Resp 2B Flashcards

1
Q

What is vasculitis?

What are the different categories for vasculitis and examples for each?

A
  • Inflammation of vessels
  • Leads to vessel wall damage –> in turn bleeding, stenosis, ischaemia. Aneurysms can develop around stenosed segments.
  • GCA and granulomataosis w polyangitis (GPA) commonest

Categorised by size

  • Large –> Dangerous due to risk of impaired blood flow in large vessels. –> GCA and takayasus.
  • Medium –> polyarteritis nodosa (PAN) and kawasakis
  • Small –> arterioles, venules, capillaries –> immune complex related e.g ANCA, anti GBM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the generic presentation of vasculitis?

A
  • Purpura. These are purple-coloured non-blanching spots caused by blood leaking from the vessels under the skin.
  • Joint and muscle pain
  • Peripheral neuropathy
  • Renal impairment
  • GI –> diarrhoea, abdominal pain and bleeding
  • Anterior uveitis and scleritis
  • Hypertension

Systemic –> Fatigue, Fever, Weight loss, Anorexia (loss of appetite), Anaemia

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

What are the investigations for vasculitis?

What are the different types of ….. blood tests?

A
  • Inflammatory markers –> CRP and ESR are usually raised in vasculitis.
  • Anti neutrophil cytoplasmic antibodies (ANCA) –> blood test to remember for vasculitis.
  • There are two type of ANCA blood tests: p-ANCA and c-ANCA.
  • P-ANCA are also called anti-MPO antibodies –> microscopic polyangitis, churg strauss.
  • C-ANCA are also called anti-PR3 antibodies –> wegeners granulomatosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the management for vasculitis?

A

Depends on type

  • Refer to rheumatologist.
  • Treatment usually involves a combination of steroids and immunosuppressants.
  • Prednisolone –> oral/IV/nasal/inhaled (lung, churg strauss)
  • Immunosuppressants –> Cyclophosphamide, Methotrexate, Azathioprine, Rituximab and other monoclonal antibodies
  • The management of HSP and Kawasaki disease (the types mainly affecting children) is different.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly