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Pathoma > 7.1 Vasculitis > Flashcards

7.1 Vasculitis Flashcards

1
Q

What is vasculitis?

A

Inflammation of blood vessel wall

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2
Q

What are the symptoms of vasculitis?

A
  • Nonspecific

- Organ ischemia

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3
Q

What does large vessel vasculitis tend to affect?

A

Aorta and its branches

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4
Q

What are the types of large vessel vasculitides?

A
  • Giant Cell Arteritis (GCA)

- Takayasu’s Arteritis

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5
Q

What is the typical patient of GCA?

A

Older females (>50)

Tends to affect Caucasians

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6
Q

What is the classic location of GCA?

A

Branches of the carotid

  • temporal artery
  • ophthalmic artery causing visual disturbance
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7
Q

What is seen on LM of GCA?

A

Granulomatous vasculitis with giant cells and intimal fibrosis

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8
Q

Why must a long piece be taken for GCA biopsy?

A

The lesions are segmental - negative biopsies may not exclude the disease

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9
Q

How does GCA cause ischemia?

A

Fibrosis in between the intimal and the media that leads to narrowing of the lumen which decreases perfusion

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10
Q

What is the treatment for GCA?

A

Corticosteroids - treat ASAP

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11
Q

What is the typical patient of Takayasu’s Arteritis?

A

Adults less than the age of 50 - typically an Asian female

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12
Q

What does LM of Takayasu’s Arteritis show?

A

Granulomatous vasculitis

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13
Q

What vessels does Takayasu’s Arteritis tend to affect?

A

Aortic arch at the branch points

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14
Q

What are some clinical signs of Takayasu’s Arteritis?

A
  • Weak or absent pulse in the upper extremities

- ESR is elevated

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15
Q

What is the treatment for Takayasu’s Arteritis?

A

Corticosteroids

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16
Q

What does medium vessel vasculitis tend to affect?

A

Muscular arteries that supply organs

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17
Q

What are the types of medium vessel vasculitis?

A
  • Polyarteritis Nodosa (PAN)
  • Kawasaki Disease
  • Buerger Disease
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18
Q

What are the effects of polyarteritis nodosa?

A

Necrotizing vasculitis that involves multiple organs

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19
Q

What organ is spared by PAN?

A

Lungs

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20
Q

What is the characteristic finding of PAN on imaging?

A

“String on pearls” - aneurysms between fibrous areas of the vessel

21
Q

What are some of the characteristics of PAN?

A
  • Fibrinoid necrosis

- Varying stages of disease along the same artery

22
Q

What is the the treatment for PAN?

A

Corticosteroids
Cyclophosphamide
-Fatal if not treated

23
Q

What is the typical patient of Kawasaki Disease?

A

Asian children less than the age of 4

24
Q

What are the presentations of Kawasaki Disease?

A

Fever
Conjunctivitis
Erythematous rash of palms and soles - “motorcycle”

25
Q

What is the preferential artery involved in Kawasaki Disease?

A

Coronary Artery

26
Q

What are the complications of Kawasaki Disease?

A
  • MI

- Aneurysm and rupture

27
Q

What is the treatment of Kawasaki Disease and why is it unique?

A

Aspirin and IVIG

- Normally you would NEVER give a child aspirin as it risks Reye’s Disease

28
Q

How does aspirin treat Kawasaki Disease?

A

Aspirin prevents TXA2 to prevent thrombus formation in the coronary artery

29
Q

What is Buerger Disease?

A

Necrotizing vasculitis of the digits that presents with ulcers and gangrene

30
Q

What is Buerger Disease associated with?

A

Smoking

31
Q

What is the treatment for Buerger Disease?

A

Cessation of smoking

32
Q

What is a sign of Buerger Disease?

A

Raynaud’s Phenomenon

33
Q

What does small vessel vasculitis affect?

A

Arterioles, capillaries and venules

34
Q

What is Wegener’s Granulomatosis?

A

Necrotizing granulomatous vasculitis that involves the nasopharynx, lungs and kidneys

35
Q

What is the pathogenesis of Wegener’s Granulomatosis?

A

c-ANCA

36
Q

What is the typical patient of Wegener’s Granulomatosis?

A

Middle aged male with sinusitis or nasopharyngeal ulceration and hemoptysis with hematuria

37
Q

What is the treatment for Wegener’s Granulomatosis?

A

Cyclophosphamide

Corticosteroids

38
Q

What is Microscopic Polyangiitis?

A

Necrotizing vasculitis with lung and kidney involvement

39
Q

What are the difference between Microscopic Polyangiitis and Wegener’s?

A
  • No nasopharyngeal
  • No granulomas
  • pANCA instead of cANCA
40
Q

What is the treatment for Microscopic Polyangiitis?

A

Cyclophosphamide

Corticosteroids

41
Q

What is Churg-Strauss Syndrome?

A

Necrotizing granulomatous vasculitis with eosinophils

42
Q

What is the pathogenesis of Churg-Strauss Syndrome?

A

pANCA

43
Q

What are the differences between Churg-Strauss Syndrome and Microscopic Polyangiits?

A

CS wil have:

  • Granulomas
  • Eosinophilia
  • Asthma
44
Q

What is the most common vasculitis in children?

A

Henoch-Shonlein Purpura

45
Q

What is the pathogenesis of Henoch-Shonlein Purpura?

A

Deposition of IgA following an URI due to excessive production

46
Q

What are the signs of Henoch-Shonlein Purpura?

A
  • Palpable purpura on buttocks and legs

- Hematuria with IgA nephropathy

47
Q

What does Henoch-Shonlein Purpura tend to follow?

A

Respiratory tract infection

48
Q

What is the treatment for Henoch-Shonlein Purpura?

A

Self-limiting - use steroids only in severe cases

Pathoma (119 decks)

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