10. Dyspnea and Cough DSAs

Question 1

Granulomatosis with polyangiitis has a triad of upper respiratory tract disease, lower respiratory disease and glomerulonephritis, usually see what kind of ANCAs?

Answer 1

PR3-ANCA

Question 2

Granulomatosis with polyangiitis sx include fever, mailase, weight loss, upper and lower tract symptoms, what can be seen in the nasal septum?

Answer 2

crusting, ulceration bleeding and perforation

Question 3

Granulomatosis with polyangiitis histologically will have vasculitis, granulomatous inflammation, geographic necrosis, acute/chronic inflam, and a renal biopsy mau show segmental necrotizing glomerulonephritis with?**

Answer 3

multiple crescents (chracteristeic- RPGN)

Question 4

Churg strauss is an idiopathic vasculitis of small and medium sized arteries in patients with ASTHMA, clinically can see marked peripheral?

Answer 4

eosinophilia* (eosinophilic granulomas)

Question 5

Note : treat Granulomatosis with polyangiitis with cyclophosphamide and prednisone and remissions have been induced in up to ?

Answer 5

75% of patients

Question 6

Tx for churg strauss (MPO ANCA), requires prednisone and cyclophosphamide initially and cyclo is replaced by what for maintenance therapy?

Answer 6

methotrexate

Question 7

Sarcoidosis has NONCASEATING granulomas on biopsy, highest incidence in blacks and northern european white, woman more than men in 30s/40s. Sx include iritis, peripheral neuropathy, arthritis, and?

Answer 7

erythema nodosum

Question 8

Sarcoidosis also has restrictive cardiomyopathy, cardiac arrhythmias and conduction disturbances. Labs: high ACE, and ESR and on CXR you can see either hilar lymphadenopathy or?

Answer 8

parenchymal involvement (diffuse reitcular infiltrates) or both together

Question 9

Idiopathic pulmonary fibrosis shows on histo UIP, in the absence of an identifiable cause of lung injury. MC in 60/70s men, current/past smokers, What is usually the most prominent symptom?

Answer 9

Progressive dyspnea

Question 10

Idiopathic pulmonary fibrosis has a cough and fine bibasilar inspiratory crackles with cyanosis and RHF later in the dz. On CXR you can see diffuse bilateral?

Answer 10

lower lung predominant reticular opacities

Question 11

Idiopathic pulmonary fibrosis peripheral honeycombing is seen, PFT shows restrictive pattern and reduced carbon monoxide diffusion, gold standard for diagnosis is>

Answer 11

Lung biopsy with hallmark features of heterogeneous distributions of parenchymal fibrosis against background of mild inflammation (UIP)