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5 Written questions

5 Matching questions

  1. What has an ESR >50, is ANCA-negative, has low titers of ANA or RF?
  2. What are the different types of systemic vasculitis?
  3. In myasthenia gravis what do you see with the thymus gland?
  4. 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.
  5. How do you tx Wegener's Granulomatosis?
  1. a Giant Cell Arteritis (blindness if untreated)
  2. b 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
  3. c Polyarteritis Nodosa
  4. d it is abnormal (thymoma = thymic hyperplasia)/ it has clusters of immune cells indicative of lymphoid hyperplasia/ autoimmunity and production of the acetylcholine receptor antibodies setting the stage for attack on neuromuscular transmission -> skel muscle weakness
  5. e PoG -> Wegman's for Japanese + German food = Polyarteritis Nodosa, Giant Cell Arteritis, Wegener's Granulomatosis, Takayasu's arteritis, Churg-Strauss Syndrome

5 Multiple choice questions

  1. idiopathic thrombocytopenia purpura (ITP); chief complaint - mucosal or skin bleeding
  2. 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
  3. Wegener's Granulomatosis
  4. High dose prednisone 40-60 mg/d tapered slowly after 1 month; immunosuppressive agents
  5. 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

5 True/False questions

  1. What Ig is involved with ITP? Which cell lines are affected?hematologic malignancies, aplastic anemia

          

  2. What is the tx for ITP?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. 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

          

  4. What are the Diagnostic Criteria for Churg-Strauss Syndrome?PE MEAT: Paranasal sinus abnormalities, Eosinophilia > 10% on diff, Mononeuropathy, Extravascular eosinophils positive biopsy, Asthma, Transient pulmonary infiltrates

          

  5. What has asthma as its cardinal feature and the pt also has nasal polyps and allergic rhinitis. This affects small to medium sized vessels and can also be associated with tingling in extremities, can affect the lungs, etc...Churg-Strauss Syndrome

          

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