{"id":36954,"date":"2026-06-06T09:08:36","date_gmt":"2026-06-06T03:38:36","guid":{"rendered":"https:\/\/atsixty.com\/?p=36954"},"modified":"2026-06-06T09:43:08","modified_gmt":"2026-06-06T04:13:08","slug":"rheumatology-vasculitides","status":"publish","type":"post","link":"https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/","title":{"rendered":"Vasculitides"},"content":{"rendered":"\n\n\n<meta charset=\"UTF-8\">\n<meta name=\"viewport\" content=\"width=device-width, initial-scale=1.0\">\n<title>Morning Rounds \u00b7 Vasculitides<\/title>\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Playfair+Display:ital,wght@0,400;0,600;0,700;1,400;1,600&#038;family=Source+Serif+4:ital,wght@0,300;0,400;0,600;1,400&#038;display=swap\" rel=\"stylesheet\">\n<style>\n#rhmq05 *,#rhmq05 *::before,#rhmq05 *::after{box-sizing:border-box;margin:0;padding:0}\n#rhmq05{\n  --ter:#8B3D20;\n  --ter-light:#B85A38;\n  --ter-pale:#FDF0EB;\n  --ter-dark:#6B2D14;\n  --correct:#2D6B47;--correct-bg:#EAF6EF;--correct-border:#3A9960;\n  --wrong:#B83232;--wrong-bg:#FDF0F0;--wrong-border:#E53935;\n  --ink:#2C1810;--ink-mid:#5A3D30;--ink-soft:#9A7060;\n  --line:#E8DDD8;--cream:#FAF6F2;--warm:#FFFDF9;\n  font-family:'Source Serif 4',Georgia,serif;\n  font-size:16px;color:var(--ink);background:var(--cream);\n  line-height:1.7;padding:0 0 64px;\n}\n#rhmq05 .mr-header{background:var(--ter);color:#FFFDF9;padding:34px 24px 28px;text-align:center}\n#rhmq05 .mr-eyebrow{font-size:0.68rem;letter-spacing:0.18em;text-transform:uppercase;font-weight:600;opacity:0.65;margin-bottom:10px}\n#rhmq05 .mr-title{font-family:'Playfair Display',serif;font-size:1.75rem;font-weight:700;line-height:1.2;margin-bottom:4px}\n#rhmq05 .mr-title em{font-style:italic;font-weight:400;opacity:0.88}\n#rhmq05 .mr-subtitle{font-size:0.82rem;opacity:0.7;margin-top:8px;font-style:italic}\n#rhmq05 .mr-chips{display:flex;justify-content:center;gap:10px;margin-top:18px;flex-wrap:wrap}\n#rhmq05 .mr-chip{background:rgba(255,255,255,0.13);border:1px solid rgba(255,255,255,0.22);border-radius:20px;padding:4px 13px;font-size:0.73rem}\n#rhmq05 .mr-sentinel{height:1px}\n#rhmq05 .mr-progress{position:fixed;top:0;left:0;right:0;z-index:9999;background:var(--warm);border-bottom:1px solid var(--line);box-shadow:0 2px 12px rgba(44,24,16,0.08);padding:9px 16px;display:none}\n#rhmq05 .mr-progress.visible{display:block}\n#rhmq05 .mr-prog-inner{max-width:720px;margin:0 auto;display:flex;align-items:center;justify-content:center}\n#rhmq05 .mr-pips{display:flex;align-items:center;justify-content:center}\n#rhmq05 .mr-pip-wrap{display:flex;align-items:center}\n#rhmq05 .mr-pip-line{width:28px;height:2px;background:var(--line);transition:background 0.35s}\n#rhmq05 .mr-pip-line.done{background:var(--ter)}\n#rhmq05 .mr-pip{width:28px;height:28px;border-radius:50%;border:2px solid var(--line);background:var(--warm);display:flex;align-items:center;justify-content:center;font-size:0.63rem;font-weight:700;color:var(--ink-soft);transition:all 0.3s;flex-shrink:0}\n#rhmq05 .mr-pip.correct{background:var(--correct-border);border-color:var(--correct-border);color:#fff}\n#rhmq05 .mr-pip.wrong{background:var(--wrong-border);border-color:var(--wrong-border);color:#fff}\n#rhmq05 .mr-body{max-width:720px;margin:0 auto;padding:0 16px}\n#rhmq05 .mr-case{background:var(--warm);border:1px solid var(--line);border-left:4px solid var(--ter);border-radius:10px;margin:28px 0;overflow:hidden;box-shadow:0 1px 6px rgba(44,24,16,0.05)}\n#rhmq05 .mr-case-top{padding:16px 20px 14px;display:flex;gap:14px;align-items:flex-start}\n#rhmq05 .mr-num{font-family:'Playfair Display',serif;font-size:2.2rem;font-weight:700;color:var(--ter);opacity:0.16;line-height:1;margin-top:-2px;flex-shrink:0}\n#rhmq05 .mr-meta{flex:1}\n#rhmq05 .mr-tag-row{display:flex;align-items:center;justify-content:space-between;margin-bottom:5px}\n#rhmq05 .mr-tag{font-size:0.61rem;font-weight:700;letter-spacing:0.14em;text-transform:uppercase;color:var(--ter);opacity:0.8}\n#rhmq05 .mr-diff{font-size:0.61rem;font-weight:700;letter-spacing:0.10em;text-transform:uppercase;color:var(--ink-soft)}\n#rhmq05 .mr-stem{font-size:0.94rem;color:var(--ink);line-height:1.72}\n#rhmq05 .mr-stem strong{font-weight:600}\n#rhmq05 .mr-stem em{font-style:italic}\n#rhmq05 .mr-rule{height:1px;background:var(--line);margin:0 20px}\n#rhmq05 .mr-opts{padding:12px 20px 16px;display:flex;flex-direction:column;gap:8px}\n#rhmq05 .mr-opt{display:flex;align-items:flex-start;gap:11px;padding:10px 14px;border:1.5px solid var(--line);border-radius:8px;cursor:pointer;background:var(--warm);transition:border-color 0.15s,background 0.15s;-webkit-tap-highlight-color:transparent}\n#rhmq05 .mr-opt:hover{border-color:var(--ter);background:var(--ter-pale)}\n#rhmq05 .mr-opt.locked{cursor:default}\n#rhmq05 .mr-opt.locked:hover{border-color:var(--line);background:var(--warm)}\n#rhmq05 .mr-opt.correct{border-color:var(--correct-border);background:var(--correct-bg);cursor:default}\n#rhmq05 .mr-opt.correct:hover{border-color:var(--correct-border);background:var(--correct-bg)}\n#rhmq05 .mr-opt.wrong{border-color:var(--wrong-border);background:var(--wrong-bg);cursor:default}\n#rhmq05 .mr-opt.wrong:hover{border-color:var(--wrong-border);background:var(--wrong-bg)}\n#rhmq05 .mr-opt.dimmed{opacity:0.35;cursor:default}\n#rhmq05 .mr-opt.dimmed:hover{border-color:var(--line);background:var(--warm)}\n#rhmq05 .mr-ltr{flex-shrink:0;width:20px;height:20px;border-radius:50%;border:1.5px solid var(--line);display:flex;align-items:center;justify-content:center;font-size:0.62rem;font-weight:700;color:var(--ink-soft);margin-top:2px;transition:all 0.15s}\n#rhmq05 .mr-opt.correct .mr-ltr{background:var(--correct-border);border-color:var(--correct-border);color:#fff}\n#rhmq05 .mr-opt.wrong .mr-ltr{background:var(--wrong-border);border-color:var(--wrong-border);color:#fff}\n#rhmq05 .mr-opt-text{font-size:0.9rem;color:var(--ink-mid);line-height:1.58}\n#rhmq05 .mr-opt.correct .mr-opt-text{color:var(--correct);font-weight:600}\n#rhmq05 .mr-opt.wrong .mr-opt-text{color:var(--wrong)}\n#rhmq05 .mr-exp{display:none;border-top:1px solid #c8e0d8;background:linear-gradient(180deg,#edf7f4 0%,#f4faf8 100%);padding:13px 20px 15px}\n#rhmq05 .mr-exp-lbl{font-size:0.61rem;font-weight:700;letter-spacing:0.12em;text-transform:uppercase;color:var(--correct);margin-bottom:6px}\n#rhmq05 .mr-exp-text{font-size:0.86rem;color:#1c4a3a;line-height:1.68}\n#rhmq05 .mr-exp-text strong{font-weight:600}\n#rhmq05 .mr-exp-text em{font-style:italic}\n#rhmq05 .mr-exp-extra{margin-top:11px;padding-top:10px;border-top:1px dashed #9ACCC4;font-size:0.84rem;color:#1c4a3a;line-height:1.66}\n#rhmq05 .mr-exp-extra-lbl{font-size:0.59rem;font-weight:700;letter-spacing:0.12em;text-transform:uppercase;color:var(--ter);margin-bottom:4px;display:block}\n#rhmq05 .mr-exp-extra