Vasculitides Flashcards
Gaint cell (temporal) arteritis: who and what age?
Female >50
Gaint cell (temporal) arteritis: symptoms? (3)
unilateral headache
jaw claudication
possible temporal artery tenderness
Gaint cell (temporal) arteritis: important complication?
irreversible blindness die to AION (anterior ischemic optic neuropathy)
irriversible blindness in Gaint cell (temporal) arteritis: cause?
anterior ischemic optic neuropathy (AION)
= interruption of blood flow to the front (anterior) of the optic nerve
Gaint cell (temporal) arteritis: associated with which other disease?
polymyalgia rheumatica
which arteritis is associated with PMG?
Gaint cell (temporal) arteritis
which arteritis is most common in female >50?
Gaint cell (temporal) arteritis
unilateral headache, tenderness of temporal artery, jaw claudication
what can it be?
Gaint cell (temporal) arteritis
which arteritis may lead to irreversible blindness due to AION?
Gaint cell (temporal) arteritis
Gaint cell (temporal) arteritis: which artery branches most commonly affected?
carotid branches
Gaint cell (temporal) arteritis: what kind of inflammation?
focal granulomatous
Gaint cell (temporal) arteritis: which inflammation marker very high?
ESR
Gaint cell (temporal) arteritis: levels of which cytokine correlate with disease activity?
IL-6
Gaint cell (temporal) arteritis: treatment?
high dose glucocorticocoids
Gaint cell (temporal) arteritis: when to apply treatment, before or after biopsy?
before
Gaint cell (temporal) arteritis: diagnosis?
temporal artery biopsy
Gaint cell (temporal) arteritis: why start treatment before biopsy?
to prevent blindness
Takayasu arteritis: in who and what age?
asian female <40
Takayasu arteritis: symptoms?
weak upper extremity pulses
fever, night sweats, arthritis, myalgias
skin nodules and ocular disturbances
other name for Takayasu arteritis?
pulselessness disease
pulselessness disease: what is this?
takayasu
takayasu arteritis: pathophysiology?
granulomatous thickening/narrowing of aortic arch and proximal great vessels
35 y/o chinese woman
weak upper extremity pulses,
night sweats, myalgias, skin nodules
elevated ESR
suggestive of?
takayasu
takayasu: which inflammation marker elevated?
ESR
takayasu: treatment?
glucocorticoids
granulomatous thickening/narrowing of aortic arch and proximal great vessels
which disease?
takayasu
what are the large vessel vasculitides?
giant cell arteritis
takayasu
what are the medium vessel vasculitides?
Buerger, Kawasaki, polyarteritis nodosa
Buerger: in who?
males <40
heavy tabacco smoking
Buerger: other name?
thromboangiitis obliterans
Buerger: symptoms?
intermittent claudication
may lead to gangrene, autoamputation of digits, superficial nodular phlebitis
Raynaud phenomen often present
man 35, heavy tobacco smoking history
intermittent claudication, gangrene toe, Raynaud phenomen
suggestive of?
Buerger
Buerger: pathophysiology?
segmental thrombosing vasculitis
vein and nerve involvement
Buerger: treatment?
smoking cessation
segmental thrombosing vasculitis
vein and nerve involvement
what is this?
Buerger
Kawasaki: in who?
Asian kids <4
vasculitis common in asian kids <4?
kawasaki
kawasaki: symptoms?
CRASH and burn
Conjunctivitis
Rash
Adenopathy
Strawberry tongue
Hand and foot changes
and burn: fever
3 y/o japanese kid
fever, cervical adenopathy, desquamating rash, red and swollen feet and hands
suggestive of which vasculitis?
kawasaki
rash in kawasaki?
polymorphous, desquamating (shedding/scraping off)
what kind of adenopathy in kawasaki?
cervical
hand and foot changes in kawasaki?
swollen and erythema
conjunctivitis in kawasaki?
bilateral non-exudative (no fluids) bulbar
is the conjunctivitis in kawasaki unilateral or bilateral?
bilateral
what was kawasaki formerly called?
mucocutaneous lymph node syndrome
kawasaki: complications?
coronary artery aneurysms; thrombosis or rupture can cause death
what can cause death in kawasaki?
coronary artery aneurysms
kawasaki: treatment?
IVIG and aspirin
polyarteritis nodosa: in who?
middle-aged males
polyarteritis nodosa: seropositive for what in 30% of the cases?
Hepatitis B
in which arteritis 30% of patients seropositive for Hep B?
polyarteritis nodosa
polyarteritis nodosa: involvement of which systems?
cardiovascular, GI, neuro, skin, renal
polyarteritis nodosa: symptoms?
GI: abdominal pain, melena
Hypertension, neurologic dysfunction, skin sores, renal damage
52 y/o man with hypertension, abdominal pain, melena, skin sores, proteinuria and hematuria
Hep B seropositivity
suggestive of?
polyarteritis nodosa
what system is NOT involved in polyarteritis nodosa?
pulmonary
which arteries are typically involved in polyarteritis nodosa?
renal and visceral
polyarteritis nodosa: renal angiogram/ateriogram findings?
innumerable renal microaneurysms, and spams
‘string of pearl’ appearance