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FIIS > 22. Vasulitis > Flashcards

22. Vasulitis Flashcards

1
Q

What is vasculitis?

A

Inflammation within blood vessels which distrupts the internal elastic lamina

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2
Q

What kind of necrosis can be caused by vasculitis?

A

Fibrinoid

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3
Q

What are the features of widespread inflammation?

A

Temperature
Malaise
Weight loss
Fatigued

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4
Q

What are the causes of secondary systemic vasculitis?

A

Infection, drugs, malignancy
Cryoglobulinaemia
Connective tissue disease

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5
Q

It is common for vessels to rupture from vasculitis. T/F?

A

False

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6
Q

How is primary vasculitis classified?

A

Size of vessel

Whether or not there is granuloma formation

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7
Q

What type of primary granuloma occurs within large vessels?

A

Temporal arteritis

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8
Q

What type of primary granuloma occurs within medium vessels and is associated with granulomata?

A

EGPA

Eosinophilic Granulomatosis with Polyangitis

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9
Q

Which types of primary granuloma occur within medium vessels and are not associated with granulomata?

A

Polyarteritis nodosa

Kawasaki syndrome

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10
Q

What type of primary granuloma occurs in small vessels and is associated with granulomata formation?

A

GPA

Granulomatosis with Polyangiitis

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11
Q

What type of primary granuloma occurs in small vessels and is not associated with granulomata formation?

A

Microscopic polyangitis

Henoch Schonlein purpura

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12
Q

What are the causes of mortality in vasculitis?

A

Due to renal, pulmonary and neuro disease

Effects of immunosuppressive treatment

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13
Q

How is vasculitis diagnosed?

A

ANCA on serology
Biopsy of affected organ
Angiography in large vessel disease to show aneurysm formation

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14
Q

What conditions cause a false positive ANCA?

A

Infection
Inflammatory disease
Lymphoma

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15
Q

What organs are most common affected by GPA?

A

Respiratory tract
-nose bleeds
Glomerulonephritis

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16
Q

What is ANCA?

A

Collection of autoantibodies against neutrophils

17
Q

What are the types of ANCA and what do they bind to?

A

cANCA binds to PR3

pANCA binds to MPO proteins in the cytoplasm of the neutrophil

18
Q

Which type of ANCA is more closely associated with vasculitis?

A

cANCA

19
Q

What types of infection can cause secondary vasculitis?

A

Subacute Bacterial Endocarditis

Cystic Fibrosis

20
Q

What is the difference between acute and subacute bacterial endocarditis?

A

Acute directly due to infection

Subacute presentation is dominated by immune complex destruction

21
Q

What are the features of subacute bacterial endocarditis?

A

Valve damage
Immune complex deposition
Widespread inflammation

22
Q

How is subacute bacterial endocarditis diagnosed?

A

Pyrexia of unknown origin
3 blood cultures
Vegetations on echo
Acute phase response

23
Q

What are cryoglobulins?

A

Igs which stick together in the cold

24
Q

What causes the features of cryoglobulinaemia?

A

Vascular spasm

Vasculitis

25
Q

What is the dermatological presentation of cryoglobulinaemia?

A

Palpable purpura

-Bumpy due to damage to the blood vessel

26
Q

What is Raynaud’s phenomenon?

A

When exposed to the cold, vascular spasm causes fingers to turn white and blue

27
Q

How does cryoglobulinaemia present?

A

Skin and Raynaud’s
Joint, renal, neuro and GI involvement
Vasculitis

28
Q

What is Meltzer’s triad of cryglobulinaemia?

A

Purpura
Arthralgia
Weakness

29
Q

How is serum tested for cryoglobulinaemia?

A

Must be kept at 37C until it is separated in the lab

Kept at 4C and read 3 days later

30
Q

What causes type one cyroglobulinaemia?

A

Monoclonal

Myeloma, Waldenstrom’s, B cell lymphoma

31
Q

What causes type two cryoglobulinaemia?

A

Mixed monoclonal and polyclonal

Infection, connective tissue disease, lymphoproliferative disease

32
Q

What causes type three cryoglobulinaemia?

A

Polyclonal

Connective tissue disease, chronic infection

33
Q

What is the treatment for cryoglobulinaemia?

A

Treat the underlying cause
Steroids/ immunosuppression for vasculitis
Plasmaphoresis if life threatening
Rituximab to deplete B cells

FIIS (24 decks)

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