Can this work with ms paint on windows 10?

Thank you for the question. Yes this tablet will work with MS paint in windows 10.

Does the bluetooth version also come with a usb, or do you have to use bluetooth only?

Yes, it does also come with a USB cable. So you can use it connected or not connected.

Will this work with gimp or inkscape?

Yes, it will work with those applications.

If I need a spare pen which do I get

You don't have to change the whole pen unless you lost it. Just change the nibs. have a look on this: https://us-store.wacom.com/Product/Intuos-Pen-S02#/undefined1 Or this: https://www.amazon.com/Wacom-LP190K-Intuos-Pen/dp/B012WJVOVA/ref=sr_1_fkmr0_2?ie=UTF8&qid=1527920988&sr=8-2-fkmr0&keywords=intros+pen+nibs and this: https://www.amazon.com/Wacom-ACK20001-Intuos-Standard-Nibs/dp/B005KB8H7M/ref=pd_sbs_147_2?_encoding=UTF8&pd_rd_i=B005KB8H7M&pd_rd_r=PK3B8QFS70V28RVRDV79&pd_rd_w=SuoMt&pd_rd_wg=9e7VG&psc=1&refRID=PK3B8QFS70V28RVRDV79&dpID=31YxrEnRhIL&preST=_SX300_QL70_&dpSrc=detail

ASIN	B079HL9YSF
Brand	Wacom
Brand Name	Wacom
Compatible Devices	Personal Computer
Connectivity Technology	USB
Customer Reviews	4.7 out of 5 stars 22,960 Reviews
External Testing Certification	Não aplicavel
Global Trade Identification Number	00753218986887
Item Height	0.1 Inches
Item Weight Unit of Measure	8.1 Ounces
Manufacturer	Wacom Technology Co
Model Name	CTL4100
Model Number	CTL4100
Native Resolution	1920x1080
Network Connectivity Technology	USB
Operating System	OS X 10.11 El Capitan, Windows 10 Education, Windows 7 Starter, Windows 8
Pressure Sensitivity	4096 Levels
Product Features	4096 Levels of pressure sensitivity
Special Feature	4096 Levels of pressure sensitivity
Specific Uses For Product	Drawing, Painting, Photo Editing
Target Audience	Teacher
UPC	753218986887

Wacom Intuos Small, Black (CTL4100)

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