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Year 3 - Haem > Vasculitides - MedEd > Flashcards

Vasculitides - MedEd Flashcards

1
Q

Name the classifications of vasculitides

A

Small vessel
Medium vessel
Large vessel

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2
Q

Two types of large vessel vasculitis

A

Temporal arteritis

Takayasu’s arteritis

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3
Q

Symptoms of temporal arteritis/GCA

A

Unilateral headache
Jaw claudication (pain on chewing, maxillary artery affected)
Visual disturbances
Scalp tenderness

PMR symptoms
FLAWS

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4
Q

Define GCA

A

Granulomatous inflammation of large arteries affecting the external carotid artery, most commonly the temporal artery

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5
Q

Investigations for GCA

A

High ESR

Temporal artery biopsy - NOT SENSITIVE due to skip lesions

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6
Q

Diagnostic criteria + Management of GCA

A

Age of onset over 50 years,
new headache
high ESR

Oral pred

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7
Q

MOST APPROPRIATE step for presentation of GCA

A

Oral pred

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8
Q

What is PMR + symptoms

A

Inflammatory rheumatological condition of unknown cause, causing:

Bilateral hip and shoulder pain
Morning stiffness

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9
Q

Investigations for PMR + what is normal

Management of PMR

A

High ESR, CRP
NORMAL CK

Corticosteroids

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10
Q

Takasu’s arteritis + epidemiology

A

Occlusion and inflammation of AORTA and its main branches

Under 40
Asian
Females

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11
Q

Presentation of Takayasu’s arteritis depending on vessel affected

A 
Subclavian artery affected: 
Limb claudication - fatigue on exertion
Absent pulses
Bruits
Unequal BP

Carotid artery affected:
Headache, TIA, STROKE

Right coronary artery affected:
Angina

If abdominal arteries affected, mesenteric ischemia

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12
Q

Investigations for Takayasu’s arteritis

A

High ESR/CRP

CTA/MRA

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13
Q

Two types of medium vessel vasculitides

A

Polyarteritis nodosa

Kawasaki disease

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14
Q

Where does polyarteritis nodosa affect?

A

Arterioles, capillaries, venules in:

Kidneys
Abdomen
Skin
Nerves

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15
Q

Risk factors

A

Hep B infection

Idiopathic

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16
Q

Presentation of polyarteritis nodosa

A

Renal - hypertension, renal failure, haematuria
Abdo - abdo pain, PR bleeding (mesenteric ischemia, vomiting)
Skin - livedo reticularis (mottled appearance)
Nerves - peripheral neuropathy
Arthraliga
FLAWS

17
Q

Investigations for polyarteritis nodosa and key signs

A

CTangiography
MRangiography
ROSARY sign/beaded appearance due to micro aneurysms of the blood vessels

18
Q

Classification of small vessel vasculitis

A

ANCA positive and ANCA negative

19
Q

Types of ANCA positive vasculitides

A

Churg-Strauss
Wegener
MPA

20
Q

Types of ANCA negative vasculitides

A

HPA

Goodpastures

21
Q

Another name for Wegener’s disease

A

Granulomatosis polyangiitis

22
Q

Define granulomatosis with polyangiitis

A

An autoimmune necrotising granulomatous vasculitis characterised by a triad of organ involvement, including URT, LRT and kidneys.

23
Q

Presentation of granulomatosis with polyangiitis

A

URT - rhinitis, epistaxis
LRT - SOB, haemoptysis
Kidney - haematuria. dysuria

24
Q

Distinct features of GPA on genetic screening/investigations

A

cANCA
Saddle shaped nose
RBC casts
Cavitating lesions on CXR

25
Q

Another name for Churg-Strauss syndrome

A

Eosinophilic granulomatosis with polyangiitis

26
Q

Define eosinophilic granulomatosis with polyangiitis

A

A systemic autoimmune vasculitis causing blood vessel inflammation, characterised by asthma and eosinophilia

27
Q

Presentation of eosinophilic granulomatosis with polyangiitis

A

Triphasic presentation:

Allergic phase - asthma and rhinitis

Eosinophilic phase - tissue damage in lungs and GIT

Vasculitic phase - widespread organ damage

28
Q

Investigations for eosinophilic granulomatosis with polyangiitis

A

high pANCA

Eosinophilia

29
Q

Microscopic polyangiitis (MPA) presentation

A

Similar to granulomatosis with polyangiitis but no URT involvement, therefore:

LRT - Haemoptysis, SOB
Kidneys - Haematuria, proteinuria

Also:
FLAWS
Mononeuritis multiplex

30
Q

Investigations for microscopic polyangiitis

A

pANCA
U&Es
Raised CRP
Urinalysis - Haematuria and proteinuria

CXR - cavitating lesions

Renal biopsy - glomerulonephritis

31
Q

What is the name of the condition that affects all three vessel sizes?

A

Behcet’s syndrome - a multisystem disorder causing vasculitis of small, medium and large sized vessels

32
Q

Presentation of Behcet’s disease

A

Can’t see - anterior uveitis
Can’t pee - genital ulcers
Can’t eat spicy - oral ulcers
Can’t climb a tree - Thrombophlebitis, DVT, arthritis, erythema nodosum

33
Q

Rosary sign, hep B infection

A

Polyarteritis nodosa

34
Q

Uveitis, oral and genital ulcers

A

Behcet’s syndrome

35
Q

pANCA, eosinophilia and asthma

A

Churg-Strauss/eosinophilic granulomatosis with polyangiitis

36
Q

Commonly affecting asian females

A

Takayasu’s arteritis

37
Q

pANCA and glomerulonephritis

A

Microscopic polyangitis

38
Q

cANCA, URT, LRT, glomerulonephritis

A

Wegener’s/granulomatosis with polyangiitis

Year 3 - Haem (10 decks)

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