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Cutting Edge AAV

Drug Profile
Benralizumab
Drug Profile
Dupilumab
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Cyclophosphamide
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Rituximab
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Avacopan
Drug Profile
Azathioprine
Drug Profile
Thiopurine Azathioprine 50mg
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Reslizumab
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Mepolizumab
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sulfamethoxazole and trimethoprim
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Sucralfate
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Secukinumab
Anisha Dua, MD, MPH Northwestern University Feinberg School of Medicine

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Cutting Edge AAV - Case 1

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Cutting Edge AAV - Case 2

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Cutting Edge AAV - Case 3 - Basic Level

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Cutting Edge AAV - Case 4 - Intermediate Level

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Cutting Edge AAV - Case 5-Advanced Level

1. Which infectious disease is most likely to present with ANCA positivity, thus mimicking ANCA-associated vasculitis (AAV)?

Select only 1 answer.

  1. A. Hepatitis C
  2. B. HIV
  3. C. Tuberculosis
  4. D. Infective Endocarditis

2. Which diagnostic test is most definitive for differentiating between ANCA-associated vasculitis and other causes of pulmonary-renal syndrome?

Select only 1 answer.

  1. A. Renal biopsy
  2. B. Chest CT
  3. C. Serum creatinine
  4. D. Bronchoscopy with lavage

3. Which of the following is the primary advantage of using rituximab over cyclophosphamide for the induction of remission in AAV?

Select only 1 answer.

  1. A. Higher efficacy in all patients
  2. B. Lower risk of relapse
  3. C. Preservation of fertility
  4. D. Shorter duration of treatment

4. What is the most significant factor in determining the choice of maintenance therapy after induction in AAV?

Select only 1 answer.

  1. A. The patient's age
  2. B. The presence of renal involvement
  3. C. The ANCA subtype
  4. D. The response to induction therapy

5. How does maintenance treatment with rituximab influence vaccine recommendations in patients with ANCA-associated vasculitis (AAV)?

Select only 1 answer.

  1. A. Live vaccines are recommended during rituximab treatment to boost immunity
  2. B. Inactivated vaccines should be avoided due to reduced efficacy
  3. C. Vaccines should ideally be administered before starting rituximab or during periods of partial B-cell recovery
  4. D. Rituximab enhances the effectiveness of all vaccines

6. Which baseline laboratory marker is most predictive of long-term outcomes in ANCA-associated vasculitis?

Select only 1 answer.

  1. A. C-reactive protein (CRP)
  2. B. Erythrocyte sedimentation rate (ESR)
  3. C. Serum creatinine
  4. D. ANCA titer

7. Which of the following is a major contraindication to the use of cyclophosphamide in the treatment of AAV?

Select only 1 answer.

  1. A. Mild anemia
  2. B. Elevated liver enzymes
  3. C. Active infection
  4. D. Osteoporosis

8. Which imaging modality is most useful in assessing the extent of lung involvement in AAV?

Select only 1 answer.

  1. A. Chest X-ray
  2. B. High-resolution CT (HRCT)
  3. C. PET-CT
  4. D. MRI

9. Which of the following is least likely to be a manifestation of ANCA-associated vasculitis?

Select only 1 answer.

  1. A. Glomerulonephritis
  2. B. Pulmonary capillaritis
  3. C. Mononeuritis multiplex
  4. D. Hypercalcemia

10. What are the ACR and EULAR recommendations for the initial treatment of severe ANCA-associated vasculitis (AAV) with renal involvement?

Select only 1 answer.

  1. A. Low-dose corticosteroids alone
  2. B. Methotrexate combined with low-dose corticosteroids
  3. C. Cyclophosphamide or rituximab combined with high-dose corticosteroids
  4. D. Azathioprine combined with moderate-dose corticosteroids

11. Which of the following factors is most predictive of relapse in patients with ANCA-associated vasculitis?

Select only 1 answer.

  1. A. Persistent ANCA positivity after treatment
  2. B. Smoking history
  3. C. Baseline serum creatinine
  4. D. Age at diagnosis

12. Which of the following is the best strategy to reduce the long-term toxicity of cyclophosphamide in the treatment of AAV?

Select only 1 answer.

  1. A. Limit use to 3-6 months
  2. B. Use of daily oral dosing
  3. C. Avoiding concurrent corticosteroid use
  4. D. Prophylactic use of bisphosphonates

13. What advice should be given to a patient with ANCA-associated vasculitis (AAV) who is stable on maintenance rituximab and wishes to become pregnant?

Select only 1 answer.

  1. A. Continue rituximab throughout the pregnancy
  2. B. Stop rituximab immediately and switch to methotrexate
  3. C. Discuss stopping rituximab and switching to a safer maintenance therapy before conception
  4. D. Continue rituximab but add corticosteroids to manage any potential flares

14. Which of the following is a significant risk of using rituximab in the treatment of AAV?

Select only 1 answer.

  1. A. Hepatotoxicity
  2. B. Hypogammaglobulinemia
  3. C. Osteonecrosis
  4. D. Nephrotoxicity

15. Which therapeutic strategy has shown the greatest benefit in preventing end-stage renal disease (ESRD) in patients with severe renal involvement due to AAV?

Select only 1 answer.

  1. A. Early use of plasmapheresis
  2. B. High-dose corticosteroids alone
  3. C. Combined use of cyclophosphamide and corticosteroids
  4. D. Maintenance therapy with azathioprine