ABIM Rheumatology case studies
ABIM Rheumatology · Put your knowledge to work in context.
The ABIM Rheumatology Certification Examination is the American Board of Internal Medicine's subspecialty certifying assessment for physicians who have completed rheumatology fellowship training and wish to demonstrate the knowledge, clinical judgment, and skills required for independent practice in rheumatology. According to ABIM, certification examinations assess the knowledge, clinical judgment and skills essential for providing high-quality care in internal medicine and its subspecialties, and certification demonstrates that a physician is ready for independent practice. The ABIM Rheumatology case studies are 5 cases and about 2,029 words.
1New Paresthesias in a Patient on Hydroxychloroquine
A 58-year-old woman with SLE and Sjögren syndrome has been on hydroxychloroquine 400 mg daily (5.9 mg/kg actual body weight) for 9 years, with cumulative exposure estimated above 1,500 g. She presents with 4 months of progressive numbness and burning in both feet ascending to the mid-shin, new bilateral hand clumsiness, and unsteadiness in the dark.
386 words, about 2 min2Suspected Septic Arthritis Versus Flare in a Patient on Biologic Therapy
A 64-year-old man with seropositive RA on methotrexate and adalimumab presents with 36 hours of fever, chills, and a hot, swollen, exquisitely painful right knee. He cannot bear weight.
424 words, about 2 min3Proteinuria in Lupus Nephritis: When to Biopsy and How to Interpret a "Partial" Response
A 29-year-old woman with SLE diagnosed 2 years ago presents with new lower-extremity edema. Current medications: hydroxychloroquine, mycophenolate mofetil 1 g twice daily, prednisone 5 mg daily.
404 words, about 2 min4Osteoporosis Management in a Glucocorticoid-Treated Patient
A 67-year-old postmenopausal woman with polymyalgia rheumatica has been on prednisone for 5 months: 20 mg daily for 8 weeks, now tapering and currently at 7.5 mg daily, with a planned 12–18 month course. She has a prior low-trauma distal radius fracture at age 60.
422 words, about 2 min5Differentiating Flare From Infection in a Febrile Patient With Vasculitis
A 71-year-old man with recently diagnosed ANCA-associated vasculitis (MPO-positive, renal involvement) completed induction with cyclophosphamide and high-dose glucocorticoids 6 weeks ago and is now on rituximab maintenance plus prednisone 10 mg daily. He presents with 3 days of fever to 38.7°C, new dry cough, and mild dyspnea.
393 words, about 2 min