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5 Written questions

5 Matching questions

  1. How do you tx Giant Cell Arteritis?
  2. What is a vasculitis that presents in pts over 50 with a warning headache, visual symptoms, jaw claudication, throat pain, dry cough, and a fever? It affects medium and large arteries. There is an asymmetry of pulses in arms, murmur of aortic regurgitation and bruits near the clavicle.
  3. What is a group of vascular dz's that cause inflammatory injury and necrosis of the blood vessels? They are classified as small, medium or large.
  4. For ITP you are asymptomatic till you start bleeding at...? What is your prognosis?
  5. What is the tx for ITP?
  1. a nose, soft palate, petechiae, gums, GI and CNS; good
  2. b PISD = initial tx: Prednisone 1-2 mg/kg/day; high dose IV Ig of 1 g/kg for 1-2 days for platelet counts < 5000; Splenectomy is definitive tx; Danazol 600 mg/day if all of above fail
  3. c Systemic Vasculitis
  4. d Giant Cell Arteritis (blindness if untreated)
  5. e urgently with prednisone 60 mg/d immediately -> bx to confirm/ then low dose ASA 81 mg/d/ continue prednisone 1 month before tapering

5 Multiple choice questions

  1. idiopathic thrombocytopenia purpura (ITP); chief complaint - mucosal or skin bleeding
  2. Giant Cell Arteritis
  3. lateral and ap x-rays of the chest and CT scans to demonstrate a co-existing thymoma; dx can be confirmed by response to a short-acting anticholinesterase (Phone Eddie)/ Edrophonium IV 10 mg will improve muscle strength, EMG, assay of serum for elevated levels of circulating acetylcholine receptor antibodies (ANA increased but lower titers than SLE)
  4. Wegener's Granulomatosis (fatal if not treated)
  5. Takayasu's Arteritis

5 True/False questions

  1. What are the different types of systemic vasculitis?hematologic malignancies, aplastic anemia


  2. What is tx for Churg-Strauss Syndrome?P M & M: Prednisone 1 mg/kg/d tapered to < 20 in 8-20 wks with maintenance at 10 mg; Methotrexate 25 mg/wk and mycophenolate mofetil 1500 mg bid for those who are refractory


  3. How do you tx Wegener's Granulomatosis?crucial to prevent end-organ damage/ tightly control htn
    CAP: Cyclophosphamide and prednisone, ASA 325 mg for TIAs/ AM: Azathioprine 2 mg/kg/d for remission and methotrexate 20 mg/wk if not sign/renal dysfunction


  4. In myasthenia gravis what do you see with the thymus gland?NAP: (since it improves with rest)/ otherwise CT
    Anticholinesterase drugs give symptomatic relief
    i.e. Neostigmine 15 mg qid and Pyridostigmine 60 mg qid; thymectomy; failure of above - corticosteroids


  5. How do you treat polyarteritis nodosa?urgently with prednisone 60 mg/d immediately -> bx to confirm/ then low dose ASA 81 mg/d/ continue prednisone 1 month before tapering


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