American Board of Internal Medicine (ABIM) Certification Practice Exam

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Which of the following statements is true regarding Mixed Connective Tissue Disease?

It is exclusively treated with surgical methods.
It encompasses symptoms of only rheumatoid arthritis.
Positive anti-U1-RNP antibodies are a critical diagnostic marker.
It does not involve musculoskeletal symptoms.

The correct answer is: Positive anti-U1-RNP antibodies are a critical diagnostic marker.

Mixed Connective Tissue Disease (MCTD) is characterized by overlapping features of various connective tissue disorders, most notably systemic lupus erythematosus, scleroderma, and polymyositis. The presence of anti-U1-RNP antibodies is a significant and critical marker for diagnosing MCTD; the majority of patients with this condition have these antibodies in their serum. This serological finding helps differentiate MCTD from other connective tissue diseases that might present similarly but do not typically show this specific antibody profile. The other options do not accurately reflect the nature of MCTD. Treatment typically involves medical management rather than exclusive reliance on surgical methods. Additionally, MCTD includes a wide range of symptoms, not just those associated with rheumatoid arthritis, and musculoskeletal symptoms are very much part of the spectrum of manifestations in this disease.