Systemic paediatrics: Takayasu arteritis in children: practice question

A Pediatrics 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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Pediatrics · Systemic paediatrics: Takayasu arteritis in children

Sample item

An 11-year-old girl has headaches and fatigue. Blood pressure is 170/110 mmHg in the right arm, left radial and femoral pulses are weak, an abdominal bruit is heard and ESR is 85 mm in the first hour. Which investigation best defines the disease?

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

The answer and the reasoning

B. CT or MR angiography of the aorta and its branches

Takayasu arteritis is a large vessel granulomatous vasculitis of the aorta and its main branches. It presents with hypertension from renal artery stenosis, diminished pulses and bruits. CT or MR angiography maps stenoses and aneurysms and is the key investigation.

Option by option

  • A. Renal biopsy with immunofluorescence

    Renal biopsy evaluates parenchymal glomerular disease and does not show large vessel stenosis.

  • B. CT or MR angiography of the aorta and its branches (correct)

    Correct. Angiography of the aorta and its branches shows the stenoses that define Takayasu arteritis.

  • C. Echocardiography with Doppler of the heart valves

    Echocardiography examines the heart and does not show the extracardiac arterial lesions.

  • D. Antineutrophil cytoplasmic antibody titre

    ANCA titres support small vessel vasculitis such as granulomatosis with polyangiitis.

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.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, CT or MR angiography of the aorta and its branches. Takayasu arteritis is a large vessel granulomatous vasculitis of the aorta and its main branches.

Why is "Renal biopsy with immunofluorescence" not the answer?

Renal biopsy evaluates parenchymal glomerular disease and does not show large vessel stenosis.

Why is "Echocardiography with Doppler of the heart valves" not the answer?

Echocardiography examines the heart and does not show the extracardiac arterial lesions.

Why is "Antineutrophil cytoplasmic antibody titre" not the answer?

ANCA titres support small vessel vasculitis such as granulomatosis with polyangiitis.

What concept does this question test?

It tests Systemic paediatrics: Takayasu arteritis in children in Pediatrics. It presents with hypertension from renal artery stenosis, diminished pulses and bruits. CT or MR angiography maps stenoses and aneurysms and is the key investigation.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Systemic paediatrics: Takayasu arteritis in children?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.