Churg-Strauss Syndrome

CHURG-STRAUSS SYNDROME

Q. 1

Not true about churg- strauss syndrome is?

 A Asthma
 B Multisystem involvement of vessels
 C Intravascular granulomas
 D

Perpheral eosinophilia

Q. 1

Not true about churg- strauss syndrome is?

 A Asthma
 B Multisystem involvement of vessels
 C Intravascular granulomas
 D

Perpheral eosinophilia

Ans. C

Explanation:

Intravascular granulomas REF: Harrison 17th ed chapter 319

Churg-Strauss syndrome, also referred to as allergic angiitis and granulomatosis, was described in 1951 by Churg and Strauss and is characterized by asthma, peripheral and tissue eosinophilia, extravascular granuloma formation, and vasculitis of multiple organ systems.


Q. 2

Glomerulonephritis is NOT a feature of:

 A

Granulomatosis with polyangiitis (Wegener’s)

 B

Churg-Strauss syndrome

 C

Microscopic polyangiitis

 D

Polyarteritis nodosa

Q. 2

Glomerulonephritis is NOT a feature of:

 A

Granulomatosis with polyangiitis (Wegener’s)

 B

Churg-Strauss syndrome

 C

Microscopic polyangiitis

 D

Polyarteritis nodosa

Ans. D

Explanation:

In Polyarteritis nodosa the pathology in the kidney is that of arteritis without glomerulonephritis.

In patients with significant hypertension, typical pathologic features of glomerulosclerosis may be seen.

Ref: Harrisons principles of internal medicine, 18th edition, Page: 2794.


Q. 3

A 45 year old lady presented with features suggestive of mononeuritis multiplex. She gives a h/o regular attacks of bronchial asthma preceded by allergic rhinitis. She also has cutaneous purpura. Blood routine examination revealed eosinophilia. The diagnosis to be considered in this clinical scenario is?

 A

Microscopic polyangiitis

 B

Endogenous bronchial asthma

 C

Churg strauss syndrome

 D

Wegeners vasculitis

Q. 3

A 45 year old lady presented with features suggestive of mononeuritis multiplex. She gives a h/o regular attacks of bronchial asthma preceded by allergic rhinitis. She also has cutaneous purpura. Blood routine examination revealed eosinophilia. The diagnosis to be considered in this clinical scenario is?

 A

Microscopic polyangiitis

 B

Endogenous bronchial asthma

 C

Churg strauss syndrome

 D

Wegeners vasculitis

Ans. C

Explanation:

When small-vessel vasculitis is associated with peripheral eosinophilia, cutaneous purpura, mononeuritis, asthma, and allergic rhinitis, a diagnosis of Churg-Strauss syndrome is considered.

Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 2344


Q. 4

Granuloma is seen in all except –

 A

Giant cell arteritis

 B

Microscopic polyangitis

 C

Wegner’s granulomatosis

 D

Churg-strauss disease

Q. 4

Granuloma is seen in all except –

 A

Giant cell arteritis

 B

Microscopic polyangitis

 C

Wegner’s granulomatosis

 D

Churg-strauss disease

Ans. B

Explanation:

Ans. is ‘b’ i.e., Microscopic polyangitis

In microscopic polyangitis, granuloma are absent.

o There are two types of inflammation in the wall of vessels in systemic vasculitis ‑

I. Granulomatous inflammation                   —> characterized by formation of granuloma in vessel wall.

2. Necrotizing inflammation                                characterized by fibrinoid necrosis in the vessel wall.

Vasculitis with granulomatous inflammation o Giant cell arteritis

o Takayasu’s disease

o Wegner’s granulomatosis

o Churg strauss syndrome

Vasculitis with necrotizing inflammation

  • Polyarteritis nodosa
  • Churg strauss syndrome
  • Wegner’s granulomatosis
  • Microscopic polyangitis

Note – Wegner’s granulomatosis and churg strauss syndrome have feature of both granulomatous inflammation (predominant) and necrotizing inflammation.


Q. 5

Lung is characteristically involved in –

 A

Churg-Strauss syndrome

 B

HSP

 C

PAN

 D

ITP

Q. 5

Lung is characteristically involved in –

 A

Churg-Strauss syndrome

 B

HSP

 C

PAN

 D

ITP

Ans. A

Explanation:

Ans. is ‘a’ i.e., Churg-Strauss syndrome

Churg- strauss syndrome

o Also known as allergic granulomatosis and angitis.

o It is a medium and small size vasculitis, invoves mainly the blood vessels of lungs, GIT, peripheral nerves, heart, skin, kidney.

o As it is allergic, vasculitis it is associated with eosinophilia and asthma.

o It is granulomatous necrotizing vasculitis.

o It is associated with p-ANCA.

Stages

This disease has three distinct stages ‑

o Stage l              —> Involves the sinuses and the onset of allergies —> nasal polyp, allergic rhinitis.

o Stage 2            —> Acute asthma occurs.

o Stage 3            —> The third and final stage involves the various organ systems –

1.       Peripheral nervous system —> Mononeuritis multiplex with severe neural pain.

2.       Skin         -3 Palpable purpura, papules, ulcer, vesiculobillous lesion.

3.       Heart –> CHF

4.       Kidney         Pauciimmune glomerulonephritis.

5.       Joints —> Migratory arthritis.

6.       Ear               Conductive deafness.

7.      There is eosinophilia and raised IgE as occur with allergic conditions.

8.       Lung —> Nonfixed migratory pulmonary infiltrates.


Q. 6

All of the following are associated with pulmonary eosinophillic pneumonia, Except:

