American Board of Internal Medicine (ABIM) Certification Practice Exam

What condition is characterized by recurrent painful oral ulcers plus at least two additional symptoms such as genital ulcers or eye involvement?

1. Behçet syndrome

2. Sjögren syndrome

3. Eosinophilic granulomatosis

4. ANCA-associated vasculitis

The correct answer is: Behçet syndrome

Behçet syndrome is a complex, systemic condition that is characterized by recurring oral ulcers, which are painful and can significantly affect a person's quality of life. In addition to these oral ulcers, the syndrome often presents with at least two other symptoms, such as genital ulcers, eye involvement (which can range from uveitis to retinal problems), and skin lesions. These additional symptoms are crucial for the diagnosis of Behçet syndrome. The pathophysiology of Behçet’s disease is believed to involve a combination of immune dysregulation and genetic susceptibility. The recurrent nature of the oral and genital ulcers, combined with the potential for serious eye complications, underscores the systemic nature of the disease. In contrast, conditions like Sjögren syndrome primarily cause xerostomia (dry mouth) and dry eyes, without the recurrent ulcerations seen in Behçet syndrome. Eosinophilic granulomatosis is typically associated with asthma, allergies, and vasculitis affecting small to medium-sized vessels, but it does not focus on recurrent oral ulcers. ANCA-associated vasculitis involves inflammation of blood vessels and does not present with the specific symptom profile of Behçet syndrome, notably the recurring oral and genital ulcers. Therefore, the defining characteristics