American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the prominent clinical feature of eosinophilic granulomatosis with polyangiitis?

1. Severe hypertension

2. Asthma

3. Diabetes

4. Coronary artery disease

The correct answer is: Asthma

Eosinophilic granulomatosis with polyangiitis, formerly known as Churg-Strauss syndrome, is characterized by a triad of symptoms: asthma, eosinophilia, and vasculitis affecting small to medium-sized blood vessels. Asthma is particularly prominent in this condition and is often one of the earliest signs observed in patients. It can manifest as a worsening of respiratory symptoms and may or may not be accompanied by a history of allergic rhinitis or other respiratory conditions. Eosinophilic granulomatosis with polyangiitis also leads to systemic symptoms due to vasculitis, which can vary from patient to patient, but asthma stands out as a hallmark feature directly associated with the disease. The presence of eosinophils helps to differentiate this condition from other forms of vasculitis. Other options presented, such as severe hypertension, diabetes, or coronary artery disease, do not specifically distinguish eosinophilic granulomatosis with polyangiitis. While patients may experience a range of complications or comorbid conditions, asthma is a defining clinical feature essential for the diagnosis and understanding the disease's respiratory involvement.