Vasculitides Flashcards

1
Q

Define Vasculitis?

A

Vasculitis is the inflammation and necrosis of blood vessels

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2
Q

How are Primary Vasculitides classified?

A

Based on the MAIN VESSEL SIZE affected

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3
Q

What are the different classifications of Vasculitides?

A

LARGE
MEDIUM
SMALL

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4
Q

What are the Large Vasculitides?

A

Giant Cell Arteritis

Takayasu’s Aortitis

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5
Q

What are the Medium Vasculitides?

A

Polyarteritis nodosa

Kawasaki’s disease

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6
Q

What are the small Vasculitides?

A
Churg-Strauss syndrome 
Microscopic polyangiitis 
Wegner's granulomatosis 
Henoch-Schonlein purpura 
Mixed essential cryoglobulinaemia (MEC)
Relapsing polychondritis
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7
Q

What is the aetiology of Vasculitides?

A

Suggested autoimmune origin

Immune complex deposition in the walls of blood vessels leads to inflammation

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8
Q

What are the risk factors for Vasculitides?

A

Hepatitis B - polyarteritis nodosa
Hepatitis C - mixed essential cryoglobulinaemia
pANCA - microscopic polyangiitis + Churg-Strauss
cANCA - Wegner’s granulomatosis

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9
Q

What is the epidemiology of Vasculitides?

A

RARE

Takayasu’s arteritis is most common in japanese females

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10
Q

What are the presenting symptoms and signs of Vasculitides?

A

Large vessel Vasculitides have classic clinical patterns based on the vessels affected (e.g. GCA and loss of vision/headache)
Medium and small vessel Vasculitides are characterised by multiorgan involvement and have less specific clincial features

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11
Q

What are the general possible features of ALL Vasculitides?

A

Fever
Malaise
Night sweats
Weight loss

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12
Q

What are the possible features of ALL Vasculitides on the skin?

A

Rash

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13
Q

What are the possible features of ALL Vasculitides on the joints?

A

Arthralgia

Arthritis

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14
Q

What are the possible features of ALL Vasculitides in the GI?

A

Abdominal pain
Haemorrhage
Diarrhoea

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15
Q

What are the possible features of ALL Vasculitides in the kidneys?

A

Glomerulonephritis

Renal failure

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16
Q

What are the possible features of ALL Vasculitides in the lungs?

A
Dyspnoea
Cough
Chest pain
Haemoptysis 
Haemorrhage
17
Q

What are the possible CVS features of ALL Vasculitides?

A

Pericarditis
Coronary arteritis
Myocarditis

18
Q

What are the possible CNS features of ALL Vasculitides?

A

Mononeuritis
Multiplex
Infarctions

19
Q

What are the possible features of ALL Vasculitides in the Eyes?

A

Retinal haemorrhage

Cotton wool spots

20
Q

What are the feature characteristics of Giant Cell Arteritis?

A

Loss of vision
Jaw claudication
Headache
Scalp tenderness

21
Q

What are the feature characteristics of Polyarteritis Nodosa?

A
Microaneurysms 
Thrombosis 
Infarctions 
Hypertension
Testicular pain
22
Q

What are the feature characteristics of Henoch-Schonlein Purpura?

A
Purpura
Arthritis 
Gut symptoms 
Glomerulonephritis 
IgA deposition
23
Q

What are the feature characteristics of Wegner’s Granulomatosis?

A
Granulomatous vasculitis of upper and lower respiratory tract
Nasal discharge 
Ulceration and deformity 
Haemoptysis 
Sinusitis 
Glomerulonephritis 
Saddle nose
24
Q

What investigations do you do for vasculitides?

A
Bloods 
Autoantibodies
Urine 
CXR 
Biopsy 
Angiography
25
Q

What bloods do you do for Vasculitides?

A

FBC

High ESR/CRP

26
Q

What do you see specifically on the FBC for Vasculitides?

A

Normocytic anaemia
High platelets
High neutrophils

27
Q

What do we look for on Urinalysis for Vasculitides?

A

Haematuria
Proteinuria
Red cell casts (if glomerulonephritis)

28
Q

What do you look for on the CXR for Vasculitides?

A

Diffuse
Nodular or flitting shadows
Atelectasis

29
Q

What biopsy do we do fro Vasculitides?

A

Renal
Lung
Temporal artery (in GCA)

30
Q

Why do we do an Angiography for Vasculitides?

A

To identify aneurysms (in PAN)