5 Written questions
5 Matching questions
- How do you tx myasthenia gravis?
- What is tx for Churg-Strauss Syndrome?
- A pt comes in with purpura, petechiae and hemorrhagic bullae in their mouth. What do they have?
- What has an ESR >50, is ANCA-negative, has low titers of ANA or RF?
- What has lab findings of anemia, mild leukocytosis, elevated ESR, hilar adenopathy, C-ANCA (limited to kidney) and P-ANCA (localized to kidney)?
- a 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
- b idiopathic thrombocytopenia purpura (ITP); chief complaint - mucosal or skin bleeding
- c High dose prednisone 40-60 mg/d tapered slowly after 1 month; immunosuppressive agents
- d Polyarteritis Nodosa
- e Wegener's Granulomatosis
5 Multiple choice questions
- Systemic Vasculitis
- Giant Cell Arteritis
- urgently with prednisone 60 mg/d immediately -> bx to confirm/ then low dose ASA 81 mg/d/ continue prednisone 1 month before tapering
- 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
How do you tx Wegener's Granulomatosis? → 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
What is tx for Takayasu's arteritis? → angiography
What are the Diagnostic Criteria for Churg-Strauss Syndrome? → High dose prednisone 40-60 mg/d tapered slowly after 1 month; immunosuppressive agents
What is the tx 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
What are PE findings for Wegener's Granulomatosis? → congestion, crusting, bleeding around nasal mucosa, inflamed gums/ otitis media, conjunctivitis, dvt and pe