PAN, Behcets, Wegeners Granulomatosis

Question 1

What is PAN

Answer 1

Polyarteritis nodosa
Necrotising vasculitis of small and medium vessels .. organgs

Presents as
skin- nodules, infarctive ulcers
Renal - HTN
GIT - abd pain

Question 2

PAN a/w

Answer 2

1. Hep B
2. Drug abusers
3. B-cell lymphoma

Question 3

PAN c/f

Answer 3

Young-middle age, MALE
1. Livedo reticularis
2. Skin ulcers
3. Migratory polyarthritis
4. Constitutional symptoms
5. Kidney - HTN, impairment (mcc of death)
6. Heart - Arrhythmias, failure, infarction

Question 4

Confirmatory inv of PAN

Answer 4

Biopsy
Angiogram if cannot do biopsy - STRING OF BEADS

Question 5

Mx of PAN

Answer 5

1. Steroids
2. Cyclophosphamide

Question 6

What is Behcet’s syndrome, key points for clinical diagnosis?

Answer 6

Vasculitis of small, med and large vessels
Key points:
1. Oral/Genital ulcers
2. Pathergy test +
3. Ocular - uveitis, retinitis

Other points:
1. MALE»
2. Arthritis - knee
3. Erythema nodosum

Question 7

Diagnosis of Behcets

Answer 7

Clinical diagnosis

Question 8

Mx of Behcets disease

Answer 8

High dose steroids
Refer to Ophthalmologist

Question 9

What is Wegeners granulomatosis

Answer 9

Granulomatosis with polyangitis
Vasculitis of unknown cause
Triad of lung and kidney diseases

Question 10

Triad of Wegeners granulomatosis?

Answer 10

1. URTI - sinusitis, epistaxis, SADDLE NOSE
2. LRTI - bloody cough, Fleeting pulm shadows, SOB
3. Renal - glomerulonephritis, death .. ↓Urine, HTN

Polyarthritis
Oral ulcers
Orbital mass

Question 11

Diagnosis of Wegeners granulomatosis

Answer 11

c-ANCA
Confirmatory - biopsy of kidney/lung

Question 12

Rx of Wegeners granulomatosis

Answer 12

DMARDs, Steroids, cyclophophamide

Question 13

Micro polyangitis

Answer 13

Similar to wegener’s
No granulomatosis
No nose involvement

Question 14

Churg strauss syn

Answer 14

p-ANCA
Similar to allergy/asthama
↑eosinophils