Pathoma - Vasculitis Flashcards

1
Q

What are the large-vessel vasculitides?

A

Temporal (Giant cell) arteritis

Takayasu arteritis

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

What are the medium-vessel vasculitides?

A

Think: cook a COW in a PAN to get a MEDIUM BURGER

Kawasaki Disease

Polyarteritis Nodosa

Buerger Disease

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

What are the small-vessel vasculitides?

A

Wegener Granulomatosis

Microscopic polyangiitis

Churg-Strauss Syndrome

Henoch-Schonlein Purpura

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

What vessels are affected in Temporal (Giant cell) Arteritis?

A

Branches of the carotid artery

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

Presentation of Temporal (Giant cell) Arteritis?

A

Depends on artery involved:

Headache –> temporal a.

Visual disturbances –> ophthalmic a.

Jaw claudication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is polymyalgia rheumatica and what disease is it involved in?

A

Flu-like symptoms with joint and muscle pain

Presentation of Temporal (Giant cell) Arteritis

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

Describe biopsy in Temporal (Giant cell) Arteritis

A

Focal granulomatous inflammation:

Giant cells and intimal fibrosis (between intima and media)

Lesions are segmental so biopsy requires long segment and may be negative even with disease

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

Treatment and importance of treatment in Temporal (Giant cell) Arteritis

A

Corticosteroids

High risk of blindness without treatment

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

Vessels involved in Takayasu arteritis?

A

Branches of the aortic arch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Presentation of Takayasu arteritis

A

Visual and neuro symptoms with weak or absent pulse in upper extremities (e.g. pulseless disease)

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

Treatment of Takayasu arteritis

A

Corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the different populations affected by Giant cell vs Takayasu arteritis

A

Giant cell: adults > 50 y/o (usually elderly females)

Takayasu: adults < 50 y/o (usually young Asian female)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What organs are affected in polyarteritis nodosa?

A

Multiple organs with sparing of the lungs

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

Presentation of polyarteritis nodosa

A

HTN - renal artery

Abd pain with melena - mesenteric a.

Neuro disturbances

Skin lesions

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

What vasculitis is serum HBsAg associated with?

A

Polyarteritis nodosa

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

What is the appearance of polyarteritis nodosa on imaging

A

String-of-pearls appearance

Early lesion weaken the wall leading to aneurism

Late lesions heal with fibrosis

17
Q

Histology of polyarteritis nodosa

A

Transmural inflammation with fibrinoid necrosis (super pink)

18
Q

What population is typically affected by Kawasaki Disease?

A

Asian children < 4 y/o

19
Q

Presentation of Kawasaki Disease

A

Nonspecific signs that may appear as viral infection: fever, conjunctivitis, erythematous rash of palms and soles

20
Q

What vessel is often involved in Kawasaki Disease?

A

Coronary artery (thrombosis with MI or aneurysm with rupture)

21
Q

Treatment of Kawasaki Disease

A

Aspirin (to prevent thrombosis) and IVIG

22
Q

Presentation of Buerger Disease

A

Necrotizing vasculitis of digits (ulceration, gangrene, autoamputation of fingers and toes)

23
Q

What is the major risk factor of Buerger Disease

24
Q

Treatment of Buerger Disease

A

Smoking cessation

25
Affected organs/tissues in Wegener's granulomatosis
Nasopharynx, lungs, and kidney Triad: Focal necrotizing vasculitis Necrotizing granulomas in the lung and upper airway Necrotizing glomerulonephritis
26
27
Positive serum marker in Wegener's granulomatosis
c-ANCA
28
Treatment of Wegener's granulomatosis
Cyclophosphamide and corticosteroids
29
Difference in presentation between Wegener's granulomatosis and Microscopic Polyangiitis
Both involve lung and kidney, but Microscopic Polyangiitis does not involve nasopharynx and granulomas are absent
30
Positive serum marker in Microscopic Polyangiitis
p-ANCA
31
Treatment of Microscopic Polyangiitis
Cyclophosphamide and corticosteroids
32
Histology of Churg-Strauss Syndrome
Granulomatous inflammation with eosinophils
33
How to differentiate between Churg-Strauss and Microscopic polyangiitis
Churg-Straus has granulomas, asthma, and peripheral eosinophilia
34
Positive serum marker in Churg-Strauss
p-ANCA
35
Cause of vasculitis in Henoch-Schonlein Purpura
IgA immune complex deposition
36
What is the most common vasculitis in children?
Henoch-Schonlein Purpura
37
Presentation of Henoch-Schonlein Purpura
Palpable purpura on buttocks and legs
38
Disease often preceding Henoch-Schonlein Purpura
URI (recall that Henoch-Schonlein Purpura is caused by IgA deposition)