American Board of Internal Medicine (ABIM) Certification Practice Exam

Felty syndrome is characterized by which triad of symptoms?

1. Rheumatoid arthritis, splenomegaly, and neutropenia

2. Joint inflammation, arthritis, and liver dysfunction

3. Thrombocytopenia, anemia, and joint pain

4. Chronic fatigue, joint swelling, and lymphadenopathy

The correct answer is: Rheumatoid arthritis, splenomegaly, and neutropenia

Felty syndrome is a rare complication associated with rheumatoid arthritis and is specifically defined by a classic triad of symptoms: rheumatoid arthritis itself, splenomegaly, and neutropenia. Rheumatoid arthritis is an autoimmune condition that primarily causes inflammation and damage to the joints. In Felty syndrome, the presence of rheumatoid arthritis is critical, as it forms the underlying condition of this syndrome. Splenomegaly refers to the enlargement of the spleen, which can occur due to the immune and hematologic changes associated with the chronic inflammatory state caused by rheumatoid arthritis. This enlargement is linked to the increased activity of the spleen in regulating blood cells in response to the inflammatory processes. Neutropenia, which is a low level of neutrophils (a type of white blood cell), is another hallmark of Felty syndrome. This decrease can make patients more susceptible to infections and reflects the body's altered immune response in the context of rheumatoid arthritis. In contrast to the other listed symptoms from the other options, they do not accurately capture the specific and defining characteristics of Felty syndrome, which distinctly revolves around the triad of rheumatoid arthritis, splenomegaly, and neutropenia. Understanding this triad is crucial for diagnosis and