NSGl 555/l NSG555l Examl 4–l (NEWl 2026/l
2027l Update)l Nursel Practitionersl inl
Primaryl Carel IIl Guidel |l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Wilkes
QUESTION
Largel vessell vasculitisl clinicall presentation
Answer:
Fever,l weightl loss,l malaise,l arthralgias/arthritis
Limbl claudication
Asymmetricl bloodl pressures
Absencel ofl pulses
Bruits
Aorticl dilation
QUESTION
Mediuml vessell vasculitisl clinicall presentation
Answer:
Fever,l weightl loss,l malaise,l arthralgias/arthritis
Cutaneousl nodules
Ulcers
Livedol reticularis
Digitall gangrene
Mononeuritisl multiplex
Microaneurysms
QUESTION
,Smalll vessell vasculitisl clinicall presentation
Answer:
Fever,l weightl loss,l malaise,l arthralgias/arthritis
Purpura
Vesiculobullousl lesions
Urticaria
Glomerulonephritis,l hematuria
Alveolarl hemorrhage
Cutaneousl extravascularl necrotizingl granulomas
Splinterl hemorrhages
Uveitis
Episcleritis
Scleritis
QUESTION
Vasculitisl diagnosis
Answer:
Nol specificl labl values
ANCAl mayl bel positivel (antineutrophill cytoplasmicl antibodies)
Largel vessell dzl -l MRA
Mediuml vessell dzl -l biopsyl orl vascularl imagingl likel angiographyl (deepl biopsy,l notl
punchl bxl ofl ulcer)
QUESTION
Vasculitisl tx
Answer:
Highl dosel pulsel methylprednisolonel (1gl IVl dailyl x3l days)
ANDl
cyclophosphamide
THEN
methotrexatel orl azathioprinel tol maintainl remission
,QUESTION
Sclerodermal limitedl dz
Answer:
CRESTl syndrome
skinl thickening/hardeningl confinedl tol face,l neck,l andl digitall extremities
Calcinosis
Raynaudl phenomenon
Esophageall motilityl disorder
Sclerodactyly
Telangiectasia
(higherl riskl forl losingl fingersl d/tl ischemial andl pulmonaryl HTN)
QUESTION
Slcerodermal diffusel dz
Answer:
widespreadl thickeningl ofl skin,l withl areasl ofl increasedl pigmentationl andl depigmentation
QUESTION
Diffusel sclerodermal clinicall presentation
Answer:
Commonl early:
polyarthralgia
weightl loss
malaise
Other:
skinl changesl involvingl trunk,l proximall extremities
subcutaneousl edemal associatedl withl pruritus
Skinl becomesl thickenedl andl hidebound,l losesl normall folds
Telangiectasia,l pigmentation,l depigmentationl common
Ulcerationl ofl fingertips
Tendonl frictionl rubsl overl forearmsl andl shins
Restrictivel lungl dz
Cardiacl abnormalities
, Renall crisis
QUESTION
Sclerodermal systemicl features
Answer:
gastroesophageall reflux,l GIl hypomotility,l pulmonaryl fibrosis,l pulmonaryl HTN,l renall
involvement
QUESTION
Sclerodermal presentation
Answer:
-raynaudl phenomenonl andl antinuclearl antibodiesl arel presentl inl virtuallyl alll patients
QUESTION
Sclerodermal labs
Answer:
Mildl anemial (hemolytic)
Normall ESR
Mildl proteinuria
ANAl positivel andl high
anti-SCL-70l onlyl 20-30%l andl poorl prognosis
Anticentromerel antibodiesl inl 50%l withl limitedl dz
Anti-RNAl polymerasel IIIl antibodiesl 10-20%l assocl w/l rapidl dz,l renall crisis,l higherl riskl
ofl cancers,l espl breastl ca
QUESTION
Differentiatel sclerodermal andl sclerederma
Answer:
Scleredermal assocl w/l diabetesl orl inection
Skinl thickeningl ofl thel posteriorl neck,l shoulders,l upperl back
