Vasculities

Question 1

Takayasu Arteritis

Answer 1

Large Vessel
Granulomatous thickening and narrowing of the aortic arch and prox. great vessels
Inc ESRR
Sx: Pulseless disease (weak UE pulses), fever, night sweats, ocular disturbances, skin nodules, myalgia, and arthritis
Tx: corticosteriods
Affects asian women

Question 2

Polyarteritis Nodosa

Answer 2

Medium Vessel - renal and visceral vessels, NOT pulmonary **
Immune complex mediated
Transmural inflammation of the arterial wall with fibrinoid necrosis
Sx:
Hepatitis B +ve in a lot of the pts
Fever, weight loss, malaise, HA
GI: abdominal pain, melena
Hypertension, neurologic dysfunction, cutaneous eruptions, and renal damage
Findings:
- micro-aneurysms on an arteriogram
* affects young adults

Question 3

Kawasaki Disease

Answer 3

Medium Vessels
Mucocutaneous lymph node syndrome
“CRASH and BURN”
Conjunctival injection, Rash (polymorphous–> desquamating), adenopathy (cervical), strawberry tongue (oral mucositis), Hand and Foot changes (edema and eythema), Fever (burn)
- develop coronary artery aneurysms- can rupture and cause death
Tx: IV AND ASPIRIIN!!!! (only time itss okay to give a kid aspirin)
- Asian children

Question 4

Buerger Disease (Thromboangiitis obliterans)

Answer 4

Medium vessel
caused by smoking
Segmental Thrombosing vasculitis- causes intermittent claudication may lead to:
- gangrene
-Autoamputation of digits
- superficial nodular phlebitis
- Raynauds presents 
*Affects males

Question 5

Granulomatosis with polyangitis (wegner)

Answer 5

Small Vessel
Triad:
- Focal necrotizing vasculitis
- Necrotizing Granulomas in the lungs and airways
–> Upper respiratory Tract: hemoptysis, cough, dyspnea
–> Lower respiratory tract: Perforation of the nasal septum, chronic sinusitis, otitis media, mastoiditis
- Necrotizing Glomerulonephritis: hematuria and RBC casts

** PR3-ANCA (cANCA)
**CXR: large nodular densities
Tx: cyclophosphamide, and CS

Question 6

Microscopic Polyangitis

Answer 6

Small Vessel

• Necrotizing vasculitis involving the lung, kidney, skin
• Glomerulonephritiss
• Palpable purpura
• NO GRANULOMAS
• NO NASOPHARYNEAL INVOLVMENTS (
• p-ANCA (MPO-ANCA)
• otherwise same presentaion as granulomatosis with polyangitis

Question 7

Eosinophilic Granulomatosis with Polyangitis

Answer 7

Small Vessel 
Granulomatous necrotizing vasculitiss with eosinophilia 
Presents with 
- Asthma, sinusitis
- Skin nodules or purpura
- Peripheral neuropathy (Foot drop)
- Can involve heart, GI, kidneys (glomerulonephritis) 
MPO-ANCA (p-ANCA), Inc. IgE level

Question 8

Henoch-Schonlein Purpura

Answer 8

Children
Follows a URI–> vasculitiss secondary to IgA immune complex deposition
- associated with IgA nephropathy
Triad:
- Skin: palpable purpure on butt and legs
- arthralgia
- GI: abdominal pain

Question 9

Temporal Arteritis (Giant Cell)

Answer 9

Large Vessel - most commonly effect branches of the carotid
sx: unilateral HA, jaw claudication
Sequelae: Blindness sue to ophthalmic artery occlusion
Dx: Focal granulomatous inflammation, Inc. ESR, temporal arterial biopsy
Tx: corticosteriods
Associated with Polymyalgia Rheumatica, elderly females