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Vasculitis Mimics

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Methotrexate 10mg-25mg auto-injector
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Methotrexate 2.5mg Tablets
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Methotrexate 2mg/ml PO
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Methotrexate Tablet
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Methotrexate 7.5mg - 30mg Auto-Inector
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Rituximab
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Prednisone
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Prednisone 5mg/10mg/20mg Tablet
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Dapsone Gel, 7.5%
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Dapsone Tablets USP, 25 mg and 100 mg
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Colchicine
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Anakinra
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Solumedrol
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Caspofungin
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Voriconazole
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Amoxicillin, Clarithromycin, Iansoprazole
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sulfamethoxazole and trimethoprim
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Cyclophosphamide
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miltefosine
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Amphotericin B
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Flucytosine
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Celiprolol
Anisha Dua, MD, MPH Northwestern University Feinberg School of Medicine

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Vasculitis Mimics - Case 1

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Vasculitis Mimics - Case 2

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Large Vessel Vasculitis Mimics - Beginner Level

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Large Vessel Vasculitis Mimics - Intermediate Level

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Large Vessel Vasculitis Mimics - Advanced Level

1. Which condition can mimic small vessel vasculitis by presenting with skin lesions and elevated inflammatory markers, but is characterized by a dense neutrophilic infiltrate without signs of vasculitis?

Select only 1 answer.

  1. A. Sweet Syndrome
  2. B. Polyarteritis Nodosa (PAN)
  3. C. Granulomatosis with Polyangiitis (GPA)
  4. D. Erythema Nodosum

2. Which laboratory finding would most likely differentiate Sweet syndrome from ANCA-associated vasculitis?

Select only 1 answer.

  1. A. Positive MPO-ANCA
  2. B. Elevated C-reactive protein
  3. C. High neutrophil count
  4. D. Negative skin biopsy for vasculitis

3. What is the hallmark pathological finding on a biopsy of a patient with Erdheim-Chester disease that helps differentiate it from large vessel vasculitis?

Select only 1 answer.

  1. A. Dense lymphocytic infiltrates
  2. B. Presence of foamy lipid-laden histiocytes
  3. C. Granulomatous inflammation
  4. D. Fibrinoid necrosis of the vessel wall

4. In the differential diagnosis of CNS vasculitis, which imaging finding might suggest reversible cerebral vasoconstriction syndrome (RCVS) rather than primary angiitis of the CNS?

Select only 1 answer.

  1. A. "Beads on a string" appearance
  2. B. "Sausage on a string" appearance
  3. C. Bilateral infarcts on MRI
  4. D. Elevated inflammatory markers

5. Which clinical feature is more indicative of polyarteritis nodosa (PAN) compared to fibromuscular dysplasia (FMD) and segmental arterial mediolysis (SAM)?

Select only 1 answer.

  1. A. Hypertension
  2. B. Abdominal pain
  3. C. Arthralgias and systemic symptoms
  4. D. "String of beads" appearance on angiography

6. Which condition is strongly associated with the "hairy kidney sign" on imaging, aiding in its differentiation from large vessel vasculitis?

Select only 1 answer.

  1. A. Polyarteritis Nodosa
  2. B. Erdheim-Chester Disease
  3. C. Takayasu Arteritis
  4. D. Giant Cell Arteritis

7. What is the most appropriate initial management for a patient with CNS vasculitis confirmed by biopsy?

Select only 1 answer.

  1. A. Supportive care and blood pressure control
  2. B. High-dose glucocorticoids and cyclophosphamide
  3. C. Antiplatelet therapy
  4. D. Antibiotics and antifungals

8. In the context of vasculitis mimics, which condition is most likely to present with recurrent "thunderclap" headaches and normal inflammatory markers?

Select only 1 answer.

  1. A. Primary CNS Vasculitis
  2. B. Reversible Cerebral Vasoconstriction Syndrome (RCVS)
  3. C. Intravascular Lymphoma
  4. D. Giant Cell Arteritis

9. Which treatment strategy is least likely to be effective in managing Sweet syndrome with lung involvement?

Select only 1 answer.

  1. A. High-dose glucocorticoids
  2. B. Anakinra
  3. C. Colchicine
  4. D. Rituximab

10. Which of the following is NOT typically associated with an elevated ANCA (Anti-Neutrophil Cytoplasmic Antibody) titer?

Select only 1 answer.

  1. A. Granulomatosis with Polyangiitis (GPA)
  2. B. Microscopic Polyangiitis (MPA)
  3. C. Sweet Syndrome
  4. D. Eosinophilic Granulomatosis with Polyangiitis (EGPA)

11. What is the most common initial presentation of intravascular large B-cell lymphoma that can mimic vasculitis?

Select only 1 answer.

  1. A. Pulmonary hemorrhage
  2. B. Acute neurological deficit
  3. C. Renal artery stenosis
  4. D. Isolated cutaneous ulcers

12. What feature on imaging would most likely suggest fibromuscular dysplasia (FMD) over polyarteritis nodosa (PAN)?

Select only 1 answer.

  1. A. Presence of microaneurysms
  2. B. “String of beads” appearance
  3. C. Diffuse wall thickening of the aorta
  4. D. High inflammatory markers

13. Which condition is characterized by a mutation in the COL3A1 gene and is associated with spontaneous arterial ruptures and the absence of inflammatory markers?

Select only 1 answer.

  1. A. Polyarteritis Nodosa
  2. B. Takayasu Arteritis
  3. C. Ehlers-Danlos Syndrome Type IV
  4. D. Segmental Arterial Mediolysis

14. What is a common complication of using heavy immunosuppression in a patient with an infection that mimics vasculitis?

Select only 1 answer.

  1. A. Rapid improvement of symptoms
  2. B. Dissemination of the infection
  3. C. Development of vasculitis
  4. D. Resolution of the infection

15. Which condition is most likely if a young female presents with a sudden thunderclap headache during exertion and normal CSF findings?

Select only 1 answer.

  1. A. CNS Vasculitis
  2. B. Reversible Cerebral Vasoconstriction Syndrome (RCVS)
  3. C. Intravascular Lymphoma
  4. D. Giant Cell Arteritis