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My Flashcards Year 2 > MSK- vasculitis > Flashcards

MSK- vasculitis Flashcards

1
Q

two major categories of large vessel vasculitis

A

temporal (giant cell) arteritis and Takayasu arteritis (TA)

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2
Q

Takayasu arteritis aetiology

A

<40, females, Asian

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3
Q

CF Takayasu arteritis

A

systemic- weight loss, night sweats, fever, malaise
claudication in upper and lower limbs

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4
Q

CF Takaysu arteritis- if left untreated

A

vascular stenosis and aneurysms- carotid bruit, reduced pulses, bp differences extremities

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5
Q

giant cell arteritis age range

A

> 50, most commonly late 60s

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6
Q

giant cell arteritis associated with

A

polymyalgia rheumatica

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7
Q

GCA typical presentation

A

new-onset headache in patients 50 years of age or older with an elevated erythrocyte sedimentation rate (ESR), CRP or plasma viscosity

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8
Q

GCA symptoms

A

unilateral acute temporal headache with focal tenderness on direct palpation
jaw claudication on chewing firm foods or speaking
visual disturbances
visual loss
constitutional manifestations

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9
Q

GCA signs

A

Tender enlarged non-pulsatile temporal arteries

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10
Q

first line investigation in GCA

A

temporal artery USS

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11
Q

gold standard investigation in GCA

A

temporal artery biopsy

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12
Q

management of large vessel vasculitis

A

Start at prednisolone 40-60mg daily

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13
Q

TA specific management

A

more long term, use steroid sparing agents if needed e.g. leflunamide, methotraxate

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14
Q

GCA specific management

A

gradual reduction in steroid dose over 18 months to 2 years

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15
Q

GCA treatment with visual loss

A

IV methylprednisolone 500mg

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16
Q

GCA treatment for bone protection

A

bisphophonate, vitamin d, calcium

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17
Q

polyarteritis nodosa most commonly affects which sex and age group

A

men aged 40-60

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18
Q

polyarteritis nodosa associated with

A

hepatitis b

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19
Q

skin symptoms of polyarteritis nodosa

A

livedo reticularis, nodules, ulcers, palpable purpura

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19
Q

polyaeteritis nodosa affects which organ systems

A

skin
nerves
kidneys
MSK
GI
CNS
cardiac

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20
Q

polyarteritis nodosa lab results

A

Haematuria/proteinuria when renal involvement present
elevated CRP/ESR
anaemia, thrombocytosis
low albumin
hep b surface antigen

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21
Q

polyarteritis nodosa mild-moderate disease management

A

oral corticosteroids

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22
Q

polyarteritis nodosa life threatening disease management

A

high-dose pulsed IV corticosteroids

23
Q

polyateritis nodosa additional therapy

A

Additionalimmunosuppressive therapyis usually required (e.g. azathioprine, methotrexate, cyclophosphamide or rituximab)

24
Q

polyarteritis nodosa complication

A

aneurysm formation- lead to haemorrhage

25
Q

Granulomatosis with polyangiitis (GPA) affects:

A

upper and lower respiratory tract, eyes and/or kidneys

26
Q

typical age of GPA

A

35-50

27
Q

ENT symptoms of GPA

A

sinusitis
nasal crushing
mouth ulcers
epistaxis (nose bleed)
sensourineal deafness
otitis media
‘saddle nose’

28
Q

respiratory symptoms of GPA

A

cough
haemoptysis
pulmonary infiltrates
diffuse alveolar haemorrhage
cavitating nodules on CXR

29
Q

occular symptoms of GPA

A

conjunctivitis, episcleritis, uveitis, optic nerve vasculitis, retinal artery occlusion, proptosis

30
Q

cutaneous symptoms of GPA

A

palpable purpura, cutanous ulcers

31
Q

Renal symptoms of GPA

A

necrotising glomerulonephritis

32
Q

difference between GPA and EPGA

A

late onset asthma, high eosinophil count and ANCA specificity in EPGA

33
Q

Microscopic polyangiitis very common clinical feature

A

Necrotising glomerulonephritis very common - occurs in up to 90% of patients

34
Q

ANCA in GPA

A

cANCA

35
Q

ANCA in EPGA and MPA

A

pANCA

36
Q

most cases management of ANCA-associated small vessel vasculitis

A

IV steroids and cyclophosphamide

37
Q

localised and systemic ANCA associated small vessel vasculitis management usually

A

methotrexate and steroids

38
Q

generalised and systemic ANCA associated small vessel vasculitis management usually

A

Cyclophosphamide and steroids

39
Q

renal biopsy of ANCA associated small vessel vasculitis

A

crescent formation
pauci-immune

40
Q

HSP most common age range

A

children 2-11

41
Q

HSP potential triggers

A

infection
medications
vaccines
insect bites

42
Q

HSP symptoms

A

purpuric rash over buttocks and lower limbs
colicky abdominal pain
bloody diarrhoea
arthralgia/arthritis (knee and ankles predominantly)

43
Q

HSP signs

A

fever
renal involvement
history of recent upper respiratory tract infection

44
Q

HSP is a clinical diagnosis, what investigation is used for a definitive diagnosis in uncertain cases

A

tissue biopsy

45
Q

Behçet’s disease most common in people from where

A

Turkey
Mediterranean
Japan

46
Q

Behçet’s disease affects people with what HLA positivity

A

HLA-B51

47
Q

Behçet’s disease symptoms

A

recurrent oral ulcers
recurrent genital ulceration
uveitis
erythema nodosum

48
Q

test for Behect;s disease

A

the pathergy test- inflammatory papule or pustule, after mild skin trauma

49
Q

polymyalgia rheumatica affects which age group

A

> 50 years

50
Q

polymyalgia reumatica associated with

A

giant cell arteritis

51
Q

polymyalgia reumatica symtoms

A

proximal myalgia of hip and shoulder girdles with morning stiffness lasting >45mins- usually symmetrical, occurs relatively quickly, pain worse with movement
systemic symptoms

52
Q

polymyalgia reumatica signs

A

reduced movement of shoulders, neck, and hips
muscle strength normal
upper arm tenderness
carpel tunnel syndrome
pitting oedema

53
Q

polymyalgia rheumatica management

A

rapid and dramatic response to low dose steroids- start at prednisolone 15mg daily

54
Q

which ig mediates HSP

A

IgA

My Flashcards Year 2 (21 decks)

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