5 Written Questions
5 Matching Questions
- 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.
- What Ig is involved with ITP? Which cell lines are affected?
- What is tx for Churg-Strauss Syndrome?
- How do you tx Wegener's Granulomatosis?
- How do you tx Giant Cell Arteritis?
- a Systemic Vasculitis
- b urgently with prednisone 60 mg/d immediately -> bx to confirm/ then low dose ASA 81 mg/d/ continue prednisone 1 month before tapering
- c autoimmune do where IgG antibody formed that binds to platelets; destruction in spleen; isolated thrombocytopenia (other cell lines normal)
- d High dose prednisone 40-60 mg/d tapered slowly after 1 month; immunosuppressive agents
- e 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
5 Multiple Choice Questions
- Wegener's Granulomatosis (fatal if not treated)
- idiopathic thrombocytopenia purpura (ITP); chief complaint - mucosal or skin bleeding
- thrombocytopenia with platelet counts less than 10,000/mcL (counts less than 5000/mcL can lead to CNS bleeding); peripheral smear, bone marrow and coagulation studies are normal
- high dose corticosteroids (60 mg Prednisone daily), Methylprednisolone 1 g IV daily for 3 days if critically ill, immunosuppressive agents like Cyclophosphamide; Hep B responds to short course of prednisone + lamivudine 100 mg/d and plasmapheresis 3 wk for 6 weeks
- Giant Cell Arteritis (blindness if untreated)
5 True/False Questions
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
What is a rare, systemic necrotizing inflammation of medium and small arteries that is mc in males? It is characterized by abdominal pain, systemic htn, jaundice, peripheral neuropathy and gangrene as well as livedo reticularis. → Wegener's Granulomatosis (fatal if not treated)
How do you dx myasthenia gravis? → 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
How do you dx Takayasu's arteritis? → 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
What is tx for Takayasu's arteritis? → angiography