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Ryan's shit list - Step 1 > RSL - Vasculature > Flashcards

RSL - Vasculature Flashcards

1
Q

Temporal (Giant Cell) arteritis (Vessels)

A

Large cell vasculitis

Elderly females

Unilateral headache

Jaw or tongue claudication during meals

Opthalmic occlusion –> irreversible blindness

Associated to polymyalgia rheumatica

Focal granulomatous inflammation of media with intimal fibrosis (branches of carotid; more distal than takayasu)

Increased ESR

Treat high dose corticosteroids (prevent blindness)

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2
Q

Takayasu arteritis (Vessels)

A

Large cell vasculitis

Asian females <40

Pulseless disease (weak upper extremity pulse)

Fever, nightsweats, arthritis, myalgia, skin nodules, ocular disturbances

Granulomatous medial thickening and narrowing of aortic arch and proximal great vessels

Increased ESR

treat with corticosteroids

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3
Q

Polyarteritis Nodosa (Vessels)

A

Medium sized vasculitis

Young adults

Hep B positive (30%)

Fever, weight loss, malaise, headache

GI: abdominal pain, melena

Hypertension, neurologic dysfunction, cutaneous eruptions (Livedo reticularis), renal damage, palpable purpura

NOT pulmonary, typically renal and visceral (numerous microaneurisms and vasospasms)

Immune complex mediated; Transmural inflammation of arterial wall with fibrinoid necrosis

Treat with corticosteriods and cyclophosphamide

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4
Q

Kawasaki Disease (vessels)

A

Medium sized Vasculitis

Asian children <4yrs

Mucocutaneous lymph node syndrome: CRASH & burn

  • Conjunctival injection
  • Rash (polymorphous –> desquamating)
    • Begins on extremitites and moves to trunk
  • Adenopathy (cervical)
  • Strawberry tongue (oral mucositis)
  • Hand-foot changes (edema, erythema)
  • Fever

Coronary artery aneurysms; thrombosis and rupture

Treat: IV Ig, and aspirin

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5
Q

Buerger disease (thrombophlebitis obliterans)

(Vessels)

A

Medium sized vasculitis

Heavey smokers, males <40 yrs old

Direct hypersensitivity to nicotine –> endothelial/nervous damage

Intermittant claudication –> ulceration, gangrene, autoamputation of digits

Associated to Raynaud phenomenon

Segmental thrombosing vasculitis

Treat with smoking sessation

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6
Q

Granulomatosis with polyangitis

(Wegener)

Vessels?

A

Small vessel vasculitis

URT: perforation of nasal septum, chronic sinusitis, otitis media, mastoiditis

LRT: hemoptysis, cough, dyspnea

Renal: Hematuria, red cell casts (RPGN)

Triad:

  • focal necrotizing vasculitis
  • Necrotizing granulomas in lung and upper airway
  • necrotizing glomerulonephritis

PR3-ANCA / c-ANCA (antiproteinase 3)

CXR: large nodular densities

Treat: cyclophosphamide and corticosteroids

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7
Q

Microscopic polyangitis

Vessels?

A

Small vessel vasculitis

Necrotizing vasculitis of Lung, kidneys, and skin

Pauci-immune glomerulonephritis with palpable purpura

NO nasopharyngeal involvement, NO granulomas

MPO-ANCA/p-ANCA (antimyeloperoxidase)

Treat: cyclophosphamide and corticosteroids

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8
Q

Eosinophilic granulomatosis with polyangitis (Churg-strauss)

Vessels?

A

Small vessel vasculititis

Asthma, sinusitis, skin nodules, purpura, peripheral neuropathy (wrist/foot drop)

Heart, GI, kidneys (pauci-immune glomerulonephritis)

Granulomatous, necrotizing vasulitis with eosinophilia

MPO-ANCA/p-ANCA, increased IgE

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9
Q

Henoch-Schönlein purpura

(vessels)

A

Small vessel vasculitis

Follows URI (dt/ IgA) - few days

Classic triad:

  • Skin: palpable purpura on buttocks / legs
  • Arthralgias
  • GI: abdominal pain

Vasculitis 2o to IgA immune complex deposition

Associated with IgA nephropathy (Berger disease)

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10
Q

Trousseau syndrome (migratory thrombophebitis)

A

Cancer –> paraneoplastic –> hypercoaguablity

Small vessel hypersensititivy vasculitis

Adenocarcinomas; colon, pancreas, lung

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11
Q

Myxoma - symptoms

A

Ball valve obstruction –> Multiple postural sycopial episodes, hear tumor plop sound

