a young male develops serous otitis media of the left ear with cough, occassional hemoptysis, hematuria and epistaxis for 2months.hb is 7.5 g% with heavy protienuria, bp 170/100 mmhg, RA -ve and anca +ve the most probable diagnosis is
Correct Answer: wegners granulomatosis
Description: Wegener Granulomatosis * Triad of: -- Acute necrotizing granuloma of U or L -- Necrotizing or granulomatous vasculitis of small-medium vessels -- Renal disease: crescentic glomerulonephritis * C-ANCA in 95% of cases * Diagnosis -- cANCA * 95% sensitive in generalized disease * 60% sensitive in localized disease -- FBC, ESR, CRP, CXR, Urine analysis for casts -- Histology: Tissue from septum & all turbinates -- CT nose & paranasal sinuses * Non-specific mucosal thickening; bony destruction; new bone formation DIAGNOSTIC CRITERIA < ACR criteria (1990) > > 2 of 4 (Sensitivity 88%, Specificity 92%) 1. Nasal or oral inflammation 2. Abnormal chest radiograph: nodules, fixed infiltrates, or cavities 3. Urinary sediment: Microhematuria (>5 red blood cells /HPF) or RBC casts 4. Granulomatous inflammation on biopsy Histologic changes showing granulomatous inflammation within the wall of an aery or in the perivascular or extravascular area(aery ,aeriole) < CHCC nomenclature (1994) > 1. Granulomatous inflammation involving the respiratory tract 2. Vasculitis of small to medium-size vessels ref: harrisons 21st ed
Category:
Medicine
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now