Rheumatology: Vasculitis

Question 1

What are the 3 types of Vasculitis?

Answer 1

Large, medium and small

Question 2

What are the subtypes of LARGE vessel vasculitis?

Answer 2

1. Giant Cell Arteritis
2. Takayasu’s

“it TAKes a Giant to be LARGE”

Question 3

What are the subtypes of MEDIUM vessel vasculitis?

Answer 3

1. Polyarteritis Nodosa

2. Kawasaki’s Disease

Question 4

How are small vessel vasculitises categorized?

Answer 4

ANCA + or ANCA -

ANCA= AntiNeutrophil Cytoplasmic Antibody

Question 5

What are the subtypes of ANCA + small-vessel vasculitis?

Answer 5

1. Granulomatosis w/polyangiitis (GPA or Wegener)
2. Eosinophilic granulomatosis with polyangiitis (EGPA or Churg-Strauss)
3. Microscopic Polyangiitis (MPA)

Question 6

What are the subtypes of ANCA - small-vessel vasculitis?

Answer 6

1. Henoch-Schönlein Purpura (HSP)
2. Essential cryoglobulinemic vasculitis
3. Cutaneous leukocytoclastic angiitis

Question 7

When I say Giant Cell Arteritis, you think:

Answer 7

1. Temporal Headache
2. Jaw Cramps.
3. Intima fibrosis

Question 8

When I say Takayasu’s, you think:

Answer 8

1. Aortic arch

2. Cramping or weakened pulse of upper extremeties

Question 9

When I say Polyarteritis Nodosa, you think:

Answer 9

Panmural necrotizing arteritis

Question 10

When I say Kawasaki’s, you think:

Answer 10

Motorcycles….

Wouldn’t it be fun to be dirt biking right now? We gotta go to my cabin in Westcliffe soon and bring all our LITTLE ASIAN BABIES with us.

Think of all the little Asian babies…

Question 11

When I say Churg-Strauss, you think:

Answer 11

1. EOSINOPHILIA
2. Necrotizing extravascular granulomas.
   ANCA+

Question 12

When I say Microscopic polyangiitis you think:

Answer 12

1. Palpable purpura
2. Joint pain
   ANCA +

Question 13

When I say Henoch-Schönlein Purpura (HSP), you think:

Answer 13

IgA deposition

ANCA -

Question 14

When I say Essential cryoglobulinemic vasculitis, you think:

Answer 14

WTF is that?

1. Immunoglobulins precipitate due to cold.
2. Hep C +
3. ANCA -

Question 15

c-ANCA binds to

Answer 15

PR3 (proteinase 3) found in PMNs

Question 16

p-ANCA binds to

Answer 16

MPO found in PMNs.

Question 17

What are the immunopathologies of Vasculitis?

Answer 17

1. Immune Complexes
2. ANCA
3. Antiendothelial ABs
4. T Cell dependent endothelial damage
5. Infection of endothelium.

Basically, anything that will damage/irritate a blood vessel. I mean, it makes sense right?

Question 18

T/F

In primary vasculitis, the inciting agent is unknown

Answer 18

True, straight from the PDF.

Question 19

How do you treat Vasculitis?

Answer 19

Treat or remove the inciting agent or antigen.

Also, glucocorticoids help.