5 Written questions
5 Matching questions
- What are the Diagnostic Criteria for Churg-Strauss Syndrome?
- 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
- What is the tx for ITP?
- 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?
- What is tx for Churg-Strauss Syndrome?
- a Myasthenia Gravis (chronic autoimmune neuromuscular disorder with varying degrees of weakness of skeletal (voluntary) muscles of body)/ mya - muscles, anticholinesterase, acetylcholine receptor antibodies
- b Wegener's Granulomatosis (fatal if not treated)
- c PE MEAT: Paranasal sinus abnormalities, Eosinophilia > 10% on diff, Mononeuropathy, Extravascular eosinophils positive biopsy, Asthma, Transient pulmonary infiltrates
- d 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
- e High dose prednisone 40-60 mg/d tapered slowly after 1 month; immunosuppressive agents
5 Multiple choice questions
- Giant Cell Arteritis (blindness if untreated)
- Polyarteritis Nodosa; poor prognosis
- urgently with prednisone 60 mg/d immediately -> bx to confirm/ then low dose ASA 81 mg/d/ continue prednisone 1 month before tapering
- Churg-Strauss Syndrome
- Wegener's Granulomatosis
5 True/False questions
How do you tx myasthenia gravis? → 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)
A pt comes in with purpura, petechiae and hemorrhagic bullae in their mouth. What do they have? → idiopathic thrombocytopenia purpura (ITP); chief complaint - mucosal or skin bleeding
What should you screen for in pt's with polyarteritis nodosa? → Hep screening since 10% associated with Hep B
What is tx for Takayasu's arteritis? → angiography
What has an ESR > 50 or often 100 mm/h and an elevated AP? → Polyarteritis Nodosa