5 Written questions
5 Matching questions
- What is in the differential diagnosis for ITP?
- How do you tx Wegener's Granulomatosis?
- What are the Diagnostic Criteria for Churg-Strauss Syndrome?
- What are PE findings for Wegener's Granulomatosis?
- What are the different types of systemic vasculitis?
- a PE MEAT: Paranasal sinus abnormalities, Eosinophilia > 10% on diff, Mononeuropathy, Extravascular eosinophils positive biopsy, Asthma, Transient pulmonary infiltrates
- b PoG -> Wegman's for Japanese + German food = Polyarteritis Nodosa, Giant Cell Arteritis, Wegener's Granulomatosis, Takayasu's arteritis, Churg-Strauss Syndrome
- c 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
- d hematologic malignancies, aplastic anemia
- e congestion, crusting, bleeding around nasal mucosa, inflamed gums/ otitis media, conjunctivitis, dvt and pe
5 Multiple choice questions
- idiopathic thrombocytopenia purpura (ITP); chief complaint - mucosal or skin bleeding
- 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
- 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
- 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
- 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 True/False questions
What is tx for Takayasu's arteritis? → angiography
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? → idiopathic thrombocytopenia purpura (ITP); chief complaint - mucosal or skin bleeding
What is tx for Churg-Strauss Syndrome? → High dose prednisone 40-60 mg/d tapered slowly after 1 month; immunosuppressive agents
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. → Polyarteritis Nodosa; poor prognosis
What should you screen for in pt's with polyarteritis nodosa? → 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