Vasculitis Flashcards

1
Q

What is vasculitis?

A

Name of inflammation of blood vessels

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2
Q

How is vasculitis categorized?

A

On whether small, medium or large vessels are affected

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3
Q

Types of vasculitis which affects small vessels?

A
  • Henoch-Schonlein purpura
  • Eosinophilic granulomatosis + polyangitis
  • Microscopic polyangitis
  • Granulomatosis + polyangitis
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4
Q

What is Eosinophilic granulomatosis + polyangitis AKA?

A

Churg-Strauss syndrome

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5
Q

Another name for granulomatosis & polyangitis?

A

Wegner’s granulomatosis

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6
Q

Vasculitis affecting medium vessels?

A
  • Polyarteritis nodosa
  • Eosinophilic granulomatosis + polyangitis
  • Kawasaki disease
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7
Q

Vasculitis affecting large vessels?

A
  • Giant cell arteritis

- Takayosu’s arteritis

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8
Q

Presnetation of vasculitis?

A
  • Purpura
  • Joint & muscle pain
  • Peripheral neuropathy
  • Renal impairment
  • GI disturbance
  • Anterior uveitis & sclertis
  • HT
  • Fatigue, fever, wt loss, anorexia, anaemia
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9
Q

Investigation of vasculitis?

A
  • Inflamm markers (ESR, CRP)

- ANCA

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10
Q

What is the big marker for vasculitis?

A

ANCA

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11
Q

What does ANCA stand for?

A

Anti-neutrophil cytoplasmic ABs

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12
Q

How many types of ANCA are there?

A

2 types
p-ANCA
c-ANCA

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13
Q

What is p-ANCA associated with?

A

Microscopic polyangitis + Churg Strauss syndrome

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14
Q

c-ANCA associated with?

A

Wegner’s granulomatosis

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15
Q

Usual treatment of vasculitis?

A

Steroids

Immunosuppression

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16
Q

What type of steroids do you use for vasculitis?

A

Oral (prednisolone)
IV (Hydrocortisone)
Nasal spray

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17
Q

What is Henoch-Schonken Purpura (HSP)?

A

IgA Vasculitis

18
Q

Who usually gets HSP?

A

Children under 10 years

19
Q

Why does inflammation occur in HSP?

A

Due to IgA deposits in blood vessels of organs affected (skin, kidneys, GI tract)

20
Q

What is HSP triggered by?

A

Upper airway infection or gastroenteritis

21
Q

What is the rash in HSP caused by?

A

Inflammation & leaking of blood from small blood vessels under skin= purpura

22
Q

Presentation of HSP?

A
  • Purpuric rash affecting lower limbs & buttocks on children
  • Joint pain
  • Abdo pain
  • Renal involvement
  • IgA nephritis
23
Q

Management of HSP?

A

Supportive- analgesia, rest, hydration

24
Q

What is eosinophilic Granulomatosis with polyangitis?

A
  • Used to be called Churg-Strauss syndrome

- Small/medium vessel vasculitis

25
Q

Features of eosinophilic granulomatosis with polyangitis?

A
  • Skin & lung problems
  • Severe asthma in late teenager
  • Elevated eosinophil levels on FBC
26
Q

What is Wegner’s granulomatosis?

A
  • Small vessels

- Affects resp tract & kidneys

27
Q

Features of Wegner’s granulomatosis?

A
  • Commonly caused by nose bleeds & crusting nasal secretions
  • Hearing loss & sinusitis
  • Saddle shaped nose
  • Cough/wheeze & haemoptysis
  • CXR showing consolidation may be misdiagnosed as pneumonia
  • Kidneys: can cause rapidly progressive glomerulonephritis
28
Q

What does polyarteritis Nodosa affect?

A

Affects vessels in skin, GI, kidneys and heart

Medium vessels

29
Q

What is polyarteritis nodosa associated with?

A

Hep B

-Can also be idiopathic or with Hep C or HIV

30
Q

Features of polyarteritis nodosa?

A

Stroke
MI
Renal impairment
Livedo reticulans

31
Q

What is livedo reticulans?

A

Mottled, purplish, lace like rash

32
Q

What does Kawasaki disease affect?

A

Medium vessels

33
Q

Who is affected by Kawasaki disease?

A

Young children under 5 ears old

34
Q

Presentation of Kawasaki disease?

A
  • Persistent high fever
  • Bilateral conjunctivitis
  • Erythematosus rash
  • Erythema & desquamation of palms & soles
  • STRAWBERRY TONGUE
35
Q

Complication of Kawasaki disease?

A

Coronary artery aneurysms

36
Q

Management of Kawasaki disease?

A

Aspirin

IV Immunoglobulins

37
Q

What is takoyasus arteritis?

A

Large vessel vasculitis

Mainly affect saorta and branches + pulmonary arteries

38
Q

What is Takoyasus AKA?

A

Pulseless disease (vessels can swell and form aneurysms

39
Q

How does pulseless disease present?

A

Before 40
Non-specific symptoms such as fever, malaise, muscle aches,
Specific: arm claudication, syncope

40
Q

Investigations for Takoyasus arteritis?

A

CT
MRI angiography
Doppler US of carotids can be useful