Large Vessel Vasculitis
Medium Vessel Vasculitis
Small Vessel (ANCA-associated) vasculitis
Small Vessel (immune complex-mediated) vasculitis
Types of Lupus
100
What are the shared histopathological findings for giant cell arteritis and Takayasu arteritis?
Granulomatous inflammation
100
This medium-vessel vasculitis is strongly associated with tobacco use and causes distal extremity ischemia in young male smokers.
What is Buerger disease (thromboangiitis obliterans)?
100
What antibody corresponds to p-ANCA vs c-ANCA?
p-ANCA (mpo)
c-ANCA (PR3-ANCA)
100
A 5-year-old has palpable purpura on the buttocks and legs, colicky abdominal pain, and knee arthritis. Platelet count and coagulation studies are normal.
IgA vasculitis (formerly named Henoch–Schönlein purpura)
100
A woman with SLE develops annular, scaly lesions on sun-exposed areas of her chest and arms. The lesions heal without scarring. Which subtype of cutaneous lupus is most likely?
Subacute cutaneous lupus erythematosus (SCLE).
200
A 35-year-old female of Asian descent presents with chest pain, weak pulses in the upper extremities bilaterally, and tender skin nodules. What is considered the gold standard for confirming her likely diagnosis?
MR angiography
200
Children with Kawasaki disease are treated with these two medications, despite one usually being avoided in children due to Reye syndrome risk.
What are IVIG and aspirin?
200
What is the only small vessel vasculitis mediated by c-ANCA?
Granulomatosis with
polyangiitis
200
About 7–10 days after starting allopurinol, a patient develops painful palpable purpura with no visceral involvement. Skin biopsy shows neutrophil nuclear debris around vessels, fibrinoid necrosis, and RBC extravasation. This is the name of that histologic pattern.
leukocytoclastic vasculitis (vignette describes Cutaneous small vessel vasculitis)
200
A patient with SLE develops proteinuria, hematuria, and low complement levels. Renal biopsy shows granular immunofluorescence. Which complement activation pathway is primarily responsible for the inflammation?
Classical complement pathway
300
If a patient is suspected to have giant cell arteritis, what is the next best step in management of the condition and why?
High-dose glucocorticoids
To decrease the risk of complications such as aortic aneurysms, brain ischemia, and/or permanent loss of vision
300
This cardiac complication is most feared in Kawasaki disease and is the primary reason echocardiography is performed.
What are coronary artery aneurysms?
300
A child with IgA vasculitis has severe, episodic abdominal pain and currant jelly stool. Idiopathic pediatric intussusception is usually ileocolic, but in this disease it is often confined to a different location. Air or contrast enema won't reduce it, and surgery may be needed.
ileoileal (small bowel–small bowel) intussusception
300
A patient taking hydralazine develops fever, arthralgias, and positive anti-histone antibodies. Which inherited drug-metabolism phenotype increases susceptibility to this condition?
Slow acetylation (NAT2)
400
The production of which interleukin is highly associated with the severity of disease in giant cell arteritis? Thus, which monoclonal antibody can be used to treat GCA?
IL-6, Tocilizumab
400
In addition to glucocorticoids, this cytotoxic drug is added for severe polyarteritis nodosa.
What is cyclophosphamide?
400
A woman with SLE has painful hives that last more than 24 hours and heal with hyperpigmentation. She has had chronic urticaria for over 6 months, and C3 and C4 are low. Her autoantibody targets the recognition component that starts the classical complement pathway.
anti-C1q antibody (Hypocomplementemic urticarial vasculitis syndrome, or McDuffie syndrome.)
400
A patient with active SLE has elevated anti-dsDNA antibodies and decreased C3/C4. Defective clearance of apoptotic debris exposes nuclear antigens, stimulating these endosomal receptors and promoting type I interferon production.
Toll-like receptors 7 and 9 (TLR7 and TLR9)
500
A female patient recently diagnosed with Takayasu arteritis presents with severe pain in her right arm. On physical examination, her right arm is cold and pale, with no palpable pulses. What is the most appropriate management for this patient?
Emergency vascular bypass surgery
500
A child has fever for 6 days, conjunctivitis, rash, cervical lymphadenopathy, swollen hands, and a strawberry tongue. Unlike a major mimicker, this symptom is typically absent.
What is a sore throat? (helps distinguish from scarlet fever)
500
A patient with Waldenström macroglobulinemia has blurred vision, vertigo, ataxia, Raynaud phenomenon, and the below skin finding. Serum complement is normal because no immune complexes form. Severe disease is treated urgently with plasmapheresis.
what is the specific disease called and what is unique about it? 
bonus for 100 pts: what is the skin finding called?
type I cryoglobulinemia (A monoclonal IgM or IgG causes hyperviscosity and noninflammatory microvascular occlusion. In types II and III, IgM with rheumatoid factor activity forms immune complexes and C4 is low.)
bonus: skin finding is "net-like retiform purpura"
500
A patient with SLE develops rapidly progressive renal dysfunction. Biopsy reveals diffuse endocapillary proliferation, subendothelial immune-complex deposits, and wire-loop lesions. Which class of lupus nephritis is present?
Class IV (diffuse proliferative) lupus nephritis