Triad of skin lesions, asymmetric mononeuritis multiplex and eosinophilia are seen in?
A. Cryoglobulinemic vasculitis
B. Polyarteritis nodosa
C. Churg Strauss Syndrome
D. Giant cell arteritis
Correct answer : C. Churg Strauss Syndrome
Churg Strauss Syndrome
Churg Strauss Syndrome is a small vessel vasculitis.
Biopsy of affected site reveals small vessel vasculitis with eosinophilic infiltration of vessel wall.
Cryoglobulinemic vasculitis presents with rash over lower limbs, arthralgia, Raynaud’s phenomenon and neuropathy
Polyarteritis nodosa presents with fever, myalgia, arthralgia, multisystem involvement and palpable purpura.
Giant cell arteritis
Cardinal symptom of giant cell arteritis is headache localised to temporal or occipital region.
Visual disturbances can occur.
Catastrophic presentation is with blindness in one eye.
It is commonly associated with polymyalgia rheumatica.
Ref: Davidson’s Principles and Practice of Medicine, 22nd ed, p1117-1119
Which of the following genetic mutation has been described in aortic stenosis?
Correct answer: c) NOTCH1
NOTCH1 mutation can cause severe valvular calcification which can be transmitted in an autosomal dominant pattern. KCNH2 and KCNQ1 are potassium channel genes, mutations of which are seen in long QT syndrome. SCN5A is a sodium channel gene which is mutated in long QT 3 and Brugada syndrome.
Read more on the causes of aortic stenosis at: https://cardiophile.org/causes-of-aortic-stenosis/
Mitral annular area in systole:
a) Decreases by 10%
b) Decreases by 25%
c) Increases by 10%
d) Increases by 25%
Correct answer: b) Decreases by 25%
In systole, when the ventricle contracts, the mitral annulus also contracts, reducing the mitral annular area by about 25% . This is important in preventing mitral regurgitation in systole. When the left ventricle is dilated, with associated annular dilatation, even in the absence of valvular damage, mitral regurgitation can occur. Similarly, when the left ventricular systolic function is poor, the decrease in mitral annular area with systole is reduced, paving the way for mitral regurgitation.
- Orniston JA, Shah PM, Tei C, Wong M. Size and motion of the mitral valve annulus in man. I. A two-dimensional echocardiographic method and findings in normal subjects. Circulation 1981; 64: 113-20.