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5 Written questions

5 Matching questions

  1. What Ig is involved with ITP? Which cell lines are affected?
  2. 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.
  3. What has lab findings of anemia, mild leukocytosis, elevated ESR, hilar adenopathy, C-ANCA (limited to kidney) and P-ANCA (localized to kidney)?
  4. What has an ESR >50, is ANCA-negative, has low titers of ANA or RF?
  5. How do you tx Wegener's Granulomatosis?
  1. a 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
  2. b Systemic Vasculitis
  3. c Polyarteritis Nodosa
  4. d autoimmune do where IgG antibody formed that binds to platelets; destruction in spleen; isolated thrombocytopenia (other cell lines normal)
  5. e Wegener's Granulomatosis

5 Multiple choice questions

  1. 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)
  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. 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
  4. PoG -> Wegman's for Japanese + German food = Polyarteritis Nodosa, Giant Cell Arteritis, Wegener's Granulomatosis, Takayasu's arteritis, Churg-Strauss Syndrome
  5. Myasthenia Gravis (chronic autoimmune neuromuscular disorder with varying degrees of weakness of skeletal (voluntary) muscles of body)/ mya - muscles, anticholinesterase, acetylcholine receptor antibodies

5 True/False questions

  1. 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.Giant Cell Arteritis (blindness if untreated)

          

  2. How do you treat 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

          

  3. A pt comes in with purpura, petechiae and hemorrhagic bullae in their mouth. What do they have?Myasthenia Gravis (chronic autoimmune neuromuscular disorder with varying degrees of weakness of skeletal (voluntary) muscles of body)/ mya - muscles, anticholinesterase, acetylcholine receptor antibodies

          

  4. What should you screen for in pt's with polyarteritis nodosa?Hep screening since 10% associated with Hep B

          

  5. In myasthenia gravis what do you see with the thymus gland?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