strong{font-weight:600}\n#rhmq05 .mr-exp-extra em{font-style:italic}\n#rhmq05 .mr-img-wrap{margin-top:14px;background:var(--warm);border:1px solid var(--line);border-radius:8px;padding:14px;text-align:center}\n#rhmq05 .mr-img-wrap figcaption{font-size:0.73rem;color:var(--ink-soft);font-style:italic;margin-top:8px;line-height:1.4}\n#rhmq05 .mr-submit-wrap{text-align:center;padding:28px 16px 8px}\n#rhmq05 .mr-btn{background:var(--ter);color:#FFFDF9;border:none;border-radius:8px;padding:13px 44px;font-family:'Playfair Display',serif;font-size:1rem;font-weight:700;cursor:pointer;box-shadow:0 2px 8px rgba(139,61,32,0.28)}\n#rhmq05 .mr-btn:hover{background:var(--ter-dark)}\n#rhmq05 .mr-score{display:none;background:var(--warm);border:1px solid var(--line);border-top:4px solid var(--ter);border-radius:10px;margin:24px 0 0;box-shadow:0 2px 12px rgba(44,24,16,0.08);overflow:hidden}\n#rhmq05 .mr-score-in{padding:28px 24px;text-align:center}\n#rhmq05 .mr-score-ey{font-size:0.66rem;letter-spacing:0.14em;text-transform:uppercase;color:var(--ink-soft);margin-bottom:12px;font-weight:600}\n#rhmq05 .mr-ring{width:98px;height:98px;border-radius:50%;background:conic-gradient(var(--ter) 0%,var(--line) 0%);display:flex;align-items:center;justify-content:center;margin:0 auto 16px;position:relative}\n#rhmq05 .mr-ring::before{content:'';position:absolute;width:76px;height:76px;border-radius:50%;background:var(--warm)}\n#rhmq05 .mr-ring-in{position:relative;display:flex;flex-direction:column;align-items:center;line-height:1.2}\n#rhmq05 .mr-ring-pct{font-family:'Playfair Display',serif;font-size:1.3rem;font-weight:700;color:var(--ter)}\n#rhmq05 .mr-ring-sub{font-size:0.54rem;color:var(--ink-soft);text-transform:uppercase;letter-spacing:0.06em}\n#rhmq05 .mr-score-title{font-family:'Playfair Display',serif;font-size:1.15rem;font-weight:700;color:var(--ink);margin-bottom:4px}\n#rhmq05 .mr-score-net{font-size:0.9rem;color:var(--ter);font-weight:600;margin-bottom:4px}\n#rhmq05 .mr-verdict{font-size:0.83rem;color:var(--ink-soft);font-style:italic;margin-bottom:18px;padding:0 12px}\n#rhmq05 .mr-bands{display:flex;justify-content:center;gap:10px;flex-wrap:wrap}\n#rhmq05 .mr-band{padding:5px 13px;border-radius:16px;font-size:0.78rem;font-weight:600}\n#rhmq05 .mr-band-c{background:var(--correct-bg);color:var(--correct)}\n#rhmq05 .mr-band-w{background:var(--wrong-bg);color:var(--wrong)}\n#rhmq05 .mr-band-s{background:var(--ter-pale);color:var(--ter)}\n#rhmq05 .mr-retry{display:block;margin:18px auto 4px;background:transparent;border:2px solid var(--ter);color:var(--ter);border-radius:8px;padding:9px 28px;font-family:'Playfair Display',serif;font-size:0.92rem;font-weight:700;cursor:pointer}\n#rhmq05 .mr-retry:hover{background:var(--ter);color:#FFFDF9}\n@media(max-width:480px){#rhmq05 .mr-title{font-size:1.4rem}#rhmq05 .mr-num{font-size:1.7rem}#rhmq05 .mr-stem{font-size:0.9rem}#rhmq05 .mr-opt-text{font-size:0.86rem}}\n<\/style>\n\n<!-- Vasculitis classification by vessel size \u2014 SVG for Q1 debrief -->\n<div id=\"rhmq05-img1\" style=\"display:none\">\n  <figure class=\"mr-img-wrap\">\n    <svg viewBox=\"0 0 540 185\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width:100%;max-width:540px;display:block;margin:0 auto\">\n      <rect x=\"0\" y=\"0\" width=\"540\" height=\"185\" rx=\"8\" fill=\"#F4F8F6\"\/>\n      <!-- Vessel size axis -->\n      <line x1=\"30\" y1=\"155\" x2=\"510\" y2=\"155\" stroke=\"#C8D8D4\" stroke-width=\"2\"\/>\n      <text x=\"30\" y=\"172\" fill=\"#7A9A94\" font-size=\"8.5\" font-family=\"Georgia,serif\">Large<\/text>\n      <text x=\"215\" y=\"172\" fill=\"#7A9A94\" font-size=\"8.5\" font-family=\"Georgia,serif\">Medium<\/text>\n      <text x=\"420\" y=\"172\" fill=\"#7A9A94\" font-size=\"8.5\" font-family=\"Georgia,serif\">Small<\/text>\n      <text x=\"270\" y=\"182\" text-anchor=\"middle\" fill=\"#9ACCC4\" font-size=\"8\" font-family=\"Georgia,serif\" font-style=\"italic\">vessel size<\/text>\n      <!-- Tick marks -->\n      <line x1=\"90\" y1=\"150\" x2=\"90\" y2=\"160\" stroke=\"#C8D8D4\" stroke-width=\"1.5\"\/>\n      <line x1=\"270\" y1=\"150\" x2=\"270\" y2=\"160\" stroke=\"#C8D8D4\" stroke-width=\"1.5\"\/>\n      <line x1=\"420\" y1=\"150\" x2=\"420\" y2=\"160\" stroke=\"#C8D8D4\" stroke-width=\"1.5\"\/>\n      <!-- Large vessel boxes -->\n      <rect x=\"34\" y=\"10\" width=\"115\" height=\"36\" rx=\"5\" fill=\"#3D5A80\" opacity=\"0.88\"\/>\n      <text x=\"91\" y=\"24\" text-anchor=\"middle\" fill=\"#fff\" font-size=\"9.5\" font-family=\"Georgia,serif\" font-weight=\"bold\">Takayasu Arteritis<\/text>\n      <text x=\"91\" y=\"37\" text-anchor=\"middle\" fill=\"rgba(255,255,255,0.8)\" font-size=\"8\" font-family=\"Georgia,serif\">Aorta &amp; branches; &lt;40 yrs<\/text>\n      <line x1=\"91\" y1=\"46\" x2=\"91\" y2=\"155\" stroke=\"#3D5A80\" stroke-width=\"1.2\" stroke-dasharray=\"3,2\"\/>\n      <rect x=\"34\" y=\"56\" width=\"115\" height=\"36\" rx=\"5\" fill=\"#5B7FA6\" opacity=\"0.88\"\/>\n      <text x=\"91\" y=\"70\" text-anchor=\"middle\" fill=\"#fff\" font-size=\"9.5\" font-family=\"Georgia,serif\" font-weight=\"bold\">Giant Cell Arteritis<\/text>\n      <text x=\"91\" y=\"83\" text-anchor=\"middle\" fill=\"rgba(255,255,255,0.8)\" font-size=\"8\" font-family=\"Georgia,serif\">Temporal a.; &gt;50 yrs; PMR<\/text>\n      <line x1=\"91\" y1=\"92\" x2=\"91\" y2=\"155\" stroke=\"#5B7FA6\" stroke-width=\"1.2\" stroke-dasharray=\"3,2\"\/>\n      <!-- Medium vessel boxes -->\n      <rect x=\"200\" y=\"10\" width=\"130\" height=\"36\" rx=\"5\" fill=\"#8B3D20\" opacity=\"0.88\"\/>\n      <text x=\"265\" y=\"24\" text-anchor=\"middle\" fill=\"#fff\" font-size=\"9.5\" font-family=\"Georgia,serif\" font-weight=\"bold\">Polyarteritis Nodosa<\/text>\n      <text x=\"265\" y=\"37\" text-anchor=\"middle\" fill=\"rgba(255,255,255,0.8)\" font-size=\"8\" font-family=\"Georgia,serif\">Spares lung; HBV assoc.<\/text>\n      <line x1=\"265\" y1=\"46\" x2=\"265\" y2=\"155\" stroke=\"#8B3D20\" stroke-width=\"1.2\" stroke-dasharray=\"3,2\"\/>\n      <rect x=\"200\" y=\"56\" width=\"130\" height=\"36\" rx=\"5\" fill=\"#C07828\" opacity=\"0.88\"\/>\n      <text x=\"265\" y=\"70\" text-anchor=\"middle\" fill=\"#fff\" font-size=\"9.5\" font-family=\"Georgia,serif\" font-weight=\"bold\">Kawasaki Disease<\/text>\n      <text x=\"265\" y=\"83\" text-anchor=\"middle\" fill=\"rgba(255,255,255,0.8)\" font-size=\"8\" font-family=\"Georgia,serif\">Children; coronary aneurysm<\/text>\n      <line x1=\"265\" y1=\"92\" x2=\"265\" y2=\"155\" stroke=\"#C07828\" stroke-width=\"1.2\" stroke-dasharray=\"3,2\"\/>\n      <!