American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the treatment for MCTD characterized by arthritis and myositis?

1. Calcium Channel Blockers

2. Glucocorticoids and Azathioprine

3. Non-steroidal anti-inflammatory drugs (NSAIDs)

4. Immunosuppressive therapy only

The correct answer is: Glucocorticoids and Azathioprine

The treatment for mixed connective tissue disease (MCTD) characterized by arthritis and myositis typically involves a combination of glucocorticoids and immunosuppressive agents, such as azathioprine. Glucocorticoids are effective in managing inflammation and controlling symptoms associated with the disease, including joint pain and muscle inflammation. They help to reduce the overall autoimmune response that contributes to the symptoms of MCTD. Azathioprine is an immunosuppressive medication that further assists in reducing the immune system's activity and managing chronic inflammation. In the context of MCTD, where there is a potential risk of organ involvement and persistent symptoms, using both glucocorticoids and azathioprine can result in better patient outcomes compared to monotherapy. This combined approach allows for a more comprehensive management of the diverse symptoms that may present in MCTD, including arthritis and myositis. The use of calcium channel blockers primarily targets vascular issues and hypertension, and while they may play a role in some secondary symptoms, they do not specifically address the inflammatory components of MCTD. Non-steroidal anti-inflammatory drugs (NSAIDs) can be useful for symptomatic relief in cases of mild inflammation or pain but are generally