Vasculite

Question 1

Ce afecteaza purpura henloch schonlein?

Answer 1

Vase mici

Question 2

Care sunt caracteristicile PHS?

Answer 2

Purpura nontrombocitopenica cutanata
Artralgii, artrita
Manifestari GI
Glomerulonefrita, +/-orhita

Question 3

Care este etiologia?

Answer 3

Infectiile pot fi trigger
La 1-3 sapt de la IACRS
Alergii,sens la medicamente
Astea s posibile cauze/predispozitii

Question 4

Cauze infectioase de stimulare a sintezei de IgA:

Answer 4

Bacteriene:SBH, HI, Mycoplasma
Virale: rubeolic, vEB, parvo, varicela

Question 5

Debutul in PHS

Answer 5

Acut, febra si cele 4 manifestari

Question 6

Caracteristici eruptii cutanate

Answer 6

Declive, caracter ortostatice: fese+MI
Simetrice

Question 7

Cum e aspectul leziunilor si cum evolueaza?

Answer 7

Initial maculopapule eritematoase care dispar la vitropresiune
In 12-24h evol in leziuni purpurice care pot fuziona si poate aparea edem subcutanat

Question 8

Care sunt manifestarile articulare?

Answer 8

Artralgii-articulatii mari, rar mici
Artrita-rara, dureroasa la miscare
De obicei preced rash-ul cu 1-2 zile inainte, dispar in cateva zile

Question 9

Ce alte manifestari mai apar in PHS?

Answer 9

Angioedem
Manif GI
Manif renale
Manif testiculare
Manif neurologice
HSM si limfadenopatii

Question 10

Care sunt criteriile de dg pt PHS?

Answer 10

purpura(obligatoriu) si 1/4 din:
Dureri abdominale
Depozite IgA
Afectare renala
Artrita, artralgii

Question 11

Ce se observa paraclinic?

Answer 11

VSH, eozinofile, leucocite crescute
F de coag, trombocite normal
Anemie normocroma sec sangerari
IgA crescute >50% din cazuri

Question 12

Tratament PHS

Answer 12

Suportiv, simptomatic(AINS), etiologic(daca are inf) si CT: prednison

Question 13

Indicatii pentru corticoterapie in PHS

Answer 13

orhita severa
durere abdominala si hemoragie
Manif SNC
NU IN AFECTARE RENALA

Question 14

Tratament cazuri severe PHS

Answer 14

Metilprednisolon iv si eventual IS (+/-)

Question 15

Ce vase afecteaza BK?

Answer 15

vasele de calibru mediu

Question 16

Care e criteriu obligatoriu pentru diagnostic?

Answer 16

Febra>5 zile

Question 17

Factorul de risc pentru boala arteriala coronariana in BK?

Answer 17

Febra prelungita

Question 18

Factori de risc pentru boala arteriala coronariana:

Answer 18

Febra prelungita>5 zile
Varsta mica
Sdr inflamator marcat
Scadera Hb

Question 19

Criterii de dg pt BK

Answer 19

Febra>5zile (obligatoriu)
1.hiperemie conjunctivala
2.modif in mucoasa orofaringelui
3.modif extrem
4.rash
5.limfadenopatie

Question 20

Tratament BK

Answer 20

IGIV
ASPIRINA
Daca febra e persistenta sau reapare:prednisolon iv