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Kaplan Qbank USMLE



Author7 Posts
  #1

Young woman around 30s has got symptoms which sounded like new onset of asthma. On further questioning noted to have a cough with mild haemoptysis. A urine dipstick done shows 2+ blood. What is the most likely cause?

a.New onset asthma
b.Wegner's granulomatosis
c.SLE
d.Churg Strauss
e.She's faking it all!

  #2

Wegeners...affects nose, lung and kidneys. Vasculitis that is c-ANCA positive and that is treated with cyclophosphamide in some cases, which is known for cauing hemorrhagic cystitis and transitial cell CA of the bladder.

  #3

The first thing I think of is focal necrotizing vasculitis and necrotizing
granulomas in the lung.
In addition to what Idiopathic says. I think the boards would give a little more history.

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  #4

well the key thing is ashma which points to only one condition on the list---churg strauss... churg strass could be c-anca positive(70%) or negative & it usu presents with asthmatic symptoms in the middle aged with haematuria haematochezia & haemoptysis. microscopic polyangitis has the same latter 3 signs but without the asthmatic symptoms. wegners does cause the symptoms but there is no association of it with asthmasmiling face

  #5

You got me on that...I read right over it. Churg-Strauss is a vasculitis with asthma/eosinophilia. I did not know about the renal involvement though. VERY good question.

  #6

thankssmiling face i thought that might stump a few while readingsmiling face

  #7

churg straus is thought to be a variant of PAN with pulm involvemnt and eiosinophilia. As renal involvment occurs in PAN so i guess renal involvement would be there in churg straus

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