Vasculitis: eosinophilic granulomatosis with polyangiitis: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Vasculitis: eosinophilic granulomatosis with polyangiitis

Sample item

A 38-year-old man with long-standing asthma develops mononeuritis multiplex, a peripheral eosinophil count of 2,500 per microlitre and palpable purpura. Which antibody is most likely to be present?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. p-ANCA directed against myeloperoxidase

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) is a small-vessel vasculitis with asthma, eosinophilia and extravascular granulomas, and about 40% are p-ANCA (MPO) positive. Biopsy shows eosinophil-rich necrotising vasculitis. Granulomatosis with polyangiitis typically has c-ANCA.

Option by option

  • A. p-ANCA directed against myeloperoxidase (correct)

    MPO-directed p-ANCA is found in a proportion of patients with this eosinophil-rich vasculitis.

  • B. c-ANCA directed against proteinase 3

    c-ANCA with PR3 specificity is typical of granulomatosis with polyangiitis, without asthma-driven eosinophilia.

  • C. Anti-dsDNA antibody

    Anti-dsDNA is a marker of lupus.

  • D. Anti-GBM antibody

    Anti-GBM antibody causes Goodpasture disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, p-ANCA directed against myeloperoxidase. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) is a small-vessel vasculitis with asthma, eosinophilia and extravascular granulomas, and about 40% are p-ANCA (MPO) positive.

Why is "c-ANCA directed against proteinase 3" not the answer?

c-ANCA with PR3 specificity is typical of granulomatosis with polyangiitis, without asthma-driven eosinophilia.

Why is "Anti-dsDNA antibody" not the answer?

Anti-dsDNA is a marker of lupus.

Why is "Anti-GBM antibody" not the answer?

Anti-GBM antibody causes Goodpasture disease.

What concept does this question test?

It tests Vasculitis: eosinophilic granulomatosis with polyangiitis in Pathology. Biopsy shows eosinophil-rich necrotising vasculitis. Granulomatosis with polyangiitis typically has c-ANCA.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vasculitis: eosinophilic granulomatosis with polyangiitis?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.