-- Small vessel boxes -->\n      <rect x=\"385\" y=\"10\" width=\"148\" height=\"36\" rx=\"5\" fill=\"#B83232\" opacity=\"0.88\"\/>\n      <text x=\"459\" y=\"24\" text-anchor=\"middle\" fill=\"#fff\" font-size=\"9.5\" font-family=\"Georgia,serif\" font-weight=\"bold\">GPA (Wegener&apos;s)<\/text>\n      <text x=\"459\" y=\"37\" text-anchor=\"middle\" fill=\"rgba(255,255,255,0.8)\" font-size=\"8\" font-family=\"Georgia,serif\">c-ANCA\/PR3; ENT+lung+kidney<\/text>\n      <line x1=\"459\" y1=\"46\" x2=\"459\" y2=\"155\" stroke=\"#B83232\" stroke-width=\"1.2\" stroke-dasharray=\"3,2\"\/>\n      <rect x=\"385\" y=\"56\" width=\"148\" height=\"36\" rx=\"5\" fill=\"#2D6B47\" opacity=\"0.88\"\/>\n      <text x=\"459\" y=\"70\" text-anchor=\"middle\" fill=\"#fff\" font-size=\"9.5\" font-family=\"Georgia,serif\" font-weight=\"bold\">EGPA \/ MPA<\/text>\n      <text x=\"459\" y=\"83\" text-anchor=\"middle\" fill=\"rgba(255,255,255,0.8)\" font-size=\"8\" font-family=\"Georgia,serif\">p-ANCA\/MPO; asthma (EGPA)<\/text>\n      <line x1=\"459\" y1=\"92\" x2=\"459\" y2=\"155\" stroke=\"#2D6B47\" stroke-width=\"1.2\" stroke-dasharray=\"3,2\"\/>\n    <\/svg>\n    <figcaption>\n      Chapel Hill Consensus Classification of vasculitis by vessel size. <strong>Large vessel<\/strong>: Takayasu (young women, aorta) and GCA (elderly, temporal artery). <strong>Medium vessel<\/strong>: PAN (no lung, HBV) and Kawasaki (children, coronary). <strong>Small vessel ANCA-associated<\/strong>: GPA (c-ANCA\/PR3), MPA (p-ANCA\/MPO), EGPA (p-ANCA\/MPO + asthma + eosinophilia).\n    <\/figcaption>\n  <\/figure>\n<\/div>\n\n<div id=\"rhmq05\">\n\n  <div class=\"mr-header\">\n    <div class=\"mr-eyebrow\">Morning Rounds &middot; Rheumatology Series &middot; Round 05<\/div>\n    <div class=\"mr-title\">\n      Vasculitides<br><em>Clinical Reasoning<\/em>\n    <\/div>\n    <div class=\"mr-subtitle\">Five high-yield clinical cases &middot; +4 \/ &minus;1 scoring &middot; NEET-PG and UPSC CMS<\/div>\n    <div class=\"mr-chips\">\n      <span class=\"mr-chip\">5 Cases<\/span>\n      <span class=\"mr-chip\">+4 \/ &minus;1 scoring<\/span>\n      <span class=\"mr-chip\">Options reshuffled<\/span>\n    <\/div>\n  <\/div>\n\n  <div class=\"mr-sentinel\" id=\"rhmq05-sentinel\"><\/div>\n\n  <div class=\"mr-progress\" id=\"rhmq05-progress\">\n    <div class=\"mr-prog-inner\">\n      <div class=\"mr-pips\" id=\"rhmq05-pips\"><\/div>\n    <\/div>\n  <\/div>\n\n  <div class=\"mr-body\">\n    <div id=\"rhmq05-cases\"><\/div>\n    <div class=\"mr-submit-wrap\">\n      <button class=\"mr-btn\" id=\"rhmq05-submit\">Submit for Debrief<\/button>\n    <\/div>\n    <div class=\"mr-score\" id=\"rhmq05-score\">\n      <div class=\"mr-score-in\">\n        <div class=\"mr-score-ey\">Round Complete<\/div>\n        <div class=\"mr-ring\" id=\"rhmq05-ring\">\n          <div class=\"mr-ring-in\">\n            <span class=\"mr-ring-pct\" id=\"rhmq05-pct\">0%<\/span>\n            <span class=\"mr-ring-sub\">net<\/span>\n          <\/div>\n        <\/div>\n        <div class=\"mr-score-title\">Your Debrief<\/div>\n        <div class=\"mr-score-net\" id=\"rhmq05-net\"><\/div>\n        <div class=\"mr-verdict\" id=\"rhmq05-verdict\"><\/div>\n        <div class=\"mr-bands\">\n          <span class=\"mr-band mr-band-c\" id=\"rhmq05-ct-c\"><\/span>\n          <span class=\"mr-band mr-band-w\" id=\"rhmq05-ct-w\"><\/span>\n          <span class=\"mr-band mr-band-s\" id=\"rhmq05-ct-s\"><\/span>\n        <\/div>\n        <button class=\"mr-retry\" id=\"rhmq05-retry\">&#8635; New Round<\/button>\n      <\/div>\n    <\/div>\n  <\/div>\n\n<\/div><!-- end #rhmq05 -->\n\n<script>\n(function () {\n  'use strict';\n\n  var NS    = 'rhmq05';\n  var TOTAL = 5;\n  var MAX   = 20;\n  var LTRS  = ['A','B','C','D'];\n\n  var QS = [\n\n    \/* ---- Q1 : Takayasu Arteritis ---- *\/\n    {\n      id:   1,\n      diff: 'Easy',\n      tag:  'Takayasu Arteritis &mdash; Large Vessel',\n      stem: 'A <strong>24-year-old woman<\/strong> presents with a <strong>6-month history of fatigue, low-grade fever, and aching in both arms<\/strong>. On examination, <strong>blood pressure in the right arm is 85\/50 mmHg<\/strong> and in the left arm is 124\/80 mmHg. The right radial pulse is absent. A <strong>bruit is audible over the right subclavian artery<\/strong>. ESR is 88 mm\/hr and CRP is 46 mg\/L. She has no headache, no visual symptoms, and no jaw claudication. Angiography reveals long-segment stenosis of the right subclavian and right common carotid arteries. Which statement regarding the classification, investigation of choice, and initial management of this condition is <em>most accurate<\/em>?',\n      correct: 'Takayasu arteritis is a large-vessel granulomatous vasculitis predominantly affecting women under 40; MR angiography (MRA) or CT angiography is the investigation of choice for delineating vessel involvement; high-dose prednisolone is first-line treatment',\n      opts: [\n        'Takayasu arteritis is a large-vessel granulomatous vasculitis predominantly affecting women under 40; MR angiography (MRA) or CT angiography is the investigation of choice for delineating vessel involvement; high-dose prednisolone is first-line treatment',\n        'The BP asymmetry and absent pulse confirm Giant Cell Arteritis affecting the subclavian artery; temporal artery biopsy should be performed immediately and high-dose prednisolone started before any vascular imaging',\n        'The clinical picture is consistent with atherosclerotic subclavian steal syndrome; lipid-lowering therapy and antiplatelet agents are the mainstay of treatment; corticosteroids are contraindicated as they accelerate atherosclerosis',\n        'Takayasu arteritis is diagnosed by temporal artery biopsy showing giant cells; MRA is only indicated after biopsy confirmation to plan surgical revascularisation, which is the preferred initial treatment over immunosuppression'\n      ],\n      exp:  '<strong>Takayasu arteritis (TA)<\/strong> is a chronic granulomatous large-vessel vasculitis affecting the <strong>aorta and its major branches<\/strong>, predominantly in <strong>women under 40<\/strong> (in contrast to GCA which affects those over 50). It has two phases: an early inflammatory phase (constitutional symptoms, elevated ESR\/CRP) and a late fibrotic\/occlusive phase (BP asymmetry, absent pulses, bruits, claudication). The <strong>&gt;10 mmHg BP difference between arms<\/strong> is a cardinal sign. <strong>Investigation of choice: MR angiography or CT angiography<\/strong> &mdash; both visualise vessel wall thickening (mural oedema on MRI) and luminal stenosis\/occlusion. Temporal artery biopsy is for GCA, not TA. <strong>Treatment<\/strong>: high-dose prednisolone (1 mg\/kg\/day) is first-line; methotrexate or azathioprine are steroid-sparing agents. Revascularisation (angioplasty, bypass) is reserved for critical ischaemia and only performed during disease remission.',\n      extra: '<strong>ACR 1990 Criteria for Takayasu Arteritis<\/strong> (&ge;3 of 6): age of onset &le;40 years; claudication