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 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.
- What is in the differential diagnosis for ITP?
- How do you dx Takayasu's arteritis?
- How do you tx Wegener's Granulomatosis?
- a hematologic malignancies, aplastic anemia
- b angiography
- c Polyarteritis Nodosa; poor prognosis
- d 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
- e Systemic Vasculitis
5 Multiple choice questions
- 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
- PE MEAT: Paranasal sinus abnormalities, Eosinophilia > 10% on diff, Mononeuropathy, Extravascular eosinophils positive biopsy, Asthma, Transient pulmonary infiltrates
- Myasthenia Gravis (chronic autoimmune neuromuscular disorder with varying degrees of weakness of skeletal (voluntary) muscles of body)/ mya - muscles, anticholinesterase, acetylcholine receptor antibodies
- Giant Cell Arteritis (blindness if untreated)
- 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)
5 True/False questions
What are the different types of systemic vasculitis? → PoG -> Wegman's for Japanese + German food = Polyarteritis Nodosa, Giant Cell Arteritis, Wegener's Granulomatosis, Takayasu's arteritis, Churg-Strauss Syndrome
What Ig is involved with ITP? Which cell lines are affected? → autoimmune do where IgG antibody formed that binds to platelets; destruction in spleen; isolated thrombocytopenia (other cell lines normal)
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 → Polyarteritis Nodosa; poor prognosis
What is the tx for ITP? → hematologic malignancies, aplastic anemia
What is tx for 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