pain that eases with exercise points to the spine as the source.

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 Uvea: HLA-B27 acute anterior uveitis?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology 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.