Rheumatology - Vasculitis

Question 1

Henloch-Schonlein Purpura

Answer 1

Question 2

Microscopic Polyangitis

Answer 2

Question 3

Granulomatosis with Polyangiitis

Answer 3

Question 4

Eosinophilic Granulomatosis with Polyangiitis

Answer 4

Question 5

Polyarteritis Nodosa

Answer 5

Question 6

Kawasaki Disease

Answer 6

Question 7

GCA

Answer 7

Question 8

Takayasu’s Arteritis

Answer 8

Question 9

How is vasculitis managed?

Answer 9

Steroids to target affected area e.g. prednisolone and hydrocortisone

Cyclophosphamide
Rituximab

Question 10

What is Henoch-Schonlein purpura?

Answer 10

IgA vasculitis

Presents in children with a purpuric rash affecting lower limbs and buttocks

Question 11

Why does inflammation occur in Henoch-Schonlein purpura?

Answer 11

IgA deposition in blood vessels

Question 12

What is affected in Henoch-Schonlein purpura?

Answer 12

Skin
Kidneys
GI

Question 13

What can trigger Henoch-Schonlein purpura?

Answer 13

URTI
Gastroenteritis

Question 14

Who is commonly affected by Henoch-Schonlein purpura?

Answer 14

Kids under 10

Question 15

What are the 4 classic features of Henoch-Schonlein purpura?

Answer 15

Purpura
Joint pain
Abdominal pain
Renal involvement (IgA nephritis)

Question 16

How is Henoch-Schonlein purpura managed?

Answer 16

Supportive

Monitored with
Urine dipstick
BP

Question 17

What are the main features of microscopic polyangiitis?

Answer 17

Renal failure due to glomerulonephritis

Haemoptysis due to diffuse alveolar haemorrhage

Question 18

What is affected in Granulomatosis with polyangiitis?

Answer 18

Respiratory tract
Kidneys- causes rapidly progressing glomerulonephritis

Question 19

In the respiratory tract what are the effects in Granulomatosis with polyangiitis?

Answer 19

Upper
Nose bleeds
Hearing loss
Sinusitis

Lower
Haemoptysis

Question 20

What is a classic sign of Granulomatosis with polyangiitis?

Answer 20

Saddle-shaped nose
Due to nasal bridge collapse causing the nasal ridge to dip inwards

Question 21

What is Eosinophilic Granulomatosis with Polyangiitis?

Answer 21

Small-vessel vasculitis

Affects the lungs and skin
Can affect kidneys

Question 22

How does Eosinophilic Granulomatosis with Polyangiitis present?

Answer 22

Severe asthma in middle age
Sinusitis
Allergic rhinitis
Raised eosinophils

Question 23

What is Polyarteritis Nodosa?

Answer 23

Medium-vessel vasculitis
Idiopathic or secondary to infection especially Hep B

Question 24

What are the typical features of Polyarteritis Nodosa?

Answer 24

Renal impairment
Hypertension
Tender, erythematous skin nodules
MI
Stroke
Mesenteric arteritis

Question 25

What is Kawasaki Disease?

Answer 25

Medium-vessel vasculitis

Affects kids under 5
No clear cause

Question 26

What are the features of Kawasaki Disease?

Answer 26

Persistent higher fever for over 5 days
Widespread erythematous maculopapular rash
Desquamation
Bilateral conjunctivitis
Strawberry tongue

Question 27

What is a key complication of Kawasaki Disease?

Answer 27

Coronary artery aneurysms

Aspirin and IV immunoglobulins

Question 28

What is Takayasu’s Arteritis?

Answer 28

Large vessel vasculitis

Mainly affects aorta, can affect pulmonary arteries

Vessels swell and form aneurysms or become narrowed and blocked

Stenosis or occlusion can reduce pulse and BP in the limb

Question 29

When does Takayasu’s Arteritis present?

Answer 29

Before 40
Non-specific symptoms

Claudication symptoms particularly in arm

Question 30

How is Takayasu’s Arteritis diagnosed?

Answer 30

CT
MRI angiography