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12
Q

Hepatic angiosarcoma

A

Blood vessel malignancy associated with vinyl chloride and arsenic exposures and thorotrast

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13
Q

Bacillary angiomatosis

A

Benign capillary skin papule in AIDS patients - caused by Bartonella henselae - Has neutrophilic infiltrate (vs. Kaposi with lymphocytic)

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14
Q

Cherry hemangioma

A

Elderly, does not regress

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15
Q

Cystic Hygroma (+ associatioN)

A

Cavernous lymphangioma of neck associated with Turners

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16
Q

Glomus tumor

A

Benign, painful, red-blue tumor under fingernails that arises from modified smooth muscle cells of thermoregulatory glomus body

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17
Q

Kaposi sarcoma

A

HHV-8 and HIV; lymphocytic infiltrate (vs. bacilliary angiomatosis which is neutrophillic)

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18
Q

Pyogenic granuloma

A

Polypoid capillary hemangioma; can ulcerate and bleed; associating with trauma and pregnancy

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19
Q

Strawberry hemangioma

A

Infants; grows rapidly and regresses spontaneously by 5-8 years

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20
Q

Raynaud phenomenon - pathophys

A

Vasospasm of skin blood vessels in response to cold or stress

White (ischemia), to blue (hypoxia), to red (reperfusion)

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21
Q

lymphangiosarcoma

A

Angiosarcome associated with radiationa nd chronic post-mastectomy lymphedema

22
Q

Raynaud’s Rx

23
Q

Temporal (Giant Cell) arteritis - who

A

Elderly females

24
Q

Takayasu arteritis - who

A

Asian females

25
Q

Polyarteritis Nodosa - who

A

Medium sized vasculitis

Young adults

26
Q

Kawasaki Disease - Symptoms

A

Asian children

Mucocutaneous lymph node syndrome: CRASH & burn

  • Conjunctival injection
  • Rash (polymorphous –> desquamating)
    • Begins on extremitites and moves to trunk
  • Adenopathy (cervical)
  • Strawberry tongue (oral mucositis)
  • Hand-foot changes (edema, erythema)
  • Fever

Coronary artery aneurysms; thrombosis and rupture

Treat: IV Ig, and aspirin

27
Q

Buerger disease (thrombophlebitis obliterans)

  • pathophys
A

Heavey smokers, males

Direct hypersensitivity to nicotine –> endothelial/nervous damage

Intermittant claudication –> ulceration, gangrene, autoamputation of digits

Associated to Raynaud phenomenon

Segmental thrombosing vasculitis

Treat with smoking sessation

28
Q

Granulomatosis with polyangitis

(Wegener)

  • Symptoms
A

Small vessel vasculitis

URT: perforation of nasal septum, chronic sinusitis, otitis media, mastoiditis

LRT: hemoptysis, cough, dyspnea

Renal: Hematuria, red cell casts (RPGN)

Triad:

  • focal necrotizing vasculitis
  • Necrotizing granulomas in lung and upper airway
  • necrotizing glomerulonephritis

PR3-ANCA / c-ANCA (antiproteinase 3)

CXR: large nodular densities

Treat: cyclophosphamide and corticosteroids

29
Q

Microscopic polyangitis

  • Histology
A

Small vessel vasculitis

Necrotizing vasculitis of Lung, kidneys, and skin

Pauci-immune glomerulonephritis with palpable purpura

NO nasopharyngeal involvement, NO granulomas

MPO-ANCA/p-ANCA (antimyeloperoxidase)

Treat: cyclophosphamide and corticosteroids

30
Q

Eosinophilic granulomatosis with polyangitis (Churg-strauss)

  • Symptoms
A

Small vessel vasculititis

Asthma, sinusitis, skin nodules, purpura, peripheral neuropathy (wrist/foot drop)

Heart, GI, kidneys (pauci-immune glomerulonephritis)

Granulomatous, necrotizing vasulitis with eosinophilia

MPO-ANCA/p-ANCA, increased IgE

31
Q

Henoch-Schönlein purpura

  • Symptoms
A

Small vessel vasculitis

Follows URI (dt/ IgA) - few days

Classic triad:

  • Skin: palpable purpura on buttocks / legs
  • Arthralgias
  • GI: abdominal pain

Vasculitis 2o to IgA immune complex deposition

Associated with IgA nephropathy (Berger disease)

