Rheumatology: relapsing polychondritis: practice question

A General Medicine 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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General Medicine · Rheumatology: relapsing polychondritis

Sample item

A 40-year-old woman has repeated episodes of painful red swelling of both ear pinnae that spares the lobules, along with a saddle-nose deformity and hoarseness. Blood tests show a raised ESR. What is the most likely diagnosis?

ARelapsing polychondritisBGranulomatosis with polyangiitisCSarcoidosisDBacterial auricular cellulitis

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

The answer and the reasoning

A. Relapsing polychondritis

Relapsing polychondritis is an immune-mediated inflammation of cartilage. Auricular chondritis spares the lobule, which has no cartilage, and nasal and laryngotracheal cartilage involvement cause saddle nose and airway symptoms. Treatment is with corticosteroids and immunosuppression.

Option by option

A. Relapsing polychondritis (correct)
Correct. Bilateral auricular inflammation sparing the lobules with nasal and airway cartilage disease is characteristic.
B. Granulomatosis with polyangiitis
Granulomatosis with polyangiitis causes sinus disease and renal or lung involvement, rather than recurrent pinna chondritis.
C. Sarcoidosis
Sarcoidosis may involve the nose and skin but does not typically cause recurrent pinna chondritis sparing the lobules.
D. Bacterial auricular cellulitis
Cellulitis is usually unilateral, involves the lobule and responds to antibiotics.

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.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Relapsing polychondritis. Relapsing polychondritis is an immune-mediated inflammation of cartilage.

Why is "Granulomatosis with polyangiitis" not the answer?

Granulomatosis with polyangiitis causes sinus disease and renal or lung involvement, rather than recurrent pinna chondritis.

Why is "Sarcoidosis" not the answer?

Sarcoidosis may involve the nose and skin but does not typically cause recurrent pinna chondritis sparing the lobules.

Why is "Bacterial auricular cellulitis" not the answer?

Cellulitis is usually unilateral, involves the lobule and responds to antibiotics.

What concept does this question test?

It tests Rheumatology: relapsing polychondritis in General Medicine. Auricular chondritis spares the lobule, which has no cartilage, and nasal and laryngotracheal cartilage involvement cause saddle nose and airway symptoms. Treatment is with corticosteroids and immunosuppression.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Rheumatology: relapsing polychondritis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.