of extremities; decreased brachial artery pulse; BP difference &gt;10 mmHg between arms; bruit over subclavian arteries or aorta; arteriographic narrowing of aorta, its primary branches, or proximal large limb arteries. Sensitivity 90.5%, specificity 97.8%. <strong>Types of TA (Numano classification)<\/strong>: Type I (aortic arch branches only); Type IIa (ascending aorta + arch); Type IIb (descending thoracic aorta); Type III (thoracic + abdominal); Type IV (abdominal only); Type V (combined). The most common type in India and Japan is <strong>Type V<\/strong>. <strong>Distinction from GCA<\/strong>: age (&lt;40 vs &gt;50); ethnicity (Asian vs European); arteries involved (aortic branches vs temporal\/ophthalmic); PMR association (GCA only); temporal artery biopsy (GCA only).',\n      imgId: 'rhmq05-img1'\n    },\n\n    \/* ---- Q2 : GPA (Wegener's) ---- *\/\n    {\n      id:   2,\n      diff: 'Medium',\n      tag:  'GPA (Wegener&apos;s) &mdash; ANCA-Associated',\n      stem: 'A <strong>48-year-old man<\/strong> presents with a <strong>3-month history of bloody nasal discharge, recurrent sinusitis, and crusting of the nasal mucosa<\/strong>. Over the past four weeks he has developed <strong>haemoptysis, dyspnoea<\/strong>, and a rising creatinine (from 88 to 224 &mu;mol\/L over 6 weeks). CXR shows multiple bilateral nodular opacities, some with central cavitation. Urinalysis reveals <strong>3+ haematuria and RBC casts<\/strong> on microscopy. c-ANCA (PR3-ANCA) is strongly positive. Which statement most accurately describes the renal histology, the immediate risk, and the correct induction regimen?',\n      correct: 'Renal biopsy in GPA shows focal segmental necrotising glomerulonephritis with crescents and no immune deposits (pauci-immune); the immediate risk is pulmonary-renal syndrome with life-threatening alveolar haemorrhage; induction with high-dose prednisolone plus cyclophosphamide or rituximab is standard',\n      opts: [\n        'Renal biopsy in GPA shows focal segmental necrotising glomerulonephritis with crescents and no immune deposits (pauci-immune); the immediate risk is pulmonary-renal syndrome with life-threatening alveolar haemorrhage; induction with high-dose prednisolone plus cyclophosphamide or rituximab is standard',\n        'Renal biopsy in GPA characteristically shows granular IgG and C3 immune deposits along the glomerular basement membrane (immune-complex GN), similar to lupus nephritis; the ANCA titre directly predicts renal prognosis and should guide therapy escalation',\n        'The cavitating lung nodules confirm pulmonary tuberculosis with secondary renal involvement; c-ANCA positivity is a non-specific finding in chronic infections and does not establish a diagnosis of GPA without tissue biopsy of the nasal granulomas',\n        'Induction therapy for GPA consists of methotrexate plus low-dose prednisolone; cyclophosphamide is reserved for relapsing disease only and rituximab is contraindicated in the presence of active haematuria'\n      ],\n      exp:  '<strong>GPA (Granulomatosis with Polyangiitis)<\/strong>, formerly Wegener&rsquo;s, is a small-vessel ANCA-associated vasculitis (AAV) with the classical triad: <strong>upper respiratory tract<\/strong> (sinusitis, saddle-nose deformity, subglottic stenosis) + <strong>lower respiratory tract<\/strong> (cavitating nodules, alveolar haemorrhage) + <strong>renal disease<\/strong> (rapidly progressive GN). Renal histology shows <strong>pauci-immune focal necrotising crescentic GN<\/strong> &mdash; minimal or no immune deposits on immunofluorescence, distinguishing it from immune-complex GN (SLE, IgA nephropathy) and anti-GBM disease. <strong>c-ANCA\/PR3-ANCA<\/strong> is positive in ~90% of active generalised GPA. The <strong>pulmonary-renal syndrome<\/strong> is an emergency: alveolar haemorrhage + GN. <strong>Induction<\/strong>: high-dose prednisolone (1 mg\/kg\/day or IV methylprednisolone pulses) + either <strong>cyclophosphamide<\/strong> (IV or oral) or <strong>rituximab<\/strong> (preferred for relapsing disease and in younger patients to spare fertility). Plasma exchange is added for severe alveolar haemorrhage or creatinine &gt;500 &mu;mol\/L.',\n      extra: '<strong>ANCA patterns and their disease associations<\/strong>:<br>c-ANCA (cytoplasmic) \/ <strong>PR3-ANCA<\/strong>: GPA (&gt;90% in active generalised disease); also MPA (~30%).<br>p-ANCA (perinuclear) \/ <strong>MPO-ANCA<\/strong>: MPA (~60%); EGPA (~40%); occasionally drug-induced vasculitis.<br><strong>ANCA titre and disease activity<\/strong>: PR3-ANCA titres correlate moderately with GPA flares; MPO-ANCA titres correlate less reliably. Rising titre is a warning of relapse but treatment decisions should be based on clinical assessment, not titre alone. <strong>Maintenance therapy in AAV<\/strong>: after 3&ndash;6 months of induction, switch to maintenance with rituximab (preferred, 500 mg every 6 months for 2 years) or azathioprine. Methotrexate is an alternative for non-renal\/non-severe GPA. <strong>Subglottic stenosis<\/strong> in GPA: occurs in 16&ndash;23% and may cause stridor; it responds poorly to systemic immunosuppression and often requires intralesional corticosteroid injection or surgical dilation.',\n      imgId: null\n    },\n\n    \/* ---- Q3 : Polyarteritis Nodosa ---- *\/\n    {\n      id:   3,\n      diff: 'Medium',\n      tag:  'Polyarteritis Nodosa &mdash; Medium Vessel',\n      stem: 'A <strong>52-year-old man<\/strong> presents with a <strong>4-month history of constitutional symptoms<\/strong> (weight loss 8 kg, fever, malaise), <strong>mononeuritis multiplex<\/strong> (foot drop right, then wrist drop left, developing sequentially over weeks), <strong>testicular pain<\/strong>, and livedo reticularis. BP is 168\/102 mmHg (new hypertension). Urinalysis is <strong>normal<\/strong> (no haematuria, no proteinuria). CXR is clear. Hepatitis B surface antigen is <strong>positive<\/strong>. ANCA is <strong>negative<\/strong>. Mesenteric angiography reveals multiple <strong>microaneurysms<\/strong> and irregular segmental narrowing of medium-sized renal and mesenteric arteries. Which statement is <em>most accurate<\/em> about this presentation?',\n      correct: 'This is HBV-associated PAN; the absence of lung and glomerular involvement and the presence of microaneurysms on angiography are characteristic; treatment requires antiviral therapy for HBV in addition to corticosteroids, not immunosuppression alone',\n      opts: [\n        'This is HBV-associated PAN; the absence of lung and glomerular involvement and the presence of microaneurysms on angiography are characteristic; treatment requires antiviral therapy for HBV in addition to corticosteroids, not immunosuppression alone',\n        'The positive ANCA result confirms ANCA-associated