32
Q

Temporal (Giant Cell) arteritis

  • Symptoms
A

Large cell vasculitis

Elderly females

Unilateral headache

Jaw or tongue claudication during meals

Opthalmic occlusion –> irreversible blindness

Associated to polymyalgia rheumatica

Focal granulomatous inflammation of media with intimal fibrosis (branches of carotid; more distal than takayasu)

Increased ESR

Treat high dose corticosteroids (prevent blindness)

33
Q

Takayasu arteritis

  • symptoms
A

Large cell vasculitis

Asian females

Pulseless disease (weak upper extremity pulse)

Fever, nightsweats, arthritis, myalgia, skin nodules, ocular disturbances

Granulomatous medial thickening and narrowing of aortic arch and proximal great vessels

Increased ESR

treat with corticosteroids

34
Q

Polyarteritis Nodosa

  • SYmptoms
A

Medium sized vasculitis

Young adults

Hep B positive (30%)

Fever, weight loss, malaise, headache

GI: abdominal pain, melena

Hypertension, neurologic dysfunction, cutaneous eruptions (Livedo reticularis), renal damage, palpable purpura

NOT pulmonary, typically renal and visceral (numerous microaneurisms and vasospasms)

Immune complex mediated; Transmural inflammation of arterial wall with fibrinoid necrosis

Treat with corticosteriods and cyclophosphamide

35
Q

Kawasaki Disease

  • treat
A

Asian children

Mucocutaneous lymph node syndrome: CRASH & burn

  • Conjunctival injection
  • Rash (polymorphous –> desquamating)
    • Begins on extremitites and moves to trunk
  • Adenopathy (cervical)
  • Strawberry tongue (oral mucositis)
  • Hand-foot changes (edema, erythema)
  • Fever

Coronary artery aneurysms; thrombosis and rupture

Treat: IV Ig, and aspirin

36
Q

Buerger disease (thrombophlebitis obliterans)

  • Associations
A

Heavey smokers, males

Direct hypersensitivity to nicotine –> endothelial/nervous damage

Intermittant claudication –> ulceration, gangrene, autoamputation of digits

Associated to Raynaud phenomenon

Segmental thrombosing vasculitis

Treat with smoking sessation

37
Q

Granulomatosis with polyangitis

(Wegener)

  • Investigations
A

Small vessel vasculitis

URT: perforation of nasal septum, chronic sinusitis, otitis media, mastoiditis

LRT: hemoptysis, cough, dyspnea

Renal: Hematuria, red cell casts (RPGN)

Triad:

  • focal necrotizing vasculitis
  • Necrotizing granulomas in lung and upper airway
  • necrotizing glomerulonephritis

PR3-ANCA / c-ANCA (antiproteinase 3)

CXR: large nodular densities

Treat: cyclophosphamide and corticosteroids

38
Q

Microscopic polyangitis

  • Symptoms
A

Small vessel vasculitis

Necrotizing vasculitis of Lung, kidneys, and skin

Pauci-immune glomerulonephritis with palpable purpura

NO nasopharyngeal involvement, NO granulomas

MPO-ANCA/p-ANCA (antimyeloperoxidase)

Treat: cyclophosphamide and corticosteroids

39
Q

Eosinophilic granulomatosis with polyangitis (Churg-strauss)

  • histology
A

Small vessel vasculititis

Asthma, sinusitis, skin nodules, purpura, peripheral neuropathy (wrist/foot drop)

Heart, GI, kidneys (pauci-immune glomerulonephritis)

Granulomatous, necrotizing vasulitis with eosinophilia

MPO-ANCA/p-ANCA, increased IgE

40
Q

Henoch-Schönlein purpura

  • Associations
A

Small vessel vasculitis

Follows URI (dt/ IgA) - few days

Classic triad:

  • Skin: palpable purpura on buttocks / legs
  • Arthralgias
  • GI: abdominal pain

Vasculitis 2o to IgA immune complex deposition

Associated with IgA nephropathy (Berger disease)

41
Q

Temporal (Giant Cell) arteritis

  • histology
A

Large cell vasculitis

Elderly females

Unilateral headache

Jaw or tongue claudication during meals

Opthalmic occlusion –> irreversible blindness

Associated to polymyalgia rheumatica

Focal granulomatous inflammation of media with intimal fibrosis (branches of carotid; more distal than takayasu)

Increased ESR

Treat high dose corticosteroids (prevent blindness)

42
Q

Takayasu arteritis

  • histology
A

Large cell vasculitis

Asian females

Pulseless disease (weak upper extremity pulse)

Fever, nightsweats, arthritis, myalgia, skin nodules, ocular disturbances

Granulomatous medial thickening and narrowing of aortic arch and proximal great vessels

