Immunology

Question 1

Giant cell arteritis diagnosis

Answer 1

TEMPORAL ARTERITIS DIAGNOSTIC CRITERIA: ACR

• Headache
• Abnormalities of temporal artery: decreased pulsation, tenderness
• Temporal artery biopsy +
• Age >50 (elderly)
• Raised ECR

Question 2

Treatment of giant cell arteritis

Answer 2

Steroids

Question 3

Takayasu arteritis

Answer 3

Large vessel vasculitis affecting the aorta

- Granulomatous inflammation resulting in stenosis seen on ct angiogram

Question 4

Kawasaki

Answer 4

CRASH (symptoms) BURN (fever for at least 5 days)
Conjunctivitis- bilateral non exudative
Rash
Adenopathy
Strawberry tongue (+ other mucositis)
Hands: erythema, + edema desquamation

Fever for 5 days
Either coronary artery involvement OR
4 of above (CRASH) criteria

Question 5

Treatment of Kawasaki disease

Answer 5

IvIG

High dose aspirin can be added

Question 6

Complication of Kawasaki

Answer 6

Coronary artery aneurysms

Question 7

Polyarteritis nodosa

Answer 7

Associated with Hep B+C
Clinical presentation:
- Young person, more in males
- Expect in young people presenting with strokes and myocardial infarction
- Acute kidney injury 
- Spares the lungs 
- ANCA neg

Question 8

Granulomatosis with polyangitis (WEGENER’S)

Answer 8

• Associated with pr3-ANCA and C-ANCA
• Glomerulonepritis, upper and lower resp involvement
• Haemoptysis + upper resp infections
• Can have occular, skin, cardio involvement
• Biopsy- see granulomas

Treatment: steroids, cyclophosphymide, ritoximab

Question 9

Eosinophilic granulomatosis with polyangitis (Churg Strauss)

Answer 9

p-ANCA

• Severe allergic asthma
• Rhinitis
• Glomerulonephritis

Question 10

Microscopic polyangitis

Answer 10

p-ANCA + MPO-ANCA

- Renal and pulmonary without upper resp

Question 11

Henoch Schonlein Purpura features: (Hint: JAPAN)

Answer 11

Group A strep

• Abdo pain
• Palpable purpura
• Nephritic syndrome
• Joint pain

Question 12

Treatment of HSP

Answer 12

• Supportive treatment

- Steroids if severe renal involvement