Renal Artery Aneurysms PAN — ESENeph MCQ

Correct answer: B — Fibromuscular dysplasia versus medium-vessel vasculitis

The best answer is “Fibromuscular dysplasia versus medium-vessel vasculitis”. Polyarteritis nodosa and fibromuscular dysplasia can both produce renal arterial stenoses and aneurysms, but treatment differs radically; systemic assessment, hepatitis testing and expert vascular imaging review are essential. “Atherosclerosis versus diabetic nephropathy” is less appropriate because the age and multifocal aneurysmal pattern are atypical for routine atherosclerosis “Minimal-change disease versus membranous nephropathy” is less appropriate because these glomerular diseases do not create renal-artery aneurysms “Alport syndrome versus thin basement membrane disease” is less appropriate because these cause haematuria rather than medium-vessel lesions “Renal-vein thrombosis versus nephroptosis” is less appropriate because neither explains the arterial beading and aneurysms

Reference: British Society for Rheumatology guideline management page: https://www.rheumatology.org.uk/practice-quality/guidelines