Increased ESR

treat with corticosteroids

43
Q

Polyarteritis Nodosa

  • histology
A

Medium sized vasculitis

Young adults

Hep B positive (30%)

Fever, weight loss, malaise, headache

GI: abdominal pain, melena

Hypertension, neurologic dysfunction, cutaneous eruptions (Livedo reticularis), renal damage, palpable purpura

NOT pulmonary, typically renal and visceral (numerous microaneurisms and vasospasms)

Immune complex mediated; Transmural inflammation of arterial wall with fibrinoid necrosis

Treat with corticosteriods and cyclophosphamide

44
Q

Buerger disease (thrombophlebitis obliterans)

  • histology
A

Heavey smokers, males

Direct hypersensitivity to nicotine –> endothelial/nervous damage

Intermittant claudication –> ulceration, gangrene, autoamputation of digits

Associated to Raynaud phenomenon

Segmental thrombosing vasculitis

Treat with smoking sessation

45
Q

Granulomatosis with polyangitis

(Wegener)

  • treat
A

Small vessel vasculitis

URT: perforation of nasal septum, chronic sinusitis, otitis media, mastoiditis

LRT: hemoptysis, cough, dyspnea

Renal: Hematuria, red cell casts (RPGN)

Triad:

  • focal necrotizing vasculitis
  • Necrotizing granulomas in lung and upper airway
  • necrotizing glomerulonephritis

PR3-ANCA / c-ANCA (antiproteinase 3)

CXR: large nodular densities

Treat: cyclophosphamide and corticosteroids

46
Q

Microscopic polyangitis

  • investigations
A

Small vessel vasculitis

Necrotizing vasculitis of Lung, kidneys, and skin

Pauci-immune glomerulonephritis with palpable purpura

NO nasopharyngeal involvement, NO granulomas

MPO-ANCA/p-ANCA (antimyeloperoxidase)

Treat: cyclophosphamide and corticosteroids

47
Q

Eosinophilic granulomatosis with polyangitis (Churg-strauss)

  • investigations
A

Small vessel vasculititis

Asthma, sinusitis, skin nodules, purpura, peripheral neuropathy (wrist/foot drop)

Heart, GI, kidneys (pauci-immune glomerulonephritis)

Granulomatous, necrotizing vasulitis with eosinophilia

MPO-ANCA/p-ANCA, increased IgE

48
Q

Temporal (Giant Cell) arteritis

  • treat
A

Large cell vasculitis

Elderly females

Unilateral headache

Jaw or tongue claudication during meals

Opthalmic occlusion –> irreversible blindness

Associated to polymyalgia rheumatica

Focal granulomatous inflammation of media with intimal fibrosis (branches of carotid; more distal than takayasu)

Increased ESR

Treat high dose corticosteroids (prevent blindness)

49
Q

Takayasu arteritis

  • treat
A

Large cell vasculitis

Asian females

Pulseless disease (weak upper extremity pulse)

Fever, nightsweats, arthritis, myalgia, skin nodules, ocular disturbances

Granulomatous medial thickening and narrowing of aortic arch and proximal great vessels

Increased ESR

treat with corticosteroids

50
Q

Polyarteritis Nodosa

  • treat
A

Medium sized vasculitis

Young adults

Hep B positive (30%)

Fever, weight loss, malaise, headache

GI: abdominal pain, melena

Hypertension, neurologic dysfunction, cutaneous eruptions (Livedo reticularis), renal damage, palpable purpura

NOT pulmonary, typically renal and visceral (numerous microaneurisms and vasospasms)

Immune complex mediated; Transmural inflammation of arterial wall with fibrinoid necrosis

Treat with corticosteriods and cyclophosphamide

51
Q

Buerger disease (thrombophlebitis obliterans)

  • treat
A

Heavey smokers, males

Direct hypersensitivity to nicotine –> endothelial/nervous damage

Intermittant claudication –> ulceration, gangrene, autoamputation of digits

Associated to Raynaud phenomenon

Segmental thrombosing vasculitis

Treat with smoking sessation

52
Q

Microscopic polyangitis

  • treat
A

Small vessel vasculitis

Necrotizing vasculitis of Lung, kidneys, and skin

Pauci-immune glomerulonephritis with palpable purpura

NO nasopharyngeal involvement, NO granulomas

MPO-ANCA/p-ANCA (antimyeloperoxidase)

Treat: cyclophosphamide and corticosteroids

Ryan's shit list - Step 1 (27 decks)

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