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A 48-year-old male presents to his primary physician with the chief complaints of fever, abdominal pain, weight loss, muscle weakness, and numbness in his lower extremities. UA is normal. A biopsy of the sural nerve reveals transmural inflammation and fibrinoid necrosis of small and medium arteries. Chart review reveals a remote history of cigarette smoking as a teenager and Hepatitis B seropositivity. What is the most likely diagnosis?
Systemic lupus erythematosis
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An 31-year-old Israeli male with a history of heavy smoking presents to your office with painful ulcerations on his hands and feet. Upon examination, he is found to have hypersensitivity to intradermally injected tobacco extract. Which of the following processes is most likely responsible for his condition?
Increased endothelial permeability
Necrotizing inflammation involving renal arteries
Segmental vasculitis of small and medium-sized arteries
Eosinophil-rich granulomatous inflammation
Concentric thickening of the arteriolar wall