Polyarteritis Nodosa — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateVasculitisPolyarteritis NodosaSCE Rheumatology

A 50-year-old man with a history of hepatitis B presents with testicular pain fever weight loss livedo reticularis and new-onset foot drop. Mesenteric angiography shows multiple microaneurysms. ANCA is negative. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Polyarteritis nodosa

The best answer is “Polyarteritis nodosa”. Polyarteritis nodosa is a medium vessel vasculitis associated with hepatitis B. Classical features include constitutional symptoms, testicular pain, mononeuritis multiplex (foot drop), livedo reticularis, and microaneurysms on angiography. PAN is ANCA-negative, distinguishing it from the ANCA-associated vasculitides (GPA, MPA, EGPA). The hepatitis B association and medium vessel involvement pattern are characteristic. The competing options represent related diagnoses, tests or treatments, but they do not match the decisive phenotype, safety constraint or management point in this stem.

Reference: ACR polyarteritis nodosa classification criteria interpreted in British Society for Rheumatology UK vasculitis practice: https://pubmed.ncbi.nlm.nih.gov/1975174/