Vasculitis Flashcards
What is the treatment for most types of vasculitis?
- corticosteroids +/- other immunosuppressive agents
A young female of asian descent who presented with a flulike illness at first has now returned to clinic complaining of claudication of the upper extremities. What is the diagnosis?
Takayasu Arteritis
How is Takayasu arteritis diagnosed?
- clinical and imaging
* don’t biopsy d/t large vessels*
What is the superficial temporal artery a branch of?
- internal carotid
- external carotid
- occipital artery
- ophthalmic artery
- superficial thyroid artery
- external carotid
What is the treatment for giant cell arteritis?
prolonged course steroids, started immediately
start treatment before confirmation because you can have irreversible vision loss
An old male patient presents with an abrupt onset of visual disturbances and headaches. Labs demonstrated a highly elevated ESR. What is the diagnosis?
Giant Cell arteritis
How is giant cell arteritis diagnosed?
temporal artery biopsy
What is polymyalgia rheumatica?
What vasculitis is it associated with?
- Chronic anti-inflammatory disorder characterized by symmetric aching and morning stiffness in the shoulder and hip girdle
- associated with giant cell arteritis
- in a patient with PMR always ask do they also have GCA?*
How is polymyalgia rheumatica (PMR) managed?
low-dose daily prednisone
A 60 yo patient with a PMHx of Hep B presents with fever, abdominal pain, and unexplained acute kidney injury. The abdominal CT demonstrates aneurysms of the blood vessels in the kidney. What is the diagnosis?
polyarteritis nodosa
What is the feared complication of Kawasaki disease?
coronary artery aneurysms
cardiac testing is indicated early
A child presents with prolonged fever, cracked lips, and a strawberry tongue. What type of vasculitis is this?
Kawasaki Disease
Lower extremity purpuric rash that is palpable is consistent with which of the following:
a. small vessel vasculitis
b. medium vessel vasculitis
c. large vessel vasculitis
a. small vessel vasculitis
A patient presents with chronic sinusitis and hemoptysis. On PE you notice a saddle deformity of the nose. Labs are positive for c-ANCA. The biopsy demonstrates necrotizing vasculitis with granulomas, but without immune complex deposits. What is the diagnosis?
a. granulomatosis with polyangiitis
b. eosinophilic granulomatosis with polyangiitis
c. microscopic polyangiitis
d. IgA Vasculitis
e. Cryoglobulinemic vasculitis
a. granulomatosis with polyangiitis
previously known as Wegener’s
A patient with a PMHx of asthma presents with chronic sinusitis. Labs are positive for p-ANCA. The biopsy demonstrates necrotizing vasculitis with granulomas, but without immune complex deposits. What is the diagnosis?
a. granulomatosis with polyangiitis
b. eosinophilic granulomatosis with polyangiitis
c. microscopic polyangiitis
d. IgA Vasculitis
e. Cryoglobulinemic vasculitis
b. eosinophilic granulomatosis with polyangiitis
* difference between GPA and e-GPA is the antibodies*
A patient presents with glomerulonephritis. On PE you notice palpable purpura. Labs are positive for p-ANCA. The biopsy demonstrates necrotizing vasculitis WITHOUT immune complex deposits or granuloma. What is the diagnosis?
a. granulomatosis with polyangiitis
b. eosinophilic granulomatosis with polyangiitis
c. microscopic polyangiitis
d. IgA Vasculitis
e. Cryoglobulinemic vasculitis
c. microscopic polyangiitis
A child presents with palpable purpura and associated abdominal pain with bloody stool. Labs are negative for ANCA. The biopsy demonstrates IgA immune deposits. What is the most likely diagnosis?
IgA Vasculitis
A patient with a PMHx of Hep C presents with palpaple purpura and joint pain. He notes this symptoms are worse with cold weather. Labs are negative for ANCA. The biopsy demonstrates cryoglobulin immune deposits and circulating serum cryoglobulin. What is the diagnosis?
Cryoglobulinemic vasculitis
A patient of Turkish descent presents with recurrent, painful mucocutaneous ulcers of the mouth and scrotum. He also has associated uveitis and abdominal pain with n/v. What is the diagnosis?
Behcet Syndrome
Behcet syndrome involves what type of vessel?
any type of vessel!
A 5-year-old patient presents with a sore throat, sandpaper rash, and a “strawberry tongue”. What is the most likely diagnosis?
Scarlet Fever!
Clinical manifestations of vasculitis are confirmed with ________.
biopsy
What CXR findings is commonly seen in granulomatosis with polyangiitis?
cavitary lesions
Which small vessel vasculitis is associated with cANCA?
GPA (Wegener’s) EGPA (CSS) MPA Cryoglobulinemia IgAV (HSP)
GPA (Wegener’s)
Which small vessel vasculitis is associated with pANCA and necrotizing granulomas?
GPA (Wegener’s) EGPA (CSS) MPA Cryoglobulinemia IgAV (HSP)
EGPA (CSS)
Which small vessel vasculitis is associated with pANCA, but NOT necrotizing granulomas?
GPA (Wegener’s) EGPA (CSS) MPA Cryoglobulinemia IgAV (HSP)
MPA (microscopic polyangiitis)
Which small vessel vasculitis is associated with no ANCA, but cryoglobulin immune deposits?
GPA (Wegener’s) EGPA (CSS) MPA Cryoglobulinemia IgAV (HSP)
Cryoglobulinemia
Which small vessel vasculitis is associated with no ANCA, but with IgA immune deposits?
GPA (Wegener’s) EGPA (CSS) MPA Cryoglobulinemia IgAV (HSP)
IgAV (HSP)
Aneurysms of what artery are you concerned with in Behcet syndrome?
pulmonary arteries