vasculitis (MPA); testicular involvement and mononeuritis multiplex are atypical for MPA but the angiographic findings are consistent; standard AAV induction with cyclophosphamide is indicated',\n        'Normal urinalysis excludes vasculitis affecting the kidneys; the new hypertension and renal artery narrowing on angiography are caused by atherosclerotic renovascular disease; antihypertensive therapy and statin treatment are the priorities',\n        'Mononeuritis multiplex with constitutional symptoms in an HBsAg-positive patient indicates hepatitis B-associated cryoglobulinaemia, not PAN; cryoglobulins should be measured and the diagnosis revised before starting any immunosuppression'\n      ],\n      exp:  '<strong>Polyarteritis Nodosa (PAN)<\/strong> is a necrotising vasculitis of <strong>medium-sized arteries<\/strong> with no glomerulonephritis and no pulmonary vasculitis &mdash; these two absences are its defining negative features. It characteristically produces <strong>mononeuritis multiplex<\/strong> (successive peripheral nerve infarcts), renovascular hypertension, mesenteric ischaemia, testicular pain (testicular artery involvement), and skin findings (livedo reticularis, nodules). <strong>ANCA is negative in PAN<\/strong> &mdash; positivity argues against PAN and towards MPA or GPA. <strong>Microaneurysms<\/strong> on mesenteric\/renal angiography are characteristic (also seen in MPA). <strong>HBV-associated PAN<\/strong> occurs in 30&ndash;50% of PAN cases historically (now declining with HBV vaccination); it requires <strong>antiviral therapy<\/strong> (tenofovir or entecavir) as a cornerstone of treatment alongside a short course of corticosteroids &mdash; prolonged immunosuppression can worsen viral replication.',\n      extra: '<strong>PAN vs MPA &mdash; the critical distinction:<\/strong><br>PAN: medium vessels; no GN; no pulmonary involvement; ANCA negative; microaneurysms on angiography; HBV association; no ANCA-directed treatment.<br>MPA (Microscopic Polyangiitis): small vessels; pauci-immune crescentic GN (like GPA); pulmonary capillaritis and haemorrhage; p-ANCA\/MPO positive (~60%); no microaneurysms; treated like other AAV (cyclophosphamide\/rituximab).<br><strong>Mononeuritis multiplex differentials<\/strong>: vasculitis (PAN, GPA, cryoglobulinaemia, SLE); diabetes mellitus; leprosy; sarcoidosis; lymphoma; amyloidosis. The sequential, asymmetric pattern distinguishes it from symmetrical polyneuropathy. <strong>ACR 1990 PAN criteria<\/strong>: &ge;3 of 10 features including weight loss &gt;4 kg, livedo reticularis, testicular pain, myalgia\/weakness, mononeuropathy, new hypertension, elevated creatinine, HBsAg positivity, arteriographic abnormality, biopsy showing PMN infiltration of arterial wall.',\n      imgId: null\n    },\n\n    \/* ---- Q4 : EGPA (Churg-Strauss) ---- *\/\n    {\n      id:   4,\n      diff: 'Hard',\n      tag:  'EGPA (Churg-Strauss) &mdash; Eosinophilic',\n      stem: 'A <strong>39-year-old woman<\/strong> with a <strong>12-year history of severe asthma<\/strong> and chronic rhinosinusitis with nasal polyps presents with a <strong>6-week history of progressive numbness and weakness in her right foot<\/strong> (foot drop) and left hand. She has eosinophilia: <strong>absolute eosinophil count 4,800 cells\/&mu;L<\/strong> (4.8 &times; 10&sup9;\/L). CXR shows fleeting bilateral pulmonary infiltrates. p-ANCA (MPO) is weakly positive. Echocardiogram is requested. Tissue biopsy of a sural nerve shows eosinophilic infiltration of vessel walls with necrotising granulomas. She is currently on high-dose inhaled corticosteroids and a leukotriene receptor antagonist. Which statement about her condition and its management is <em>most accurate<\/em>?',\n      correct: 'EGPA has three phases: allergic (asthma, rhinitis), eosinophilic (tissue eosinophilia, pulmonary infiltrates), and vasculitic (mononeuritis multiplex, cardiac involvement); echocardiogram is mandatory as cardiac EGPA carries the highest mortality; systemic corticosteroids are first-line',\n      opts: [\n        'EGPA has three phases: allergic (asthma, rhinitis), eosinophilic (tissue eosinophilia, pulmonary infiltrates), and vasculitic (mononeuritis multiplex, cardiac involvement); echocardiogram is mandatory as cardiac EGPA carries the highest mortality; systemic corticosteroids are first-line',\n        'The combination of asthma, eosinophilia, and pulmonary infiltrates confirms hypereosinophilic syndrome (HES), not EGPA; mononeuritis multiplex in HES is treated with imatinib targeting the FIP1L1-PDGFRA fusion gene, not corticosteroids',\n        'Leukotriene receptor antagonists (montelukast) are a recognised cause of EGPA-like syndrome by unmasking occult vasculitis; stopping montelukast alone will resolve her eosinophilia and mononeuritis without need for systemic corticosteroids',\n        'Weakly positive p-ANCA\/MPO in a patient with asthma and eosinophilia confirms MPA with secondary eosinophilia; the treatment is identical to GPA (cyclophosphamide + prednisolone) and mepolizumab has no role in ANCA-associated vasculitis'\n      ],\n      exp:  '<strong>EGPA (Eosinophilic Granulomatosis with Polyangiitis)<\/strong>, formerly Churg-Strauss syndrome, has three sequential phases: (1) <strong>Allergic phase<\/strong>: asthma, allergic rhinitis, nasal polyposis (often precedes vasculitis by years); (2) <strong>Eosinophilic phase<\/strong>: peripheral eosinophilia &gt;1.5 &times; 10&sup9;\/L, tissue eosinophilia, fleeting pulmonary infiltrates (L&ouml;ffler-like); (3) <strong>Vasculitic phase<\/strong>: small-vessel necrotising vasculitis &mdash; mononeuritis multiplex, purpura, glomerulonephritis. <strong>Cardiac involvement<\/strong> (eosinophilic myocarditis, endomyocardial fibrosis, pericarditis) occurs in 15&ndash;25% and is the <strong>leading cause of death<\/strong> in EGPA. Echocardiogram is mandatory at diagnosis. <strong>p-ANCA\/MPO<\/strong> is positive in only 40% of EGPA (vs &gt;60% in MPA) &mdash; ANCA-negative EGPA tends to have more eosinophilic organ damage; ANCA-positive EGPA has more vasculitic features (GN, alveolar haemorrhage). <strong>Treatment<\/strong>: high-dose prednisolone is first-line. Cyclophosphamide is added for organ-threatening disease.',\n      extra: '<strong>Montelukast and EGPA<\/strong>: leukotriene receptor antagonists were historically suspected of causing EGPA, but current evidence suggests they <em>unmask<\/em> pre-existing EGPA by allowing reduction of oral corticosteroid dose, rather than being causative. The association is now considered coincidental in most cases. <strong>Mepolizumab<\/strong> (anti-IL-5 monoclonal antibody): approved for <strong>relapsing or refractory EGPA<\/strong>. IL-5 is the key cytokine for eosinophil survival and activation. Mepolizumab