5 Written questions
5 Matching questions
- What has an ESR >50, is ANCA-negative, has low titers of ANA or RF?
- What Ig is involved with ITP? Which cell lines are affected?
- How do you dx Takayasu's arteritis?
- A pt comes in with ptosis, diplopia, difficulty in chewing and swallowing, respiratory difficulties and limb weakness. The muscle weakness increases with activity and improves after periods of rest. What do they have?
- What is a rare disorder with vasculitis of small arteries and symptoms of nasal congestion, sinusitis and otitis media as well as fever, cough, dyspnea, wt loss and malaise? It is in males or females in their 4th-5th decades
- a Polyarteritis Nodosa
- b angiography
- c Wegener's Granulomatosis (fatal if not treated)
- d autoimmune do where IgG antibody formed that binds to platelets; destruction in spleen; isolated thrombocytopenia (other cell lines normal)
- e Myasthenia Gravis (chronic autoimmune neuromuscular disorder with varying degrees of weakness of skeletal (voluntary) muscles of body)/ mya - muscles, anticholinesterase, acetylcholine receptor antibodies
5 Multiple choice questions
- 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)
- idiopathic thrombocytopenia purpura (ITP); chief complaint - mucosal or skin bleeding
- PE MEAT: Paranasal sinus abnormalities, Eosinophilia > 10% on diff, Mononeuropathy, Extravascular eosinophils positive biopsy, Asthma, Transient pulmonary infiltrates
- Hep screening since 10% associated with Hep B
- PoG -> Wegman's for Japanese + German food = Polyarteritis Nodosa, Giant Cell Arteritis, Wegener's Granulomatosis, Takayasu's arteritis, Churg-Strauss Syndrome
5 True/False questions
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
What has an ESR > 50 or often 100 mm/h and an elevated AP? → Polyarteritis Nodosa
How do you tx Giant Cell Arteritis? → urgently with prednisone 60 mg/d immediately -> bx to confirm/ then low dose ASA 81 mg/d/ continue prednisone 1 month before tapering
What are PE findings for 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
What is the hallmark in lab findings for ITP? → hematologic malignancies, aplastic anemia