Page Contents
OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose topic is granulomatosis with polyangiitis (formerly Wegener granulomatosis). While this may seem a odd practice, it is useful to see multiple examples of how granulomatosis with polyangiitis will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a traditional question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a topic is quite valuable.
KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)
When it comes to standardized exams, each topic has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for granulomatosis with polyangiitis.
- Upper respiratory tract involvement/symptoms
- Perforation of nasal septum:
- Chronic sinusitis: ulcers/granulomas can be present
- Otitis media
- Mastoiditis
- Lower respiratory tract involvement/symptoms
- Hemoptysis
- Cough
- Dyspnea
- Renal involvement/symptoms
- Hematuria
- Red blood cell casts
- Large nodular densities can be seen on imaging (such as a chest X-ray)
- Serum serologies: c-ANCA/PR3-ANCA (anti-proteinase 3)
- Large necrotizing granulomas may be revealed on biopsy
QUESTION EXAMPLES
Question # 1
Explanation # 1
Question # 2
Explanation # 2
TESTABLE FACTS ABOUT THIS TOPIC (BEYOND ITS IDENTIFICATION)
Many questions on standardized exams go beyond simply recognizing the underlying topic. Often there are specific testable facts regarding some aspect of the topic’s pathophysiology/management/clinical implications that are commonly asked. Some of these are listed below:
- What is it: small vessel vasculitis
- What organs does it involve: lungs, upper airway, kidney (causes necrotizing glomeruloneprhitis)
- Histology: focal necrotizing vasculitis with necrotizing granulomas present
- Complications: this condition can cause rapidly progressive (crescentic) glomerulonephritis (RPGN)
- Treatment: cyclophosphamide, corticosteroids.
Page Updated: 04.24.2017