significantly reduces relapse rates and allows corticosteroid tapering. This is a high-yield pharmacological point for NEET-PG. <strong>Five Factor Score (FFS) in EGPA<\/strong>: predicts prognosis &mdash; one point each for: proteinuria &gt;1 g\/day; creatinine &gt;1.58 mg\/dL; cardiomyopathy; GI involvement; CNS involvement. FFS &ge;2: cyclophosphamide added to prednisolone. FFS 0&ndash;1: prednisolone alone may suffice.',\n      imgId: null\n    },\n\n    \/* ---- Q5 : GCA \u2014 PMR Overlap & Tocilizumab ---- *\/\n    {\n      id:   5,\n      diff: 'Hard',\n      tag:  'GCA &mdash; PMR Overlap &amp; Steroid Sparing',\n      stem: 'A <strong>71-year-old woman<\/strong> presents with a <strong>5-month history of bilateral shoulder and hip girdle aching with morning stiffness &gt;45 minutes<\/strong>, fatigue, and a <strong>4 kg weight loss<\/strong>. ESR is 92 mm\/hr, CRP 58 mg\/L, and ALP is mildly elevated. She has <strong>no headache, no scalp tenderness, no visual symptoms, and no jaw claudication<\/strong>. Temporal artery ultrasound shows a bilateral <strong>halo sign<\/strong>. She is started on prednisolone 40 mg\/day with dramatic symptomatic improvement within 48 hours. After three months, during steroid tapering, her symptoms relapse and her CRP rises to 44 mg\/L. Which statement most accurately characterises the diagnosis, the significance of the ultrasound finding, and the next management step?',\n      correct: 'She has GCA with PMR overlap; the halo sign on temporal artery ultrasound (hypoechoic wall thickening surrounding the vessel lumen) has replaced biopsy as the diagnostic standard in experienced centres; relapse during tapering is an indication for tocilizumab (IL-6 receptor inhibitor) as a steroid-sparing agent',\n      opts: [\n        'She has GCA with PMR overlap; the halo sign on temporal artery ultrasound (hypoechoic wall thickening surrounding the vessel lumen) has replaced biopsy as the diagnostic standard in experienced centres; relapse during tapering is an indication for tocilizumab (IL-6 receptor inhibitor) as a steroid-sparing agent',\n        'She has isolated polymyalgia rheumatica (PMR) without GCA; the temporal artery halo sign is a non-specific finding seen in atherosclerosis and cannot distinguish GCA from PMR; prednisolone should be increased to 60 mg\/day and temporal artery biopsy performed before considering any steroid-sparing agent',\n        'The absence of cranial symptoms (headache, visual loss, jaw claudication) definitively excludes GCA; a halo sign in this context indicates atherosclerotic plaque within the temporal artery; methotrexate is the first-line steroid-sparing agent for isolated PMR relapse and tocilizumab has no evidence base in this condition',\n        'Relapse during prednisolone tapering indicates steroid resistance, which is characteristic of giant cell lymphoma mimicking PMR; PET-CT should be performed urgently to exclude lymphoma before escalating immunosuppression with tocilizumab'\n      ],\n      exp:  '<strong>GCA and PMR<\/strong> are closely related conditions. PMR occurs in 40&ndash;60% of GCA patients; conversely, 15&ndash;20% of PMR patients have subclinical GCA. PMR symptoms (bilateral shoulder\/hip girdle aching, &gt;45 min morning stiffness, markedly elevated ESR\/CRP) can occur <em>without<\/em> cranial symptoms even in confirmed GCA. The <strong>temporal artery halo sign<\/strong> on high-frequency ultrasound (hypoechoic, non-compressible wall thickening &mdash; the &ldquo;halo&rdquo; surrounding the vessel lumen) represents inflammatory mural oedema. Per <strong>EULAR 2018 recommendations<\/strong>, ultrasound by an experienced operator has sensitivity ~75&ndash;80% for GCA and can replace temporal artery biopsy in many centres. The starting dose for GCA with PMR overlap is <strong>40&ndash;60 mg prednisolone\/day<\/strong>. <strong>Tocilizumab<\/strong> (IL-6 receptor inhibitor, 162 mg SC weekly) is approved for GCA: the GiACTA trial showed significantly higher sustained remission rates and reduced cumulative prednisolone dose vs prednisolone alone. It is the standard steroid-sparing agent for relapsing GCA.',\n      extra: '<strong>PMR vs GCA &mdash; when to suspect GCA in a PMR patient<\/strong>: any new headache; scalp tenderness; jaw claudication; visual symptoms; upper limb claudication or BP asymmetry (large-vessel GCA); fever unexplained by PMR alone; ALP elevation disproportionate to ESR. <strong>ACR\/EULAR 2022 Classification Criteria for GCA<\/strong>: new scoring system incorporating ultrasound and PET-CT; bilateral halo sign on ultrasound scores +5 points alone (highest single item score). <strong>Large-vessel GCA<\/strong>: aorta and its branches involved in up to 50% of GCA &mdash; detected by PET-CT (FDG uptake in vessel wall) or MR\/CT angiography; risk of aortic aneurysm in long-term follow-up is increased 2&ndash;3 fold. <strong>PMR treatment<\/strong>: prednisolone 12.5&ndash;25 mg\/day (much lower than GCA); tocilizumab is now approved for PMR as well (PMR-SPARE trial), allowing faster steroid tapering in relapsing cases.'\n    }\n\n  ];\n\n  var answers  = {};\n  var answered = 0;\n  var shuffled = {};\n  var done     = false;\n\n  function byId(id) { return document.getElementById(id); }\n  function gid(sfx) { return byId(NS + '-' + sfx); }\n\n  function shuffleArr(arr) {\n    var a = arr.slice(), i, j, t;\n    for (i = a.length - 1; i > 0; i--) {\n      j = Math.floor(Math.random() * (i + 1));\n      t = a[i]; a[i] = a[j]; a[j] = t;\n    }\n    return a;\n  }\n\n  function countVal(val) {\n    var k, n = 0;\n    for (k in answers) {\n      if (answers.hasOwnProperty(k) && answers[k] === val) n++;\n    }\n    return n;\n  }\n\n  function buildPips() {\n    var cont = gid('pips'), i, q, wl, wp, line, pip;\n    if (!cont) return;\n    cont.innerHTML = '';\n    for (i = 0; i < QS.length; i++) {\n      q = QS[i];\n      if (i > 0) {\n        wl = document.createElement('div'); wl.className = 'mr-pip-wrap';\n        line = document.createElement('div'); line.className = 'mr-pip-line';\n        line.id = NS + '-pl' + q.id;\n        wl.appendChild(line); cont.appendChild(wl);\n      }\n      wp  = document.createElement('div'); wp.className = 'mr-pip-wrap';\n      pip = document.createElement('div'); pip.className = 'mr-pip';\n      pip.id = NS + '-pip' + q.id;\n      pip.textContent = String(q.id);\n      wp.appendChild(pip); cont.appendChild(wp);\n    }\n  }\n\n  function build() {\n    var cont, i, q, opts, card, top, nd, meta, tagRow, tg, dl,\n        st, rule, od, ed, lb, tx, ep, epl, ept, imgSrc, imgDiv, j, oe, ls, ts;\n    cont = gid('cases');\n    if (!cont) return;\n    cont.innerHTML = '';\n    answers = {}; answered = 0; shuffled = {}; done = false;\n    if (gid('score')) gid('score').style.display = 