(1) Blood Vessels ; Part 2 (Martin)

Question 1

Noninfectious vasculitis

What is the major cause?

Answer 1

IMMUNE RESPONSE

*This is REALLY common

Question 2

What are the four most prominent forms of noninfectious vasculitis?

Answer 2

Giant cell (temporal) arteritis

Polyarteritis nodosa (PAN)

Granulomatosis with Polyangiitis

Thromboangiitis Obliterans (aka Buerger disease)

Question 3

What is the only form of vasculitis that is associated with the aorta?

Answer 3

Giant cell arteritis

Question 4

What is the only form of vasculitis that REQUIRES eosinophils?

Answer 4

Churg-Strauss syndrome

Question 5

What is the only form of vasculitis that REQUIRES neutrophils?

Answer 5

Behcet disease

Question 6

Clinical history: Name the associated vasculitis

>40yrs old , +/- polymyalgia rheumatica

Answer 6

Giant cell arteritis

Question 7

Clinical history: Name the associated vasculitis

Asthma, Atopy

Answer 7

Churg-Strauss Syndrome

Question 8

Clinical history: Name the associated vasculitis

Young male smoker

Answer 8

Buerger Disease

*It’s nice for young males to eat a BUERGER while smoking

Question 9

Clinical history: Name the associated vasculitis

Orogenital ulcers

Answer 9

Behcet disease

Question 10

Immune complex vasculitis

Describe the pathogenesis

Answer 10

Autoantibody production and formation of immune complexes

Deposition of antigen-antibody complexes in vascular walls

Question 11

Immune complex vasculitis may be seen in…

1.

2.

3.

Answer 11

1. Systemic immunologic diseases (SLE)
2. Drug hypersensitivity
3. Secondary exposure to infectious agent

Question 12

What is the only infectious agent involved in immune complex vasculitis?

What is it associated with?

Answer 12

Polyarteritis nodosa

Hep B

Question 13

Giant cell (temporal) arteritis and aortitis

Population?

Immune players?

Anatomy?

Symptoms?

Answer 13

Older pts

T cell mediated

Temporal arteries

Double vision, constitutional symptoms (fever, fatigue, wt loss, headache)

***Remember: The symptoms make sense because headaces, double vision are in close proximity to the temporal artery

Question 14

Takayasu arteritis

Unique sx?

Population?

Similar to giant cell arteritis except?

Answer 14

Pulseless disease, weak pulse and low BP in UE

Historically Japanese, now global , <50

Involves aortic arch and major branch vessels

Question 15

Polyarteritis nodosa (PAN)

Anatomy?

Population?

1/3 of pts have?

Unique sx?

Answer 15

Involves Renal vessels, GI tract

Young adult

Chronic hepatitis B

Abdominal pain, bloody stools

***You use a PAN to cook food that you will eat, and your GI system will digest. (way to remember symptoms and anatomy of PAN)

Question 16

Kawasaki disease

Population?

Anatomy?

Unique symtpoms?

Answer 16

Infants and Small children

Coronary arteries

Erythema of the conjunctiva, oral mucosa, palms and soles

***Imagine: A small child riding a Kawasaki motorcycle…the child’s palms and soles must be firmly on the motorcyle or it will fall off and die

Question 17

Microscopic polyangiitis

Anatomy?

Associated with?

Aka?

Unique Sx?

Answer 17

Renal glomeruli and lung capillaries

MPO-ANCA

Leukocytoclastic vasculitis/hypersensitivity vasculitis

Palpable cutaneous purpura

Question 18

Churg-Strauss syndrome

HIGHLY associated with?

Highly resembles PAN or microscopic polyangiitis with the addition of?

Answer 18

Allergies!!!

Eosinophils and granulomas

Question 19

What is the classic triad sx of behcet disease?

Answer 19

• Aphthous ulcers of the oral cavity
• Genital ulcers
• Uveitis

Question 20

What non-infectious vasculitis is associated with HLA-B51?

Answer 20

Behcet disease

Question 21

Granulomatosis with Polyangiitis

Sx?

Associated with?

Morphology?

Answer 21

Penumonitis, sinusitis, renal disease and nasopharyngeal ulceration

PR3-ANCA

Geographic patterns of central necrosis, lung cavitations

Question 22

Thromboangiitis obliterans (Buerger disease)

Anatomy?

Sx?

Popoulation?

Answer 22

Tibial and radial arteries

chronic ulcerations, may lead to gangrene

Heavy smokers <35y/o

Question 23

What are the three direct infectious agents for infectious vasculitis?

Answer 23

• Pseudomonas
• Aspergillus
• Mucor

Question 24

Raynaud phenomenon

What is it?

Common saying?

Answer 24

Excessive vasospasm of small arteries and arterioles, especially fingers and toes

“red, white and blue”=proximal vasodilation, central vasoconstriction and distal cyanosis

Question 25

What are the main differences b/w Primary and Secondary Raynaud?

Answer 25

Primary= induced by cold or emotion, symmetric, common in young women, benign

Secondary= Scleroderma, asymmetric, worsens with time

Question 26

Varicose veins are…

Answer 26

SUPERFICIAL

This is important because you do NOT get DVTs from varicose veins

Question 27

What is the most important risk factor for developing a DVT?

Answer 27

Thrombophlebitis

Question 28

What is the most common agent of lymphangitis?

Answer 28

Group A Beta-hemolytic streptococci

Question 29

What is lymphangitis?

Answer 29

Acute inflammation and spread of bacterial infection into lymphatics

Red, painful subcutaneous streaks & painful enlargement of draining lymph nodes

Question 30

What are hemangiomas?

Answer 30

Common tumors that are benign and vascular

Question 31

What are kaposi sarcomas (KS) caused by?

Answer 31

HHV8

Question 32

What are the three major ways to stent endovascularly?

Answer 32

Balloon angioplasty

Coronary stents

Drug-eluting stents