Vascular Pathology Practice Questions

Q: Which vasculitis is positive for pANCA?

Churg-Strauss syndrome. The correct answer is **Churg-Strauss syndrome** (now known as Eosinophilic Granulomatosis with Polyangiitis or EGPA). **1. Why Churg-Strauss syndrome is correct:** ANCA-associated vasculitides are characterized by the presence of Antineutrophil Cytoplasmic Antibodies. **pANCA** (perinuclear) primarily targets the enzyme **myeloperoxidase (MPO)**. Approximately 40–60% of patients with Churg-Strauss syndrome are pANCA positive [1]. It is clinically defined by the triad of asthma, hypereosinophilia, and necrotizing vasculitis [1]. **2. Why the other options are incorrect:** * **Wegener’s granulomatosis (GPA):** This is classically associated with **cANCA** (cytoplasmic), which targets **Proteinase-3 (PR3)**. While pANCA can rarely occur, cANCA is the hallmark (90% sensitivity in active disease). * **Polyarteritis nodosa (PAN):** PAN is a medium-vessel vasculitis that is characteristically **ANCA-negative**. Its pathogenesis is often linked to Hepatitis B surface antigen, not antineutrophil antibodies. * **All of the above:** Incorrect because PAN is ANCA-negative and Wegener’s is predominantly cANCA-positive. **3. NEET-PG High-Yield Clinical Pearls:** * **pANCA (MPO-ANCA) Positive:** Churg-Strauss syndrome, Microscopic Polyangiitis (MPA), and Primary Sclerosing Cholangitis (PSC). * **cANCA (PR3-ANCA) Positive:** Granulomatosis with Polyangiitis (Wegener’s). * **Rule of Thumb:** If a question mentions "pauci-immune glomerulonephritis" with lung involvement, think of ANCA-associated vasculitis. * **Churg-Strauss Key Feature:** Look for "Asthma" or "Eosinophilia" in the clinical vignette to differentiate it from MPA or Wegener’s [1].

Question 1

ANCA is found in all except?

Accepted Answer

Bacterial Vasculitis

Answer

Wegener's granulomatosis

Answer

Churg-Strauss syndrome

Answer

Microscopic Polyangiitis

Question 2

Foamy macrophages are formed by?

Accepted Answer

Oxidized LDL

Answer

LDL

Answer

HDL

Answer

Oxidized HDL

Question 3

Endarteritis obliterans is seen in which of the following conditions?

Accepted Answer

Neurosyphilis

Answer

Marfan's syndrome

Answer

Turner's syndrome

Answer

Ankylosing spondylitis

Question 4

Which of the following is an example of small vessel vasculitis?

Accepted Answer

Churg-Strauss syndrome

Answer

Takayasu arteritis

Answer

Kawasaki disease

Answer

Polyarteritis nodosa (PAN)

Question 5

Hypersensitivity angiitis is typically seen in which of the following conditions?

Accepted Answer

Henoch-Schonlein purpura

Answer

Systemic lupus erythematosus

Answer

Polyarteritis nodosa

Answer

Buerger's disease

Question 6

Which of the following conditions is NOT associated with ANCA?

Accepted Answer

Henoch-Schonlein purpura

Answer

Microscopic polyangitis

Answer

Churg-Strauss syndrome

Answer

Wegener's granulomatosis

Question 7

Which vasculitis is positive for pANCA?

Accepted Answer

Churg-Strauss syndrome

Answer

Wegener's granulomatosis

Answer

Polyarteritis nodosa

Answer

All of the above

Question 8

Which of the following blood vessels is most commonly affected by atherosclerosis?

Accepted Answer

Abdominal aorta

Answer

Popliteal artery

Answer

Thoracic aorta

Answer

Coronary arteries

Question 9

A 56-year-old woman diagnosed with cancer in her left breast underwent a mastectomy with axillary lymph node dissection. Postoperatively, she develops marked swelling of the left arm that has persisted for 6 months. On physical examination, her temperature is 36.9°C. Her left arm is not tender or erythematous, and it is not painful with movement or to touch, but it is enlarged with a doughy consistency. Which of the following is the most likely mechanism for these findings?

Accepted Answer

Lymphedema

Answer

Cellulitis

Answer

Congestive heart failure

Answer

Decreased plasma oncotic pressure

Question 10

An elderly female presents with fever, headache, and diplopia. Biopsy of the artery revealed panarteritis. What is the most probable diagnosis?

Accepted Answer

Temporal arteritis

Answer

Nonspecific arteritis

Answer

Polyarteritis nodosa (PAN)

Answer

Wegener's granulomatosis

Vascular Pathology — MCQs

Vascular Pathology — MCQs

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