 A

ABPA

 B

Loeffler’s pneumonia

 C

Churg Strauss Syndrome

 D

Wegener’s granulomatosis

Q. 6

All of the following are associated with pulmonary eosinophillic pneumonia, Except:

 A

ABPA

 B

Loeffler’s pneumonia

 C

Churg Strauss Syndrome

 D

Wegener’s granulomatosis

Ans. D

Explanation:

Answer is D (Wegener’s granulomatosis)

Pulmonary Eosinophilia

Extrinsic eosinophilic syndromes:

  • Loeffler syndrome
  • DRESS syndrome: The Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome Parasitic infections
  • Schistosomiasis
  • TPE: Tropical Pulmonary Eosinophilia.
  • Bronchocentric granulomatosis
  • Fungal causes: Allergic bronchopulmonary aspergillosis (ABPA)
  • Strongyloidiasis

Intrinsic pulmonary eosinophilic syndromes:

  • Chronic eosinophilic pneumonia
  • Idiopathic hypereosinophilic syndrome
  • Churg-Strauss syndrome
  • Eosinophilic granuloma (pulmonary histiocytosis X or Langerhans cell granulomatosis).

Q. 7

All of the following are small vessels vasculitis, Except:

 A

Classical PAN

 B

Wegner’s granulomatosis

 C

HSP

 D

Churg Strauss Syndrome

Q. 7

All of the following are small vessels vasculitis, Except:

 A

Classical PAN

 B

Wegner’s granulomatosis

 C

HSP

 D

Churg Strauss Syndrome

Ans. A

Explanation:

Answer is A (Classical PAN):

Classical PAN is a predominantly medium vessel vasculitis and not a small vessel vasculitis.


Q. 8

ANCA positive vasculitis include all of the following Except:

 A

Wegner’s granulomatosis

 B

Churg strauss syndrome

 C

Microscopic PAN

 D

Good pasture’s syndrome

Q. 8

ANCA positive vasculitis include all of the following Except:

 A

Wegner’s granulomatosis

 B

Churg strauss syndrome

 C

Microscopic PAN

 D

Good pasture’s syndrome

Ans. D

Explanation:

Answer is D (Good pasture’s syndrome):

Goodpasture’s syndrome is not classified as an ANCA positive vasculitis.


Q. 9

Which of the following is not true about Churg Strauss Syndrome

 A

Asthma

 B

Peripheral eosinophilia

 C

Vasculitis of multiple organ systems

 D

Intravascular Granulomas

Q. 9

Which of the following is not true about Churg Strauss Syndrome

 A

Asthma

 B

Peripheral eosinophilia

 C

Vasculitis of multiple organ systems

 D

Intravascular Granulomas

Ans. D

Explanation:

Answer is D (Intravascular Granulomas):

Churg Strauss Syndrome is typically charachterized by extravascular granulomas.

`Churg Strauss Syndrome also referred to allergic angitis and granulomatosis is charachterized by asthma, peripheral and tissue eosinophilia, extravascular granuloma formation and vasculitis of multiple organ systems ‘- Harrison’s 18th

`Churg Strauss Syndrome is typically associated with Cutaneous Extravascular Necrotizing Granulomas (CENG)’. – Practical Immunodermatology

Note that intravascular granulomas present within the walls of the vessels themselves may also be seen in Churg Strauss Syndrome. This is however not a charachteristic feature.


Q. 10

All of the following statements about Churg Strauss Syndrome are true, except:

 A

Marked Eosinophilia

 B

Mononeuritis multiplex is common

 C

Renal failure is common

 D

Often associated with Allergic Rhinitis

Q. 10

All of the following statements about Churg Strauss Syndrome are true, except:

 A

Marked Eosinophilia

 B

Mononeuritis multiplex is common

 C

Renal failure is common

 D

Often associated with Allergic Rhinitis

Ans. C

Explanation:

Answer is C (Renal failure is common):

Churg Strauss Syndrome is not prominent and renal failure is rare.

The Renal disease in Churg Strauss Syndrome is less common and generally less severe than with granulomatosis with polyangitis (Wegener’s) and microscopic polyangitis ‘- Harrison’s 18th/2793

‘Renal failure is rare in Churg Strauss syndrome – Pulmonary Involvement in Systemic Autoimmune Disease


Q. 11

Which of the following is more frequently seen in Churg Strauss Syndrome in comparison to Wegener’s Granulomatosis

 A

Renal involvement

 B

Lower Respiratory Tract involvement

 C

Eye involvement

 D

Upper Respiratory Tract involvement

Q. 11

Which of the following is more frequently seen in Churg Strauss Syndrome in comparison to Wegener’s Granulomatosis

 A

Renal involvement

 B

Lower Respiratory Tract involvement

 C

Eye involvement

 D

Upper Respiratory Tract involvement

Ans. B

Explanation:

Answer is B (Lower Respiratory Tract involvement):

Lower Respiratory Tract involvement is typically more common in Churg Strauss Syndrome in comparison to Wegener’s Granulomatosis.

Organs involved in small vessels vasculitis:

Organ involvement throughout disease course

Wegner’s granulomatosis

Microscopic polyangitis

Churg-Strauss syndrome

Upper respiratory tract

80%

Uncommon

55%

Lower respiratory tract

70%

30%

100%

Eye

46%

10%

6%

Kidney

80%

90%

33%

Peripheral nervous system

35%

20%

67%

Gastrointestinal system

5%

5%

17%

Heart

Uncommon

Uncommon

28%

Skin

50%

25%

44%

Constitutional symptoms

95%

90%

94%



Leave a Reply

Free Mini Course on Stomach

Mini Course – Stomach

22 High Yield Topics in Stomach

in Just 2 Hours

Submission received, thank you!

Close Window
%d bloggers like this:
Malcare WordPress Security