Rheumatology - Vasculitis Flashcards
what are the medium vessel vasculitis?
kawasaki
polyarteritis nodosum
what are the large vessel vasculitis?
GCA
takayasu
what are the small vessel ANCA +ve vasculitis?
GPA (wegner’s)
MPA
eGPA (churg strauss)
what are the small vessel ANCA -ve vasculitis?
henoch schonlein
goodpasture’s
behcet’s
cryoglobulinaemia
what is GPA?
small vessel ANCA +ve vasculitis
what is the pathology in GPA?
granulomatous inflam in resp tract and small vessels
what is the triad of features in GPA?
upper RT
lower RT
glomerulonephritis
features of GPA?
sinusitis nasal crusting saddle shaped node haemoptysis fever
what type of glomerulonephritis do vasculitis get? features, Ix and management?
rapidly progressive
NEPHRITIC
fever, wt loss, haemoptysis
biopsy and urinalysis
steroids, cyclophosphamide and plasma exchange
Ix in GPA?
CXR
urinalysis
ESR, PV, CRP, FBC, U+Es
ANCA/cANCA
Tx for GPA?
steroids (can use topical for nasal disease)
cyclophosphamide
what is eGPA?
small vessel ANCA +ve vasculitis
what is the triad of pathology behind eGPA?
eosinophilia
granulomas
vasculitis
features of eGPA?
late onset asthma
rhinitis
purpura
mononeuritis multiplex
what is mononeuritis multiplex?
painful assymetrical peripheral neurpathy
affects 2 seperate nerve areas
Ix for eGPA?
ANCA pANCA ESR, PV, CRP, FBC, U+E urinalysis CXR eosinophils echo biopsy affected area
Tx for eGPA?
steroids
cyclophosphamide
what is microscopic polyangitis?
small vessel ANCA +ve vasculitis
what is nephritic syndrome a triad of?
AKI (oliguria)
HT/oedema
urinary sediment
features of microscopic polyangitis?
nephritic syndrome (GN)
haemoptysis
purpura
Ix for microscopic polyangitis?
ANCA pANCA ESR, PV, CRP, FBC, U+Es urinalysis CXR
Tx for microscopic polyangitis?
steroids
cyclophosphamide
what is henoch schonlein purpura?
small vessel ANCA -ve vasculitis
IgA mediated disorder with immune complex deposition
who gets henoch schonlein purpura?
2-11yrs
Hx of URTI weeks ago
features of henoch schonlein purpura?
purpuric rash on lower limbs
joint pain
nephritic syndrome
what GN do those with henoch schonlein purpura get? treatment?
IgA
ACE for BP control
self limiting
Ix for henoch schonlein purpura?
urinalysis
U+Es
renal biopsy
what is polyarteritis nodosa?
medium vessel vasculitis
affects arteries at bifurcations -> aneurysms form
risk factors for polyarteritis nodosa?
male
hep B
40-60yrs
features of polyarteritis nodosa?
wt loss
athralgia
high BP
livedo reticularis
what is kawasaki disease?
medium vessel vasculitis
features of kawasaki disease?
fever >5days dry mouth/lips strawberry tongue maculopapular rash abdo pain
Ix for kawasaki disease? results?
FBC (raised WCC, platelets, anaemic)
deranged LFTs
raised PV/CRP/ESR
echo
Tx for kawasaki disease?
steroids
Igs
NSAIDs
what are those with kawasaki disease at risk of?
coronary aneurysms
what is takayasu arteritis? pathology?
large vessel vasculitis
granulomas in large vessels (aorta and branches)
features of takayasu arteritis?
fever
wt loss
fatigue
upper/lower limb claudication
what is found on examination in takayasu arteritis?
weak upper limb pulses
increased BP
unequal BP on either side
murmurs
Ix for takayasu arteritis?
PV, ESR, CRP
PET CT
MR angio
what is goodpasture’s? pathology?
ANCA -ve small vessel vasculitis
anti GBM abs produced against Type IV collagen in he GBM
in goodpasture’s, do they get nephritic/nephrotic syndrome?
nephritic
features of goodpasture’s?
haemoptysis haematuria oedema HT fever
Ix for goodpasture’s?
urinalysis U+Es, creatinine renal biopsy CXR anti GBM antibodies
Tx for goodpasture’s?
steroids
plasmaphoresis
cyclophosphamide
what is behcet’s syndrome?
ANCA -ve small vessel vasculitis
features of behcet’s syndrome?
oral and genital ulcers
skin involvement
arthritis
short duration of symptoms
what are cryoglobulins?
Igs that precipitate at low temperatures
features of cryoglobulinaemia?
rash
GN (nephrotic - membranoproliferative)
old people
what conditions can cause cryoglobulinaemia?
myeloma
Hep C
autoimmune conditions
CLL
