Rheumatology/immunology

Question 1

Wegener’s granulomatosis
- AKA
- What is it?
- Classic triad
- Where else?

Answer 1

Granulomatosis with polyangiitis

Small and medium vessel vasculitis

Classic triad = URT, LRT, pauci-immune glomerulonephritis.

Also cutaneous, ocular, PNS, MSK

Question 2

Churg-Strauss syndrome
- AKA
- Classic triad
- blood count feature

Answer 2

Eosinophilic granulomatosis with polyangiitis

classic triad = asthma, gastrointestinal and cardiac involvement.

significant (>10% of WBC) peripheral eosinophils or tissue eosinophilia

Question 3

Goodpasture’s syndrome
- AKA
- Where

Answer 3

Anti-glomerular basement membrane antibody disease

Pulmonary haemorrhage and glomerulonephritis. Not at other sites

Question 4

Berger’s disease/IgA nephropathy

Answer 4

Commonest GN in adults worldwide.

Nephritic syndrome 24-48hr post URTI

Question 5

Post-streptococccal glomerulonephritis

Answer 5

Visible haematuria 1-3 weeks after onset of streptococcal infection

Question 6

Henoch-Schönlein Purpura
- AKA
- demographic
- systemic features

Answer 6

IgA vasculitis

Predominantly occurs in children

Systemic features = purpuric rash, abdominal pain, joint pain, GI bleeding

Question 7

Myasthenia gravis diagnosis

Answer 7

Electromyography under repetitive stimulation - will see progressive decrease in amplitude of muscle potential

Question 8

Peanut/penicillin anaphylaxis immune mediator

Answer 8

IgE on presensitised basophils and mast cells

Question 9

Selective IgA deficiency

Answer 9

Absent IgA - needed for mucous membrane infections
May develop anti-IgA antibodies so risk of anaphylaxis with blood transfusions or IVIG

Question 10

C1 inhibitor deficiency AKA
Cause/mechanism
Presentation
Management

Answer 10

Hereditary angio-edema

Unchecked activation of classic complement pathway

Cutaneous angio-oedema, abdominal pain, airway obstruction

Acute: FFP (contains C1-INH)
Prophylaxis: androgens, TXA

Question 11

Behcet’s disease
- describe
- features
- management

Answer 11

Chronic multisystem vasculitis

Oral/genital ulcers, arthritis, iritis, neurological disease

Corticosteroids, anti-TNFa

Question 12

Rhuematoid factor what kind of Immunoglobulin?

Answer 12

IgM

Question 13

Immunoglobulin in secretions (tears, saliva, sweat)

Answer 13

IgA

Question 14

Rheumatoid arthritis
- management

Answer 14

Methotrexate, sulfasalazine