Pathoma- Vasculitis Flashcards

1
Q

What symptoms are common to all vasculidities?

A
  1. nonspecific symptoms (myalgia, malaise, etc)

2. symptoms of organ ischemia (depending on the organ)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are 2 ways organ ischemia can occur?

A
  1. thrombosis in a BV

2. fibrosis of the BVs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 2 large vessel vasculidities?

A
  1. temporal (Giant Cell) arteritis

2. Takayasu Arteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is temporal (Giant Cell) arteritis?

A

the most common form of vasculitis in older adults, usually affects females over age 50; manifests in carotid artery and its branches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the s/s of temporal (Giant Cell) arteritis?

A
headache
visual disturbances
jaw claudication
flu-like symptoms (joint and muscle pain)
elevated ESR (>100)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is seen in the biopsy of temporal (Giant Cell) arteritis?

A

inflamed vessel wall
giant cells (due to granulomatous vasculitis)
intimal fibrosis
segmental lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the tx for temporal (Giant Cell) arteritis?

A

corticosteroids ASAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why is tx so important in temporal (Giant Cell) arteritis?

A

high risk of blindness w/o tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How are Takayasu Arteritis and temporal (Giant Cell) arteritis different?

A

in Takayasu:

  • younger than age 50, usually young Asian females
  • usu aortic arch at branch points
  • weak or absent pulse in upper extremities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What BVs do the medium-vessel vasculidities supply?

A

they’re muscular arteries that supply organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name the medium vessel vasculidities.

A
  1. Polyarteritis Nodosa
  2. Kawasaki Disease
  3. Buerger Disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the features of Polyarteritis Nodosa?

A
  1. multiple artery inflammation
  2. necrotizing vasculitis
  3. involves most organs EXCEPT THE LUNG
  4. in young adults
  5. serum HBsAg (hep B surface antigen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do the Polyarteritis Nodosa lesions look on imaging?

A

string-of-pearls nodulation (fibrinoid necrosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the tx for Polyarteritis Nodosa?

A

corticosteroids and cyclophosphamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What happens in untreated Polyarteritis Nodosa?

A

death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Who does Kawasaki Disease affect?

A

Asian children <4yo

17
Q

What is the presentation for Kawasaki Disease?

A

fever
conjunctivitis
erythematous rash of palms and soles
enlarged cervical lymph nodes

18
Q

What artery is preferred in Kawasaki Disease?

A

the coronary artery

19
Q

What is the tx for Kawasaki Disease?

A

aspirin and IVIG

20
Q

What vessels does Buerger Disease affect?

A

BVs of the fingers

21
Q

Buerger Disease is only associated with _____.

22
Q

What is Raynaud phenomenon?

A

discoloration of the fingers/toes bc of vasospasm

23
Q

What is the presentation for Buerger Disease?

A
  1. necrotizing vasculitis of digits (ulcers, gangrene, autoamputation)
  2. Raynaud phenomenon
24
Q

What is the tx for Buerger Disease?

A

smoking cessation

25
What are the small vessel vasculidies?
1. Wegener Granulomatosis * WeCKener 2. Microscopic Polyangiitis 3. Churg-Strauss Syndrome 4. HSP
26
What does Wegener Granulomatosis look like?
1. necrotizing granulomatous vasculities involving the nasopharynx, lungs, and kidneys 2. serum C-ANCA 3. sinusitis/nasopharyngeal ulceration 4. hematuria due to rapidly progressive glomerulonephritis (RPGN)
27
What is the tx for Wegener Granulomatosis?
cyclophosphamide and corticosteroids
28
What is the ANCA test?
neutrophil on a slide is given pt's serum- if Abs are present, they will present near the nucleus (P-ANCA) or on the outer rim of the nucleus (C-ANCA)
29
What are the features of Microscopic Polyangiitis?
1. necrotizing vasculitis of multiple organs, esp lung and kidney 2. P-ANCA 3. NO granulomas or nasopharyngeal involvement
30
What is the tx for Microscopic Polyangiitis?
cyclophosphamide and corticosteroids
31
What is Churg-Strauss Syndrome?
1. necrotizing granulomatous vascultis with eos and asthma 2. multiple organs, esp lungs and heart 3. P-ANCA
32
What does HSP stand for?
h___ine purpura
33
What is HSP?
1. vasculitis due to IgA immune complex deposition | 2. most common vasculitis of children
34
What is the classical presentation of HSP?
1. classical purpura on buttocks and legs 2. GI pain and bleeding 3. hematuria (kidney IgA nephropathy) 4. post URI/viral infection