Systemic Vascultitis

Question 1

Systemic vasculitis Definition

Answer 1

Inflammation of blood vessels

Question 2

Systemic vasculitis Pathology

Answer 2

Inflammatory infiltration of blood vessel walls
Aneurysm formation
Stenosis
May be activate my infection

Question 3

Giant cell arteritis

Answer 3

Large vessel vasculitis -> ischaemia
1-5/100,000
>60y
Females
50% have PMR 

Jaw claudication
Thickened temporal art 
Visual disturbances
-> amourosis fugax
-> blind

Question 4

Poly myalgia rheumatica

Answer 4

Non vasculitic pain and stiffness in the shoulders and hips
20-50% have GCA
Symmetrical pain and stiffness, hips and shoulders
Proximal muscle tenderness
Peripheral synovitis

Question 5

Systemic vasculitis Investigations

Answer 5

PMR is a clinical diagnosis
Temporal artery biopsy
Increased ESR
Anaemia

Question 6

Systemic vasculitis Management

Answer 6

Urgent corticosteroids
Methotrexate/azothioprine
Bone prophylaxis

Question 7

Clinical features suggestive of vasculitis

Answer 7

Multi system disease
Autoimmune rheumatic disease 
Infections
Increased inflam markers
Abnormal serology 
Biopsy
Fevers, anorexia, wt loss, fatigue 
Rashes, purpura, ischaemia
Arthritis 
Glomerulonephritis 
Ischaemia 
Neuopathies
Strokes

Question 8

Investigations for vasculitis

Answer 8

Systems review 
BP and urine dip
Wt
Bloods
-acute phase reactants
-autoantibodies
-viral screen
-ANCA
-U and E
-LFT

Question 9

Systemic vasculitis Management

Answer 9

Depends on which organs
Immune suppression-> steroids
Anti virals
Bone prophylaxis