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msk > vasculitis > Flashcards

vasculitis Flashcards

1
Q

what can vasculitis lead to

A

inflammation
ischemia
necrosis

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2
Q

what causes primary vasculitis

A

an inflammatory response that targets the vessel walls and has no known cause

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3
Q

what causes secondary vasculitis

A

may be triggered by an infection, a drug, or a toxin or may occur as part of another inflammatory disorder or cancer

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4
Q

clinical features of vasculitis

A

depends on which vessel is affected

  • fever
  • malaise
  • weight loss
  • fatigue
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5
Q

what are the categories of vasculitis

A
  • medium vessel vasculitis
  • immune complex small-vessel vasculitis
  • ANCA-associated small-vessel vasculitis
  • large vessel vasculitis
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6
Q

what are the two main causes of large cell vasculitis

A
  • takayasu arteritis

- Giant cell arteritis

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7
Q

pathophysiology of vasculitis

A

granulomatous infiltration of the walls of the large vessels

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8
Q

features of Takayasus arteritis

A
  • under 40
  • females
  • claudication
  • asian populations
  • bruit
  • carotid artery
  • bp difference of extremities
  • angiogram
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9
Q

features of giant cell arteritis

A
  • over 50
  • temporal arteritis
  • headache
  • scalp tenderness
  • visual disturbances
  • jaw claudication
  • associated with polymyalgia rheumatica
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10
Q

investigations for giant cell arteritis

A
  • ESR or plasma viscosity
  • CRP raised
  • temporal artery biopsy
  • USS
  • PET CT or CT angiogram
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11
Q

management for large vessel vasculitis

A
  • start on 40-60mg prednisolone
  • steroid sparing agent may be considered
  • Tocilizumab
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12
Q

what is the pathophysiology of granulomatosis with polyangitis

A

Granulomatous inflammation of respiratory tract, small and medium vessels. Necrotising glomerulonephritis common.

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13
Q

what is the pathophysiology of eosinophilic granulomatosis with polyangitis

A

Eosinophilic granulomatous inflammation of respiratory tract, small and medium vessels. Associated with asthma

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14
Q

what is the pathophysiology of microscopic polyangitis

A

Necrotising vasculitis with few immune deposits. Necrotising glomerulonephritis very common

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15
Q

what are the ENT features of GPA

A
  • sinusitis
  • nasal crusting
  • epistaxis
  • mouth ulcers
  • sensorineural deafness
  • otitis media and deafness
  • saddle nose
  • sub glottic inflammation
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16
Q

ocular features of GPA

A
  • conjunctivitis
  • episcleritis
  • uveitis
  • optic nerve vasculitis
  • retinal artery occlusion
  • proptosis
17
Q

resp features of GPA

A
  • cough
  • hemoptysis
  • pulmonary infiltrates
  • diffuse alveolar haemorrhage
  • cavitating nodules on CXR
18
Q

cutaneous features of GPA

A

palpable purpura

cutaneous ulcers

19
Q

renal features of GPA

A

necrotising glomerulonephritis

20
Q

nervous system features of GPA

A
  • mononeuritis multiplex
  • sensorimotor polyneuropathy
  • cranial nerve palsies
21
Q

what the main differences between EGPA and GPA

A

EPGA has late onset asthma, a high eosinophil count and ANCA

22
Q

what is Henoch-Schonlein Purpura

A

it is an acute immunoglobin A mediated disorder

-generalized vasculitis involving small vessels of the skin, GI tract, kidneys, joints and rarely lungs and CNS

23
Q

when do most cases of HSP occur

A

2-11 yrs

most also have a preceding URTI, pharyngeal infection or GI infection

24
Q

presentation of HSP

A
  • purpuric rash - buttocks and limbs
  • colicky abdo pain
  • bloody diarrhoea
  • joint pain +/- swelling
  • renal involvement
25
Q

investigations for vasculitis

A
  • urine dipstick
  • FBC, inflammatory markers
  • ANCA and specific antibodies
  • connective tissue disease screen
  • compliment levels
  • imaging
  • nerve conduction tests
  • tissue biopsy
26
Q

is cANCA associated with GPA or EPGA

A

GPA

27
Q

is pANCA associated with GPA or EPGA or MPA

A

EPGA and MPA

28
Q

what is it essential to do in HSP

A

perform urinalysis to screen for renal involvement

msk (45 decks)

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