American Board of Internal Medicine (ABIM) Certification Practice Exam

What diagnostic method is helpful in confirming eye dryness in Sjögren syndrome?

1. Gland biopsy

2. Schirmer test

3. Blood tests

4. CT scan of the abdomen

The correct answer is: Schirmer test

The Schirmer test is particularly useful for confirming eye dryness in Sjögren syndrome because it directly measures the secretory function of the lacrimal glands. During the test, small strips of filter paper are placed in the lower eyelid to quantify tear production over a defined period. A low tear production measurement indicates dryness, which is a hallmark symptom of Sjögren syndrome. Given that Sjögren syndrome primarily affects the moisture-producing glands, including the lacrimal glands responsible for tear production, the Schirmer test provides a straightforward and non-invasive means to assess this aspect of the disorder. In contrast, a gland biopsy, while valuable for examining lymphocytic infiltration in salivary glands, is not specific to eye dryness and requires more invasive procedures. Blood tests may help identify autoimmune markers but do not directly evaluate tear production. A CT scan of the abdomen is unrelated to the diagnosis of eye dryness or Sjögren syndrome and serves different diagnostic purposes entirely. Thus, the Schirmer test is the most effective method for confirming eye dryness in this condition.