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5 Written questions

5 Matching questions

  1. How do you tx myasthenia gravis?
  2. What is tx for Churg-Strauss Syndrome?
  3. A pt comes in with purpura, petechiae and hemorrhagic bullae in their mouth. What do they have?
  4. What has an ESR >50, is ANCA-negative, has low titers of ANA or RF?
  5. What has lab findings of anemia, mild leukocytosis, elevated ESR, hilar adenopathy, C-ANCA (limited to kidney) and P-ANCA (localized to kidney)?
  1. 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
  2. b idiopathic thrombocytopenia purpura (ITP); chief complaint - mucosal or skin bleeding
  3. c High dose prednisone 40-60 mg/d tapered slowly after 1 month; immunosuppressive agents
  4. d Polyarteritis Nodosa
  5. e Wegener's Granulomatosis

5 Multiple choice questions

  1. Systemic Vasculitis
  2. Giant Cell Arteritis
  3. urgently with prednisone 60 mg/d immediately -> bx to confirm/ then low dose ASA 81 mg/d/ continue prednisone 1 month before tapering
  4. angiography
  5. 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

  1. 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


  2. What is tx for Takayasu's arteritis?angiography


  3. What are the Diagnostic Criteria for Churg-Strauss Syndrome?High dose prednisone 40-60 mg/d tapered slowly after 1 month; immunosuppressive agents


  4. 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


  5. What are PE findings for Wegener's Granulomatosis?congestion, crusting, bleeding around nasal mucosa, inflamed gums/ otitis media, conjunctivitis, dvt and pe