vasculitides

Question 1

Wegener’s Ganulomatous

Answer 1

Granulomatous vasculitis of the upper and lower respiratory tracts together with glomerulonephritis (GN)

Question 2

MC initial complaint for WG?

Answer 2

chronic sinusitis, then pulmonary infiltrates are seen

saddle nose deformity

Question 3

best lab study for WG

Answer 3

C-ANCA

Question 4

how to actually dx WG?

Answer 4

Definitive diagnosis is based on biopsy:
Necrotizing granulomatous vasculitis in tissue
Pulmonay tissue highest diagnostic yield

Question 5

how to tx WG?

Answer 5

prednisone and
cyclophasphamide (Very toxic
cytopenia, infection, and hemorrhagic cystitis )

Question 6

An acute multisystem, necrotizing vasculitis of small and medium-sized muscular arteries

Answer 6

polyarteritis nodosa

Question 7

hwo to dx polyarteritis nodosa?

Answer 7

artery biopsy

tx same as WG

Question 8

Systemic vasculitis syndrome-immunoglobulin (Ig) A-mediated

A small vessel vasculitis

Answer 8

Henoch-SchÖnlein, palpable purpura on butt and LE, abdominal pain
50% of cases have antecedent URI

Question 9

how to tx hnoch-schonlein

Answer 9

usually resolves on its own

Question 10

A clinical syndrome characterized by severe pain and stiffness in the neck, shoulder girdle, and pelvic girdle
with accompanying morning stiffness that lasts for > 1 hour

Answer 10

polymyalgia rheumatica, common in people > 50 median age 72

Question 11

good lab for suspected polymyalgia rheumatica

Answer 11

ESR >40

Question 12

diagnosis criteria for polymyalgia rheumatica

Answer 12

Age 50 years or older at onset
Bilateral aching and morning stiffness for at least 1 month and involving at least 2 of 3 areas:
neck or torso, shoulders or arms, hips or thighs
ESR 40 mm/h or greater
Prompt response of symptoms to corticosteroids (treamtent req for 2-4 years)

Question 13

A systemic, inflammatory, vascular syndrome that predominantly affects the temporal arteries
M/C type of systemic vasculitis

Answer 13

giant cell arteritis, commonly assocaited with polymyalgia rheumatica

Question 14

GCA is seen in

Answer 14

people > 50, presents with a strong HA and scalp pain on palpation

Question 15

good lab for GCA

Answer 15

ESR > 50, biopsy is gold standard

Question 16

how to tx GCA

Answer 16

steroids prior to receiving biopsy results, can prevent eye damage

Question 17

who does Kawasaki’s disease affect?

Answer 17

Children < 10 most often affected, but occasionally in adults. Peak incidence between 6 months and 2 years.

Question 18

diagnostic criteria for Kawasackie’s disease?

Answer 18

fever lasting at least 5 days without explanation combined with 4 out of the following 5

• bilateral bulbar conjunctival inection
• oral mucus membrane changes, strawberry tongue
• erythema of palms and soles, periungual desquamation
• polymorphous rash
• cervical lymphadenopathy

Question 19

major complication of Kawasackie’s disease

Answer 19

arteritis of coronary vessels causing aneurysms or coronary thrombosis.

Question 20

how ot tx Kawasackie’s

Answer 20

• ASA
• IVIG
• Warfarin

Question 21

Idiopathic, multisystem vasculitis of small and medium- sized arteries that occurs in people with asthma, positive P-ANCA shown

Answer 21

Churg-Strauss syndrome

Question 22

; absent pulses in the arms, but good collateral flow in the shoulder, chest and neck areas. Most common finding is a neck bruit.

Answer 22

Takayasu’s Arteritis

Question 23

Characterized by recurrent oral and genital aphthous ulcers, ocular inflammation (hypopyon uveitis)

Answer 23

Behcet’s disease