Horton Et PPR Flashcards

0
Q

Épidémio PPR

A

> 50 ans

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1
Q

Épidémio Horton

A

> 50 ans

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2
Q

Clinique PPR isolée

A

Arthromyalgies bilat sym infla(épaule, cervic, racines MI), bur site acromiodelto bilat, tenosyno, arthrites periph, AEG, SIB, fièvre

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3
Q

Clinique Horton

A

Sd PPR (50%)+AEG+signes vascu cra ou oculaires

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4
Q

Clinique Horton : signes vascu

A

Céphalées svt unilat inhab, claudic interm langue et mâchoire, hyperesthésie cuir chevelu, dlr trajet a. Temporales

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5
Q

Clinique Horton : signes vascu oculaires

A

Diminution AV svt indolore et brutale +/- transitoire ; flou visuel ; diplopie ; amaurose…

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6
Q

Para clinique Horton et PPR

A

CRP VS (40-50 a H1), NFS(anémie, thrombocytose), fibri, alpha2globu, bilan hepa, Ac APL, écho a. Tempo, US a. Touchées, PET, biopsies a.tempo

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7
Q

Biopsie a. Tempo : description

A

Sous anesth loc +/- echoguidee, exam de 1,5-3cm: infiltrats infla prédomine média +/- destruction cellules muscu et LEI + épaiss intima /!\ éliminer pas le diag si neg

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8
Q

Complications Horton et PPR

A

AVC ou AIT, DTS/tb psy, poly neuropathie, atteinte œil, atteinte cardioaortiqueou de l’art pulmo, atteinte rénal ou dig

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9
Q

Forme cardioaortique dans Horton/PPR

A

Claudic MS, risque anevrysme, DA, IAo, IDM

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10
Q

Pec PPR isolée

A

Près usine 15-20mg/j

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11
Q

Pec Horton sans signes œil ou cereb

A

Prefnisone 0,7mg/kg/j + tt ANTIAGG + prev OP par BP et vit D + ETP

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12
Q

Pec Horton compliquée (atteinte œil ou cerv)

A

Prednisone 1mg/kg/j +/- Bolus methylpred 3j (0,5-1g/kg)

+ prev OP avec BP et vit D + ETP

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13
Q

Suivi Horton/PPR

A

VS +/- CRP ; RT et DMO/2-3 ans ; ETT

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14
Q

Modalités cct

A

Décroissance progressive quand vs normalisée (tôt 1-3 ans)
Sevrage qd asympt PLS sem avec surv
Test s’un acteur 1 sem après arrêt

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