skip to main content

ANCA-associated vasculitis — SCE Rheumatology MCQ

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

HardVasculitisANCA-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 consultant wants the next test most likely to confirm the suspected process or guide treatment. The result will change diagnosis, staging or immediate treatment. What is the most appropriate investigation?

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

Reveal the answer and explanation

Correct answer: B — Urinalysis and renal function

Urinalysis and renal function is the best answer because urinalysis and renal function is the investigation most likely to resolve the immediate diagnostic or monitoring question in anca-associated vasculitis. Hepatitis B serology is a plausible distractor, but it does not account for the key discriminator in the stem. FDG-PET CT and Chest CT would be more appropriate in a different clinical pattern or at another point in the pathway, while Tissue biopsy is suboptimal for this presentation. Clinical pearl: autoantibodies are supportive tests and should be interpreted alongside phenotype, inflammatory markers, urinalysis and imaging.

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