Number 1 – GPAA patient with a history of persistent general symptoms such as fatigue, fever, and joint pain has been diagnosed with Granulomatosis with polyangiitis (GPA) by their healthcare provider. The patient has been following their treatment plan diligently, which includes high-dose glucocorticoids and immunosuppressive therapy. However, despite the implementation of the treatment, the patient’s symptoms have not improved. As a medical expert, can you explain why the patient’s symptoms might not be responding to the current treatment? Could it be due to an inadequate dosage, improper administration, or potential side effects of the medication? Additionally, can you suggest alternative or additional treatment options for Granulomatosis with polyangiitis (GPA) that the healthcare provider might consider to improve the patient’s condition, keeping in mind the rarity and complexity of the disease?Q1 – I have a history of persistent generalized symptoms such as fatigue, fever, and joint pain, and I have been diagnosed with Granulomatosis with Polyangiitis (GPA). I’ve been treated with high-dose glucocorticoids and immunosuppressive therapy and have consistently followed my treatment plan. However, my symptoms are not responding to the planned treatment. Could I get an expert medical opinion on why my symptoms might not be responding to the treatment plan? What factors could be influencing my treatment? Are there any alternative treatment options that haven’t been considered?R1 – [Include Rituximab and Plasmapheresis]Q2 – Can you provide me with more information about Rituximab so I can discuss it with my healthcare provider?Q3 – Is Rituximab a better treatment option when compared to Plasmapheresis?Number 2 – Subarach A patient has been experiencing severe headaches and dilated pupils for the past few days. They have a history of hypertension and smoking. An initial CT scan suggested a possible aneurysm in the brain. However, the patient declined further diagnostic procedures, such as a lumbar puncture or angiogram, and decided to manage their symptoms with pain relievers. A few days later, the patient returned to the hospital, now with a sudden onset of confusion, neck stiffness, and sensitivity to light. A repeat CT scan showed evidence of a subarachnoid hemorrhage, which is often a sign of a ruptured aneurysm. What are the possible reasons that the patient’s aneurysm ruptured, and how could this have been prevented? Additionally, what are the next steps for the medical team in this situation, considering the patient’s previous reluctance to undergo further testing and treatment?Q1 – I’ve recently been diagnosed with subarachnoid haemorrhage on a CT scan. I had several days of a debilitating headache and nausea. I’ve read that this could be related to an aneurysm. Tell me more about this condition.Q2 – Was there anything I could have done to prevent this or any warning signs I should have been looking for?Q3 – What will my recovery be like, will the symptoms go away?