2027l Update)l Nursel Practitionersl inl
Primaryl Carel IIl Guidel |l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Wilkes
QUESTION
Largel vessell vasculitisl clinicall presentation
Answer:
Fever,l weightl loss,l malaise,l arthralgias/arthritis
Limbl claudication
Asymmetricl bloodl pressures
Absencel ofl pulses
Bruits
Aorticl dilation
QUESTION
Mediuml vessell vasculitisl clinicall presentation
Answer:
Fever,l weightl loss,l malaise,l arthralgias/arthritis
Cutaneousl nodules
Ulcers
Livedol reticularis
Digitall gangrene
Mononeuritisl multiplex
Microaneurysms
QUESTION
,Smalll vessell vasculitisl clinicall presentation
Answer:
Fever,l weightl loss,l malaise,l arthralgias/arthritis
Purpura
Vesiculobullousl lesions
Urticaria
Glomerulonephritis,l hematuria
Alveolarl hemorrhage
Cutaneousl extravascularl necrotizingl granulomas
Splinterl hemorrhages
Uveitis
Episcleritis
Scleritis
QUESTION
Vasculitisl diagnosis
Answer:
Nol specificl labl values
ANCAl mayl bel positivel (antineutrophill cytoplasmicl antibodies)
Largel vessell dzl -l MRA
Mediuml vessell dzl -l biopsyl orl vascularl imagingl likel angiographyl (deepl biopsy,l notl
punchl bxl ofl ulcer)
QUESTION
Vasculitisl tx
Answer:
Highl dosel pulsel methylprednisolonel (1gl IVl dailyl x3l days)
ANDl
cyclophosphamide
THEN
methotrexatel orl azathioprinel tol maintainl remission
,QUESTION
Sclerodermal limitedl dz
Answer:
CRESTl syndrome
skinl thickening/hardeningl confinedl tol face,l neck,l andl digitall extremities
Calcinosis
Raynaudl phenomenon
Esophageall motilityl disorder
Sclerodactyly
Telangiectasia
(higherl riskl forl losingl fingersl d/tl ischemial andl pulmonaryl HTN)
QUESTION
Slcerodermal diffusel dz
Answer:
widespreadl thickeningl ofl skin,l withl areasl ofl increasedl pigmentationl andl depigmentation
QUESTION
Diffusel sclerodermal clinicall presentation
Answer:
Commonl early:
polyarthralgia
weightl loss
malaise
Other:
skinl changesl involvingl trunk,l proximall extremities
subcutaneousl edemal associatedl withl pruritus
Skinl becomesl thickenedl andl hidebound,l losesl normall folds
Telangiectasia,l pigmentation,l depigmentationl common
Ulcerationl ofl fingertips
Tendonl frictionl rubsl overl forearmsl andl shins
Restrictivel lungl dz
Cardiacl abnormalities
, Renall crisis
QUESTION
Sclerodermal systemicl features
Answer:
gastroesophageall reflux,l GIl hypomotility,l pulmonaryl fibrosis,l pulmonaryl HTN,l renall
involvement
QUESTION
Sclerodermal presentation
Answer:
-raynaudl phenomenonl andl antinuclearl antibodiesl arel presentl inl virtuallyl alll patients
QUESTION
Sclerodermal labs
Answer:
Mildl anemial (hemolytic)
Normall ESR
Mildl proteinuria
ANAl positivel andl high
anti-SCL-70l onlyl 20-30%l andl poorl prognosis
Anticentromerel antibodiesl inl 50%l withl limitedl dz
Anti-RNAl polymerasel IIIl antibodiesl 10-20%l assocl w/l rapidl dz,l renall crisis,l higherl riskl
ofl cancers,l espl breastl ca
QUESTION
Differentiatel sclerodermal andl sclerederma
Answer:
Scleredermal assocl w/l diabetesl orl inection
Skinl thickeningl ofl thel posteriorl neck,l shoulders,l upperl back
