final pt 5 draft Flashcards
what are 2 non-inflammatory vascular disorders?
- Monkeberg Medial Sclerosis
- Raynaud phenomenon
what are the inflammatory vascular disorders?
- takayasu arteritis
- polarteritis nodosa
- Allergic Granulomatous and angitis (Churg-Strauss)
- Temporal Arteritis
- Kawasaki disease
- Wegeners Granulomatosis
- Thromoangitis Obliterans (Buergers)
- Behcet
what refers to a degenerative calcification of the tunica media of large and medium sized muscular arteries?
Monkeberg medial sclerosis
what age is monkeburg usually seen in?
older individual
Mokeberg medial sclerosis usually occurs in what arteries?
arteries of the upper and lower extremities (may cause post. knee pain)
T/F: Monkeberg medial sclerosis is very similar to atherosclerosis
F
it is distinct from atherosclerosis
-ordinarily does NOT lead to a clinical presentation per se
atherosclerosis is of the tunica intima where monkeberg is of the tunica media
T/F: there is major luminal narrowing in Monkeberg medial sclerosis
F: there is none
what is the etiology of Monkeberg?
unknown
is Monkeberg inflammatory or non?
non inflammatory
what is paroxysmal pallor or cyanosis of the digits of the hands or feet?
Raynaud phenomenon
what is Raynauds usually caused by?
due to cold induced vasoconstriction
what is the color change sequence in Raynauds?
white- blue- Red
T/F: Raynauds reflects an exaggeration of normal central and vasomotor responses to cold or emotion
T
what is the prognosis of RP?
- usually benign
- long-standing cases may show signs of atrophy of skin, subcutaneous tissue and muscles
T/F: ulcerations and gangrene are rare for RP
T
what is the difference between primary and secondary Raynaud Phenomenon?
- primary = you just have it
secondary = some primary disease triggers RP
what refers to the inflammation of walls of vessels (all sizes and types)?
inflammatory vasculitides
how can we classify inflammatory Vasculitis?
based on pathogenesis or etiology
what are different ways you get vasculitis?
infection
immunologic
unknown
what is the clinical presentation of vasculitis?
often a result of vessel lumen narrowing/ obliteration/ dilation / thrombosis
what therapy is usually used to treat vasculitis?
Responsive to steroid/immunosuppressive-therapy
what kind of tests will suspected Vasculitis patients have performed?
inflammatory/ autoimmune panel
what is tested in an inflammatory/autoimmune panel?
ESR
CRP
RF
ANA
ANCA
Specific Ig’s
what does ESR stand for an what is it?
- Erythrocyte sedimentation rate
- non specific indication of inflammation when elevated
what does CRP stand for and what is it?
C- reactive protein
Non specific indicator of inflammation when elevated
what does RF stand for and what is it?
Rheumatoid factor
assess for inflammatory joint disease
what does ANA stand for and what is it seen in?
Anti nuclear antibody
seen in LUPIS
what does ANCA stand for what is it predictive for if elevated?
Anti- neutrophilic cytoplasmic antibodies
will have some type of inflammatory vascular disease if elevated
what are 2 other things that may be tested on an inflammatory panel?
anti glomerular basement membrane antibody
Anti thyroglobulin antibody
what disease is seen in females under 40 and a common sign is there BP is different by over 10 mmHG in either arm?
Takayasu arteritis
Takayasu arteritis classically involves ____ and its branches, and is characterized by what?
aortic arch
characterized by principally weakening of peripheral pulses
what would examination of a person with Takayasu arteritis show?
thickening of the aorta particularly the aortic arch and its branches
near obliteration of distal portions of aortic branches
what is necrotizing vasculitis of small and medium sized visceral arteries with no lung involvement?
polyarteritis nodosa
presentation of polyarteritis nodosa is common in which organs and which sex and age?
common in kidney and liver in young males
what would a patient with polyarteritis nodosa present with?
necrotizing of the vessel wall (fibroid necrosis)
what are the three phases that polyarteritis nodosa may present itself?
acute, healing, scarred (may co-present)
what are some complications that can happen in polyarteritis nodosa and is it corticosteroid responsive?
aneurysm
thrombosis
infarct
and yes
what is systemic vasculitis in young individuals with asthma?
allergic granulomatous and angitis (churg-strauss)
2/3 of patients with Churg-Strauss will have what?
C or P-ANCA (anti-neutrophilic cytoplasmic antibodies)
does C-ANCA clump or no?
doesn’t clump
where would you seen allergic granulomatosis and angitis?
small and medium sized arteries and arterioles of the lungs, spleen, kidney, heart, CNS and others
what WBC would be seen intensely in Churg-Strauss?
Eosinophils