large vessel vasculitis

Question 2

what is it?

Answer 2

primary vasculitis that causes chronic granulomatous inflammation

Question 3

what are the 2 categories?

Answer 3

temporal/giant cell
Takayasu

Question 4

where does it predominantly affect?

Answer 4

aorta and its major branches

Question 5

what is Takayasu arteritis?

Answer 5

vasculitis of arteries that branch from aortic arch

Question 6

how does Takayasu clinically present?

Answer 6

fever
malaise
weight loss
fatigue
claudication in arms
difference of bp in extremities

Question 7

what investigations are used for Takayasu?

Answer 7

bloods
MRI angiogram

Question 8

what would bloods show for temporal?

Answer 8

raised inflammatory markers (ESR, CRP)

Question 9

what would MRI angiogram show?

Answer 9

thickened vessel walls and stenosis

Question 10

what is temporal/giant cell?

Answer 10

vasculitis of carotid artery and its branches

Question 11

what does it have a strong association with?

Answer 11

polymyalgia rheumatica

Question 12

how does it present?

Answer 12

unilateral acute temporal headache
jaw claudication
visual disturbances
vision loss

Question 13

what are the clinical signs?

Answer 13

tender enlarged non-pulsatile temporal arteries
carotid bruit

Question 14

what is the gold standard investigation?

Answer 14

temporal artery biopsy

Question 15

what is 1st line investigation?

Answer 15

bloods

Question 16

what would bloods show?r

Answer 16

raised inflammatory markers

Question 17

what would temporal artery biopsy show?

Answer 17

skip lesions

Question 18

what is the overall management for both conditions?

Answer 18

prednisolone
add biphosphate or PPI to stop GI effects
low dose aspirin to reduce risk of stroke or blindness

Question 19

what is the long term treatment for takayasu?

Answer 19

steroid sparing agents - methotrexate, lefunamide

Question 20

what is the long term treatment for giant cell?

Answer 20

gradual reduction in steroids
if relapse = lefunamide, methotrexate