Vascular Flashcards
50 y/o female with history of joint pain presents with left sided headache. She also reports pain with chewing.
What treatment should be started right away prior to obtaining a vessel biopsy?
What will be seen on biopsy?
Start corticosteroids; blindness risk
inflamed vessel wall with giant cells and fibrosis of intima
FA 302, figure A
Poma pg 65, fig 7.2
25 y/o pt presents with progressive weight loss, headache, and abdominal pain.
BP is found to be 150/95.
Microaneurysms are seen along renal artery on CT scan. What is this called?
What type of vessel damage is associated?
What surface antigen can you expect to find?
Transmural inflammation of arterial wall with fibrinoid necrosis.
HBsAg
FA 302, poma 66
3y/o asian child with strawberry tongue presents with rash to palms, fever, and cervical adenopathy.
What is the treatment and what must be taken into precaution? What disease could this lead to?
Kawasaki dz FA 302, poma 36
ASA in children with virus can cause Reye; decreased beta-oxidation in liver
FA 369
Pt with Kawasaki disease is given ASA for treatment.
What is the mechanism?
Blocks COX enzymes in platelets, so TXA2 is not formed.
FA 387
Pt who smokes heavily presents with ulcers and dry gangrene to several toes.
What is the pathology and treatment?
Necrotizing vasculitis involving digits
Segmental thrombosing vasculitis
FA 302, poma 66
treatment is to stop smoking
45 y/o male presents with nasal ulcerations, hematuria, cough.
CXR shows bilateral nodular infiltrations. Sputum culture is negative.
What is etiology of this disease? What auto-antibody can you expect to find?
small vessel vasculitis wegener: granulomatosis with polyangiitis necrotizing granuloma in lungs rapidly progressing glomerulonephritis c-ANCA
FA 213, FA 302, poma 66
40 y/o male presents with hemoptysis, cough, chronic sinusitis, and otitis media.
Image G on page FA 303 is seen.
What type of antibody?
What renal disease is associated?
c-ANCA
rapidly progressing glomerulonephritis
poma 66
Pt presents with hemoptysis, cough, hematuria, and palpable purpura.
Granulomatosis with polyangiitis and microscopic polyangiitis are expected.
What are the differences?
no nasopharyngeal ulcers, no granulomas, p-ANCA
FA 302
Pt with cough, chest pain, sinusitis.
p-ANCA is positive.
What two diseases could this be and what are the main differences?
Eosinophilic granulomatosis with polyangiitis
asthma, granulomas, peripheral eosinophilia
vs
Microscopic polyangiitis
FA 302, poma 66
Child who just got over a cold presents with palpable purpura to extremities and buttocks and slight abdominal pain.
No tick bite is reported.
What is the etiology of this disease?
what is it associated with?
URI -> increased IgA production to protect mucosa
IgA-immune complex deposition
associated with IgA nephropathy (deposition in mesangium leading to bleeding from glomerulous)
FA 303, 541, poma 67
What is the mechanism of palpable purpura?
Resembles bleeding underneath the skin however there is inflammation with the vasculitis, therefore you can palpate it.
