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Granulomatosis with polyangiitis — SCE Rheumatology MCQ

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HardVasculitisGranulomatosis with polyangiitisSCE Rheumatology

A 42-year-old woman has chronic sinusitis, otitis media, haemoptysis, cavitating pulmonary nodules, red cell casts and PR3-ANCA positivity. What is the most likely diagnosis?

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

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Correct answer: D — Granulomatosis with polyangiitis

Granulomatosis with polyangiitis is the single best answer because ENT disease, cavitating lung nodules and glomerulonephritis with PR3-ANCA indicate GPA. The stem is testing diagnostic synthesis, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Migraine is less suitable because it fits a different clinical pattern or a different treatment threshold; Sarcoidosis, Aspirin monotherapy and Etanercept do not address the key discriminator in this vignette. Clinical pearl: in SCE-style rheumatology questions, autoantibodies, imaging and synovial fluid findings should be interpreted with the whole phenotype.

Reference: BSR/EULAR vasculitis recommendations; NICE technology appraisals; BNF