5. Arteritis and Aneurysms

Question 1

What is arteritis?

Answer 1

Inflammation of the arterial wall

Question 2

Why does a negative biopsy not exclude a diagnosis of arteritis?

Answer 2

Not uniform along the length of artery so could have been missed

Question 3

What are the consequences of arteritis?

Answer 3

Thrombus > occlusion > infarction

Aneurysm > Rupture > haemorrhage

Question 4

What are the infective causes of arteritis?

Answer 4

Neisseria
Syphilis
Rickettsia
Aspergillus
Herpes

Question 5

What are the immunological causes of arteritis?

Answer 5

T2HS: ANCA, Anti-GBM disease
T3HS: SLE, RA
T4HS: allograft organ rejection
IBD and paraneoplastic

Question 6

Name 3 large elastic arteries

Answer 6

Aorta
Carotids
Iliacs

Question 7

Name 2 medium muscular arteries

Answer 7

Coronary

Renal

Question 8

Name 2 large vessel vasculitis

Answer 8

Temporal (>50)

Takayasa(<50)

Question 9

What arteries are effected by temporal arteritis?

Answer 9

Extracranial branches of the carotid

Can cause blindness

Question 10

What arteries are affected by Takayasa arteritis?

Answer 10

Aorta and its major branches

Narrowing of vessel lumen

Question 11

Name a medium vessel arteritis

Answer 11

Polyarteritis nodosa

Question 12

What vessels are affected by PAN?

Answer 12

Renal and systemic
Necrotising causes nodules
None found in arterioles, capillaries, venules

Question 13

What infection is associated with PAN?

Answer 13

Hep B

Question 14

Name 2 small vessel vasculitis

Answer 14

GPA

EGPA

Question 15

What systems are affected by GPA?

Answer 15

Respiratory

Glomerulonephritis

Question 16

What system is affected by EGPA?

Answer 16

Respiratory tract
Asthmatics
Blood eosinophilia

Question 17

What are the causes of aneurysms?

Answer 17

Atherosclerosis
Cystic medial degeneration
Congenital (berry)
Inflammatory (PAN)
Infection (syphilis)
Trauma

Question 18

What is cystic medial degeneration?

Answer 18

Deposition of mucopolysaccharides in replacement of elastic tissue in artery wall
Weakens walls

Question 19

What artery is most commonly involved with an atherosclerotic aneurysm?

Answer 19

Abdominal aorta below renal arteries

Question 20

What is a thoracic aortic dissection?

Answer 20

Blood flows into the wall and causes an intramural haematoma

Usually caused by cystic medial degeneration

Question 21

What complications are associated with thoracic aortic dissection?

Answer 21

Haemopericardium

Reduced blood supply to organs

Question 22

What are the risk factors for thoracic aortic dissection?

Answer 22

Men age 40-60 with hypertension
Marfan’s syndrome
Arterial cannulation
Pregnancy

Question 23

What stage of syphilis is associated with syphilitic aneurysms?

Answer 23

Tertiary

Question 24

What are berry aneurysms?

Answer 24

Most common type of intracranial aneurysm

Saccular aneurysm around circle of willis

Question 25

What type of haemorrhage is caused by a ruptured berry aneurysm?

Answer 25

Subarachnoid haemorrhage

Question 26

What are the risk factors for berry aneurysms?

Answer 26

Polycystic kidney
Ehler’s-Danlos syndrome
Marfan’s syndrome
Smoking and hypertension

Question 27

What are capillary microaneurysms?

Answer 27

Caused by hypertension in brain

Question 28

What type of haemorrhage is caused by a ruptured capillary microaneurysm?

Answer 28

Intracerebral

Question 29

What other morbidity are capillary microaneurysms associated with?

Answer 29

Retinal haemorrhage in diabetics