Systemic Vasculitides - medium/large vessels Flashcards
What are 3 Systemic Vasculitides that affect MEDIUM sized blood vessels?
- Thromboangiitis Obliterans
- Polyarteritis Nodosa
- Kawasaki Disease
What are 3 Systemic Vasculitides that affect MEDIUM sized blood vessels?
- Thromboangiitis Obliterans
- Polyarteritis Nodosa
- Kawasaki Disease
Who is affected by Thromboangiitis Obliterans?
Young males who SMOKE – must smoke
Symptoms of Thromboangiitis Obliterans?
Thrombosis of distal vessels
= loss of digits, hands, feet
What will be seen on angiography with Thromboangiitis Obliterans?
Corkscrew appearance
Treatment for Thromboangiitis Obliterans?
Stop smoking
What is Polyarteritis Nodosa associated with?
Hepatitis B Virus
Signs of Polyarteritis Nodosa?
Livedo Reticularis, ulcers and gangrene
Neuropathy – foot drop
Signs of Polyarteritis Nodosa?
Livedo Reticularis, ulcers and gangrene
Neuropathy – foot drop
What is newly acquired with Polyarteritis Nodosa?
HTN
Lung findings with Polyarteritis Nodosa?
SPARED – NO lung findings
What will be seen on biopsy of Polyarteritis Nodosa?
Fibrinoid Necrosis
What will be seen on angiography with Polyarteritis Nodosa?
Micro-aneurysm
Who is affected by Kawasaki Disease?
Japanese males less than 5 years old
Who is affected by Kawasaki Disease?
Japanese males less than 5 years old
Symptoms of Kawasaki Disease?
Fever, LAD, rash and strawberry tongue
Symptoms of Kawasaki Disease?
Fever, LAD, rash and strawberry tongue
What is the usually cause of morbidity with Kawasaki Disease?
Coronary A. Involvement
Treatment for Kawasaki Disease?
IVIG and Aspirin
What are 2 Systemic Vasculitides that affect LARGE blood vessels?
- Takayasu Arteritis
2. Giant Cell Arteritis
What are 2 Systemic Vasculitides that affect LARGE blood vessels?
- Takayasu Arteritis
2. Giant Cell Arteritis
Takayasu Arteritis affects which large vessels?
Aorta and renal arteries
Takayasu Arteritis affects the Aorta and obliterates?
Peripheral pulses = “pulseless disease”
Possible aorta complications with Takayasu Arteritis?
Dilation, rupture, aneurysm
When Takayasu Arteritis affects the renal arteries, what will it cause?
HTN
Retinopathy with copper wiring
When Takayasu Arteritis affects the renal arteries, what will it cause?
HTN
Retinopathy with copper wiring
What does Angiography show with Takayasu Arteritis?
Long smoother tapered stenosis
Histo findings with Takayasu Arteritis?
Granuloma with some giant cells
What vessels are affected by Giant Cell Arteritis?
Cranial arteries and aortic arch
Symptoms of Giant Cell Arteritis?
Headache
Jaw Claudication = pain while chewing
Vision abnormalities
Symptoms of Giant Cell Arteritis?
Headaches
Jaw Claudication = pain while chewing
Vision abnormalities
What HLA is associated with Giant Cell Arteritis?
HLA-DR4
What will be very elevated with Giant Cell Arteritis?
ESR
What is needed to diagnose Giant Cell Arteritis and what will it show?
Temporal A. biopsy = Multinucleated giant cells
What is needed to diagnose Giant Cell Arteritis and what will it show?
Temporal A. biopsy = multinucleated giant cells
You should administer glucocorticoids ____ biopsy with Giant Cell Arteritis
BEFORE
What will result in the patient if you do not treat them with Giant Cell Arteritis?
Blindness
What frequently coexists with Giant Cell Arteritis?
Polymyalgia Rheumatica
What frequently coexists with Polymyalgia Rheumatica?
Giant Cell Arteritis
Polymyalgia Rheumatica
Subjective feelings of weakness due to muscle pain with no true objective weakness
Polymyalgia Rheumatica
Subjective feeling of weakness due to muscle pain with no true objective weakness
Stiffness, soreness and muscle pain that causes subjective feeling of weakness
Polymyalgia Rheumatica
What is elevated with Polymyalgia Rheumatica?
ESR and CRP
What frequently coexists with Giant Cell Arteritis?
Polymyalgia Rheumatica
= subjective weakness due to muscle pain with no true objective wekaness