100+ Free Cert Rheumatology(SA) Paed Practice Questions
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Key Facts: Cert Rheumatology(SA) Paed Exam
2 components
Written + oral/OSCE
CMSA Regulations
50% each
Subminimum per component
CMSA Regulations
R24 650
Exam Fee
CMSA 2026 Fee Schedule
50% overall
Pass Mark
CMSA Regulations
CMSA
Exam Body
College of Paediatricians of SA
The Cert Rheumatology(SA) Paed is a rigorous two-component sub-specialty exit examination (written short-answer papers plus an oral/OSCE/clinical component, each 50%) for specialist paediatricians completing sub-specialty paediatric rheumatology fellowship training in South Africa. This bank provides 100 practice MCQs as a study aid.
Sample Cert Rheumatology(SA) Paed Practice Questions
Try these sample questions to test your Cert Rheumatology(SA) Paed exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 3-year-old girl is brought to the paediatric rheumatology clinic with a 2-month history of a swollen left knee and morning limp lasting 40 minutes. On examination, there is a moderate left knee effusion with warmth and restricted range of motion, but no systemic symptoms. Laboratory investigations reveal ESR 28 mm/hr, CRP 12 mg/L, ANA positive at 1:320 (speckled pattern), and negative RF. Which of the following is the most important immediate screening investigation required for this patient?
2A 4-year-old boy diagnosed with persistent oligoarticular JIA localized to the right knee has failed a 4-week trial of full-dose oral ibuprofen. What is the standard first-line targeted intervention for active monoarticular or oligoarticular JIA joint disease?
3A 6-year-old girl presents with a 3-week history of daily spiking fevers up to 39.8°C that return to baseline once daily, accompanied by a salmon-pink macular rash on her trunk that appears during fever spikes and fades as her temperature normalizes. Physical examination reveals generalized lymphadenopathy, hepatosplenomegaly, and bilateral wrist and ankle arthritis. Laboratory testing demonstrates WBC 24.5 x 10^9/L (85% neutrophils), platelets 650 x 10^9/L, ESR 95 mm/hr, CRP 140 mg/L, and serum ferritin 3,200 µg/L. ANA and RF are negative. What is the most likely diagnosis?
4A 7-year-old boy with known systemic JIA on oral prednisolone develops non-remitting high fevers, lethargy, purpura, and confusion. Laboratory results show a sudden drop in ESR from 90 mm/hr to 12 mm/hr, while CRP remains elevated at 110 mg/L. Hemoglobin drops from 11.2 to 7.8 g/dL, platelets drop from 520 x 10^9/L to 45 x 10^9/L, fibrinogen is decreased at 1.1 g/L (normal 2.0-4.0), and serum ferritin rises to 28,500 µg/L. What life-threatening sJIA complication has developed?
5An 11-year-old boy presents with painful left heel pain at the insertion of the Achilles tendon, pain over the tibial tuberosity, and right hip pain. He reports 60 minutes of morning stiffness. His father has ankylosing spondylitis. Physical examination confirms tenderness at entheseal sites and right hip limitation. HLA-B27 testing is positive. Two weeks later, he presents with acute onset of a painful, red, photophobic right eye with decreased vision. Which JIA subtype does this clinical picture represent?
6A 9-year-old girl with polyarticular RF-negative JIA involving 8 joints is commenced on subcutaneous methotrexate at 15 mg/m^2 once weekly. Which co-prescription is essential to minimize gastrointestinal toxicity and mucosal ulceration associated with methotrexate therapy?
7A 10-year-old girl with polyarticular JIA has persistent active disease despite 4 months of subcutaneous methotrexate at maximum tolerated dosage. The medical team decides to initiate anti-TNF alpha therapy with etanercept. Prior to starting etanercept in South Africa, which mandatory baseline screening test must be performed to prevent severe opportunistic reactivation?
8A 7-year-old girl presents with diffuse, painful sausage-like swelling of her right second toe extending beyond the joint boundaries, left DIP joint arthritis, and subtle pitting of multiple fingernails. She has no active skin psoriasis, but her mother has plaque psoriasis. According to the ILAR classification criteria, what is the diagnosis?
9A 5-year-old child with active systemic JIA characterized by persistent daily fevers and polyarthritis has proven inadequate response to systemic corticosteroids and methotrexate. Which biologic agent targeting the interleukin-6 (IL-6) receptor is approved and highly effective for systemic JIA?
10In a child with systemic JIA who develops acute Macrophage Activation Syndrome (MAS) refractory to high-dose pulse IV methylprednisolone, which recombinant human IL-1 receptor antagonist is recommended as rapid-onset targeted biologic therapy?
About the Cert Rheumatology(SA) Paed Exam
The Sub-specialty Certificate in Paediatric Rheumatology [Cert Rheumatology(SA) Paed] is the specialist sub-specialty qualification administered by the College of Paediatricians of South Africa. It validates expert consultant-level competency across paediatric rheumatic diseases including JIA, paediatric SLE, systemic vasculitides, juvenile dermatomyositis, autoinflammatory syndromes, post-infectious arthritides, and non-inflammatory musculoskeletal pain disorders.
Assessment
Two components each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Content spans 4 domain areas: Juvenile Idiopathic Arthritis (JIA) Subtypes & Treatment (35%), Paediatric Systemic Lupus Erythematosus & Vasculitis (25%), Juvenile Dermatomyositis & Autoinflammatory Syndromes (20%), Reactive Arthritis, Lyme, Post-Infectious Arthritides & Non-Inflammatory Musculoskeletal Pain (20%).
Time Limit
Written short-answer papers plus an OSCE and viva component.
Passing Score
Overall pass mark 50% with a 50% subminimum in each of the two components (written and oral/OSCE/OSPE/clinical).
Exam Fee
R24 650 (College of Paediatricians of South Africa (Colleges of Medicine of South Africa))
Cert Rheumatology(SA) Paed Exam Content Outline
Juvenile Idiopathic Arthritis (JIA) Subtypes & Treatment
ILAR criteria, oligoarticular JIA, polyarticular JIA (RF-positive and RF-negative), systemic JIA (sJIA), enthesitis-related arthritis (ERA), psoriatic JIA, undifferentiated JIA, uveitis screening/management, macrophage activation syndrome (MAS), DMARDs (methotrexate, leflunomide), and biologic agents (anti-TNF, IL-1, IL-6 inhibitors, JAK inhibitors).
Paediatric Systemic Lupus Erythematosus & Vasculitis
EULAR/ACR 2019 lupus classification, ISN/RPS lupus nephritis classes and induction/maintenance therapy, neuropsychiatric SLE, antiphospholipid syndrome, IgA vasculitis (Henoch-Schönlein purpura), Kawasaki disease (IVIG resistance, coronary aneurysms), Takayasu arteritis, Granulomatosis with Polyangiitis (GPA), and Polyarteritis Nodosa (PAN).
Juvenile Dermatomyositis & Autoinflammatory Syndromes
Bohan and Peter / EULAR-ACR JDM criteria, myositis-specific antibodies (anti-NXP2, anti-TIF1-gamma, anti-MDA5), calcinosis management, muscle biopsy/MRI findings, Familial Mediterranean Fever (FMF), Cryopyrin-Associated Periodic Syndromes (CAPS), TRAPS, Mevalonate Kinase Deficiency (HIDS), and STING-associated vasculopathy with onset in infancy (SAVI).
Reactive Arthritis, Lyme, Post-Infectious Arthritides & Non-Inflammatory Musculoskeletal Pain
Acute rheumatic fever (Jones criteria, secondary prophylaxis), post-streptococcal reactive arthritis, Lyme arthritis (Borrelia burgdorferi serology and antibiotic regimens), transient synovitis vs septic arthritis (Kocher criteria), hypermobility spectrum disorder / Ehlers-Danlos syndrome, chronic primary pain / amplified musculoskeletal pain syndrome (AMPS), growing pains, and bone tumors/osteoid osteoma.
How to Pass the Cert Rheumatology(SA) Paed Exam
What You Need to Know
- Passing score: Overall pass mark 50% with a 50% subminimum in each of the two components (written and oral/OSCE/OSPE/clinical).
- Assessment: Two components each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Content spans 4 domain areas: Juvenile Idiopathic Arthritis (JIA) Subtypes & Treatment (35%), Paediatric Systemic Lupus Erythematosus & Vasculitis (25%), Juvenile Dermatomyositis & Autoinflammatory Syndromes (20%), Reactive Arthritis, Lyme, Post-Infectious Arthritides & Non-Inflammatory Musculoskeletal Pain (20%).
- Time limit: Written short-answer papers plus an OSCE and viva component.
- Exam fee: R24 650
Keys to Passing
- Work through all 100 available questions
- Review every answer and explanation
- Track weak areas and revisit them
- Use our AI tutor for tough concepts
Cert Rheumatology(SA) Paed Study Tips from Top Performers
Frequently Asked Questions
What is the format of the CMSA Cert Rheumatology(SA) Paed examination?
The exit examination has two components, each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Candidates must achieve an overall 50% with a 50% subminimum in each component. This free question bank provides 100 practice MCQs as a study aid and does not replicate the official format.
What is the fee for the Cert Rheumatology(SA) Paed examination?
The official CMSA examination fee is R24 650.
What is the passing criteria for the examination?
Candidates must achieve an overall pass mark of 50%, with a 50% subminimum in each of the two components (the written component and the oral/OSCE/OSPE/clinical component).
What content areas are tested on the examination?
Content is weighted across 4 domains: JIA Subtypes & Treatment (35%), Paediatric SLE & Vasculitis (25%), JDM & Autoinflammatory Syndromes (20%), and Reactive, Lyme, Post-Infectious & Non-Inflammatory Pain (20%).