'none';\n    buildPips();\n\n    for (i = 0; i < QS.length; i++) {\n      q    = QS[i];\n      opts = shuffleArr(q.opts);\n      shuffled[q.id] = opts;\n\n      card = document.createElement('div'); card.className = 'mr-case';\n      top  = document.createElement('div'); top.className  = 'mr-case-top';\n      nd   = document.createElement('div'); nd.className   = 'mr-num';\n      nd.textContent = q.id < 10 ? '0' + q.id : String(q.id);\n      meta = document.createElement('div'); meta.className = 'mr-meta';\n\n      tagRow = document.createElement('div'); tagRow.className = 'mr-tag-row';\n      tg = document.createElement('div'); tg.className = 'mr-tag'; tg.innerHTML = q.tag;\n      dl = document.createElement('div'); dl.className = 'mr-diff'; dl.textContent = q.diff;\n      tagRow.appendChild(tg); tagRow.appendChild(dl);\n\n      st = document.createElement('div'); st.className = 'mr-stem'; st.innerHTML = q.stem;\n      meta.appendChild(tagRow); meta.appendChild(st);\n      top.appendChild(nd); top.appendChild(meta);\n      card.appendChild(top);\n\n      rule = document.createElement('div'); rule.className = 'mr-rule';\n      card.appendChild(rule);\n\n      od = document.createElement('div'); od.className = 'mr-opts';\n      for (j = 0; j < opts.length; j++) {\n        oe = document.createElement('div'); oe.className = 'mr-opt';\n        oe.id = NS + '-o' + q.id + '-' + j;\n        oe.setAttribute('role', 'button'); oe.setAttribute('tabindex', '0');\n        ls = document.createElement('span'); ls.className = 'mr-ltr'; ls.textContent = LTRS[j];\n        ts = document.createElement('span'); ts.className = 'mr-opt-text'; ts.innerHTML = opts[j];\n        oe.appendChild(ls); oe.appendChild(ts); od.appendChild(oe);\n        (function (qid, oi) {\n          oe.addEventListener('click', function () { pick(qid, oi); });\n        }(q.id, j));\n      }\n      card.appendChild(od);\n\n      ed  = document.createElement('div'); ed.className = 'mr-exp'; ed.id = NS + '-exp' + q.id;\n      lb  = document.createElement('div'); lb.className = 'mr-exp-lbl'; lb.textContent = 'Debrief';\n      tx  = document.createElement('div'); tx.className = 'mr-exp-text'; tx.innerHTML = q.exp;\n      ed.appendChild(lb); ed.appendChild(tx);\n\n      if (q.imgId) {\n        imgSrc = byId(q.imgId);\n        if (imgSrc) {\n          imgDiv = document.createElement('div');\n          imgDiv.innerHTML = imgSrc.innerHTML;\n          ed.appendChild(imgDiv);\n        }\n      }\n\n      if (q.extra) {\n        ep  = document.createElement('div'); ep.className = 'mr-exp-extra';\n        epl = document.createElement('span'); epl.className = 'mr-exp-extra-lbl'; epl.textContent = 'Extra Points';\n        ept = document.createElement('div'); ept.innerHTML = q.extra;\n        ep.appendChild(epl); ep.appendChild(ept);\n        ed.appendChild(ep);\n      }\n\n      card.appendChild(ed);\n      cont.appendChild(card);\n    }\n  }\n\n  function pick(qid, oi) {\n    var q, opts, i, el, ok;\n    if (answers[qid] !== undefined || done) return;\n    q = null;\n    for (i = 0; i < QS.length; i++) { if (QS[i].id === qid) { q = QS[i]; break; } }\n    if (!q) return;\n    opts = shuffled[qid];\n    ok   = (opts[oi] === q.correct);\n    answers[qid] = ok ? 'c' : 'w';\n    answered++;\n    for (i = 0; i < opts.length; i++) {\n      el = byId(NS + '-o' + qid + '-' + i);\n      if (!el) continue;\n      el.className = opts[i] === q.correct ? 'mr-opt correct locked'\n                   : i === oi              ? 'mr-opt wrong locked'\n                                           : 'mr-opt dimmed locked';\n    }\n    var ex = byId(NS + '-exp' + qid); if (ex) ex.style.display = 'block';\n    var pp = byId(NS + '-pip' + qid); if (pp) pp.className = 'mr-pip ' + (ok ? 'correct' : 'wrong');\n    if (qid > 1) { var pl = gid('pl' + qid); if (pl) pl.className = 'mr-pip-line done'; }\n  }\n\n  function showScore() {\n    var c, w, s, net, pct, disp, vlist, vi, sc;\n    if (done) return;\n    done = true;\n    c   = countVal('c'); w = countVal('w'); s = TOTAL - answered;\n    net  = c * 4 - w;\n    pct  = Math.max(0, Math.round((net \/ MAX) * 100));\n    disp = Math.min(100, Math.max(0, pct));\n    var rg = gid('ring');\n    if (rg) rg.style.background = 'conic-gradient(#8B3D20 ' + disp + '%, #E8DDD8 0%)';\n    var pe = gid('pct'); if (pe) pe.textContent = pct + '%';\n    var ne = gid('net'); if (ne) ne.textContent = 'Net Score: ' + net + ' \/ ' + MAX;\n    vlist = [\n      [5, 'Flawless. Every vessel calibre, every ANCA pattern \\u2014 nothing escaped you.'],\n      [4, 'Strong \\u2014 one nuance in vasculitis classification worth a final read.'],\n      [3, 'Solid base \\u2014 the Extra Points carry the distinctions that win marks.'],\n      [2, 'Halfway \\u2014 PAN vs MPA and EGPA phases repay close reading.'],\n      [0, 'Vasculitides reward systematic thinking by vessel size. One more pass through the debrief panels will make it click.']\n    ];\n    var ve = gid('verdict');\n    if (ve) {\n      ve.textContent = vlist[4][1];\n      for (vi = 0; vi < vlist.length; vi++) {\n        if (c >= vlist[vi][0]) { ve.textContent = vlist[vi][1]; break; }\n      }\n    }\n    var cc = gid('ct-c'); if (cc) cc.textContent = '\\u2705 ' + c + ' Correct';\n    var cw = gid('ct-w'); if (cw) cw.textContent = '\\u274C ' + w + ' Wrong';\n    var cs = gid('ct-s'); if (cs) cs.textContent = '\\u23ED ' + s + ' Skipped';\n    sc = gid('score');\n    if (sc) { sc.style.display = 'block'; sc.scrollIntoView({ behavior: 'smooth', block: 'center' }); }\n  }\n\n  function initObserver() {\n    var sn = gid('sentinel'), bar = gid('progress');\n    if (!sn || !bar || !window.IntersectionObserver) return;\n    new IntersectionObserver(function (en) {\n      bar.className = en[0].isIntersecting ? 'mr-progress' : 'mr-progress visible';\n    }, { threshold: 0 }).observe(sn);\n  }\n\n  function init() {\n    var sb = gid('submit'), rb = gid('retry');\n    if (!sb || !rb) return;\n    sb.addEventListener('click', showScore);\n    rb.addEventListener('click', function () { build(); window.scrollTo(0, 0); });\n    initObserver();\n    build();\n  }\n\n  function tryInit(n) {\n    if (document.getElementById('rhmq05-cases')) {\n      init();\n    } else if (n < 40) {\n      setTimeout(function () { tryInit(n + 1); }, 50);\n    }\n  }\n\n  tryInit(0);\n\n}());\n<\/script>\n\n\n","protected":false},"excerpt":{"rendered":"<p>Morning Rounds \u00b7 Vasculitides Large Medium Small vessel size Takayasu Arteritis Aorta &amp; branches; &lt;40 yrs Giant Cell Arteritis Temporal a.; &gt;50 yrs; PMR Polyarteritis Nodosa Spares lung; HBV assoc. Kawasaki Disease Children; coronary aneurysm GPA (Wegener&apos;s) c-ANCA\/PR3; ENT+lung+kidney EGPA \/ MPA p-ANCA\/MPO; asthma (EGPA) Chapel Hill Consensus Classification of vasculitis by vessel