skip to main content

Microscopic polyangiitis — SCE Rheumatology MCQ

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

HardVasculitisMicroscopic polyangiitisSCE Rheumatology

A 53-year-old woman has pulmonary haemorrhage, rapidly progressive glomerulonephritis, no asthma or sinus disease, MPO-ANCA positivity and pauci-immune crescents on biopsy. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: D — Rituximab or cyclophosphamide with glucocorticoids

Induce remission with rituximab or cyclophosphamide and glucocorticoids is the single best answer because MPO-ANCA pulmonary renal disease without granulomatous ENT features suggests microscopic polyangiitis. The stem is testing management choice, 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: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions