skip to main content

ANCA-associated vasculitis — SCE Rheumatology MCQ

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

ModerateVasculitisANCA-associated vasculitisSCE Rheumatology

A 47-year-old man has purpura, sinus symptoms and acute kidney injury. Examination shows blood pressure is elevated with ankle oedema. Investigations show urinalysis shows blood, protein and red-cell casts. The diagnosis is established and symptoms remain clinically important despite initial supportive measures. There is no contraindication to disease-modifying or anti-inflammatory escalation. 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 — Azathioprine maintenance

Azathioprine maintenance is the best answer because azathioprine maintenance is the most appropriate next step for anca-associated vasculitis in this clinical setting. Urgent antibiotics is a plausible distractor, but it does not account for the key discriminator in the stem. Urgent vascular imaging and Therapeutic exercise would be more appropriate in a different clinical pattern or at another point in the pathway, while Tocilizumab with glucocorticoid taper is suboptimal for this presentation. Clinical pearl: rheumatology management is generally treat-to-target, but infection risk, pregnancy plans and shared-care monitoring often determine the safest answer.

Reference: BSR GCA guideline; EULAR ANCA-associated vasculitis recommendations; BNF