Dry eyes and a dry mouth point nowhere on their own; behind sicca sit at least seven diseases, and telling them apart is the real work. This exercise hands you a patient whose diagnosis is unknown and lets you run the workup yourself. You order investigations one at a time and weigh each result across the competing explanations, committing whenever you have seen enough. Every test carries a cost, so which one you order matters more than ordering them all. You are scored on how well your confidence tracked the truth, and on reaching it early. The seven candidates are, in effect, the ACR/EULAR exclusion list for Sjögren’s.

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