American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the typical lung involvement in Polyarteritis Nodosa?

1. Lung parenchyma is commonly affected

2. Spared of pulmonary artery damage

3. Pleuritis common

4. Granulomatous changes in lungs

The correct answer is: Spared of pulmonary artery damage

Polyarteritis Nodosa (PAN) is primarily a medium vessel vasculitis that typically affects muscular arteries, and it is characterized by systemic involvement without primary lung involvement. The correct understanding is that the lung parenchyma is generally spared in this condition. While thrombosis and other complications can occur in a variety of organ systems, the pulmonary artery itself is less often directly involved in PAN. This contrasts with other vasculitides, such as granulomatosis with polyangiitis, where pulmonary manifestations are more prominent and common. With regard to pleuritis, while it can occur in various conditions, it is not a hallmark of PAN. Granulomatous changes in the lungs are also not characteristic of Polyarteritis Nodosa, as they denote a different pathological process typically associated with other diseases such as sarcoidosis or certain infections. Thus, the assertion that lung involvement in Polyarteritis Nodosa is characterized by being spared of pulmonary artery damage is accurate, reflecting the disease's specific clinical features.