5 Written questions
5 Matching questions
- How do you treat polyarteritis nodosa?
- How do you tx Giant Cell Arteritis?
- What is the hallmark in lab findings for ITP?
- What is tx for Takayasu's arteritis?
- 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...
- a Churg-Strauss Syndrome
- b 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
- c 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
- d urgently with prednisone 60 mg/d immediately -> bx to confirm/ then low dose ASA 81 mg/d/ continue prednisone 1 month before tapering
- e 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
5 Multiple choice questions
- congestion, crusting, bleeding around nasal mucosa, inflamed gums/ otitis media, conjunctivitis, dvt and pe
- Systemic Vasculitis
- Polyarteritis Nodosa; poor prognosis
- Wegener's Granulomatosis
- PE MEAT: Paranasal sinus abnormalities, Eosinophilia > 10% on diff, Mononeuropathy, Extravascular eosinophils positive biopsy, Asthma, Transient pulmonary infiltrates
5 True/False questions
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. → Hep screening since 10% associated with Hep B
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 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 has an ESR > 50 or often 100 mm/h and an elevated AP? → Giant Cell Arteritis
What is in the differential diagnosis for ITP? → 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