size. Large&hellip;&nbsp;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[74,24,64],"tags":[],"class_list":["post-36954","post","type-post","status-publish","format-standard","hentry","category-morning-rounds","category-neet-pg","category-orthopaedics"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Vasculitides - atsixty<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Vasculitides - atsixty\" \/>\n<meta property=\"og:description\" content=\"Morning Rounds \u00b7 Vasculitides Large Medium Small vessel size Takayasu Arteritis Aorta &amp; branches; &lt;40 yrs Giant Cell Arteritis Temporal a.; &gt;50 yrs; PMR Polyarteritis Nodosa Spares lung; HBV assoc. Kawasaki Disease Children; coronary aneurysm GPA (Wegener&amp;apos;s) c-ANCA\/PR3; ENT+lung+kidney EGPA \/ MPA p-ANCA\/MPO; asthma (EGPA) Chapel Hill Consensus Classification of vasculitis by vessel size. Large&hellip;&nbsp;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/\" \/>\n<meta property=\"og:site_name\" content=\"atsixty\" \/>\n<meta property=\"article:published_time\" content=\"2026-06-06T03:38:36+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-06-06T04:13:08+00:00\" \/>\n<meta name=\"author\" content=\"Avi\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Avi\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/neet-pg\\\/rheumatology-vasculitides\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/neet-pg\\\/rheumatology-vasculitides\\\/\"},\"author\":{\"name\":\"Avi\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"headline\":\"Vasculitides\",\"datePublished\":\"2026-06-06T03:38:36+00:00\",\"dateModified\":\"2026-06-06T04:13:08+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/neet-pg\\\/rheumatology-vasculitides\\\/\"},\"wordCount\":131,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"articleSection\":[\"Morning Rounds\",\"NEET PG\",\"Orthopaedics\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/neet-pg\\\/rheumatology-vasculitides\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/neet-pg\\\/rheumatology-vasculitides\\\/\",\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/neet-pg\\\/rheumatology-vasculitides\\\/\",\"name\":\"Vasculitides - atsixty\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\"},\"datePublished\":\"2026-06-06T03:38:36+00:00\",\"dateModified\":\"2026-06-06T04:13:08+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/neet-pg\\\/rheumatology-vasculitides\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/neet-pg\\\/rheumatology-vasculitides\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/neet-pg\\\/rheumatology-vasculitides\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/atsixty.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Vasculitides\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\",\"url\":\"https:\\\/\\\/atsixty.com\\\/\",\"name\":\"At Sixty\",\"description\":\"The Option Taken\",\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/atsixty.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\",\"name\":\"Avi\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"url\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"contentUrl\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"width\":200,\"height\":200,\"caption\":\"Avi\"},\"logo\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\"},\"sameAs\":[\"https:\\\/\\\/atsixty.com\"],\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/author\\\/avinaux\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Vasculitides - atsixty","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/","og_locale":"en_US","og_type":"article","og_title":"Vasculitides - atsixty","og_description":"Morning Rounds \u00b7 Vasculitides Large Medium Small vessel size Takayasu Arteritis Aorta &amp; branches; &lt;40 yrs Giant Cell Arteritis Temporal a.; &gt;50 yrs; PMR Polyarteritis Nodosa Spares lung; HBV assoc. Kawasaki Disease Children; coronary aneurysm GPA (Wegener&apos;s) c-ANCA\/PR3; ENT+lung+kidney EGPA \/ MPA p-ANCA\/MPO; asthma (EGPA) Chapel Hill Consensus Classification of vasculitis by vessel size. Large&hellip;&nbsp;","og_url":"https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/","og_site_name":"atsixty","article_published_time":"2026-06-06T03:38:36+00:00","article_modified_time":"2026-06-06T04:13:08+00:00","author":"Avi","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Avi","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/#article","isPartOf":{"@id":"https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/"},"author":{"name":"Avi","@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"headline":"Vasculitides","datePublished":"2026-06-06T03:38:36+00:00","dateModified":"2026-06-06T04:13:08+00:00","mainEntityOfPage":{"@id":"https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/"},"wordCount":131,"commentCount":0,"publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"articleSection":["Morning Rounds","NEET PG","Orthopaedics"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/","url":"https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/","name":"Vasculitides - atsixty","isPartOf":{"@id":"https:\/\/atsixty.com\/#website"},"datePublished":"2026-06-06T03:38:36+00:00","dateModified":"2026-06-06T04:13:08+00:00","breadcrumb":{"@id":"https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/atsixty.com\/index.php\/neet-pg\/rheumatology-vasculitides\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/atsixty.com\/"},{"@type":"ListItem","position":2,"name":"Vasculitides"}]},{"@type":"WebSite","@id":"https:\/\/atsixty.com\/#website","url":"https:\/\/atsixty.com\/","name":"At Sixty","description":"The Option Taken","publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/atsixty.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d","name":"Avi","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","url":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","contentUrl":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","width":200,"height":200,"caption":"Avi"},"logo":{"@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png"},"sameAs":["https:\/\/atsixty.com"],"url":"https:\/\/atsixty.com\/index.php\/author\/avinaux\/"}]}},"_links":{"self":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36954","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/comments?post=36954"}],"version-history":[{"count":1,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36954\/revisions"}],"predecessor-version":[{"id":36955,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36954\/revisions\/36955"}],"wp:attachment":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/media?parent=36954"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/categories?post=36954"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/tags?post=36954"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}