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Organ Pathology Exam 2 > Vasculitis > Flashcards

Vasculitis Flashcards

1
Q

Etiology of vasculitis

A

Mostly unknown
Can be associated to infectious organisms, drugs, tumors and allergic reactions.

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2
Q

Common denominator in vasculitis

A

Formation of immune complexes

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3
Q

Symptoms of vasculitis

A

A variety since its a systemic disorder

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4
Q

Treatment of vasculitis can have a different approach depending of

A

According to wether the trigger is immune or infectious

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5
Q

Clinical manifestations that are common in most vasculitis

A

Constitutional symptoms: fatigue, weight loss, fever and weakness

Anemia of chronic disease

Can affect a lot of organs

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6
Q

Chronic inflammatory disorder will show

A

Elevated ESR or CRP

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7
Q

The type of anemia associated to vasculitis

A

Anemia of chronic disease

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8
Q

Giant cells arteritis
Size of artery affected:
Typical symptoms:
Eye correlate:

A

Targets all size arteries, but specifically in the head
-Claudication of jaw & tongue
-Tenderness of skull in area and can palpate temporal arteries (reduced pulsation)
-Optic arteritis can cause permanent blindness

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9
Q

Giant cell lab findings and treatment

A

Elevated ESR, anemia/ thrombocytosis

Treat with corticosteroids bc its an inflammatory response

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10
Q

Takayasu arteritis
Common location affected:
Typically symptoms:

A

-Chronic inflammatory disorder
-granulomatous vasculitis of the aorta & narrowing branches from the aorta

  • weakening of pulses in upper extremities (pulseless)
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11
Q

Clinical presentation of takayasu arteritis

A

Early phase shows non specific symptoms: night sweats, fever, weight loss , Myalgia + arthralgia (muscle and joint pain)

Later occlusive phase: once it keeps narrowing the arteries occlusion will occur -> Claudication pain in upper extremities.
Can cause TIA
Decreased flow to upper extremities, aortic regurgitation

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12
Q

How does Claudication of upper extremities occur in takayasu?

A

Narrowing of the aorta decreases blood flow to the upper extremities which causes the claudicating pain. The flow of the circulation is unable to keep up with the demand.

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13
Q

Takayasu diagnosis and treatment

A

Chest X-ray will show widened aortic shadow, irregularity of descending aorta, or cardiac enlargement

Arteriography is most helpful

Treat with corticosteroid but might need to add cytotoxic drugs in patients failing steroid treatment
Surgery/ angioplasty might be needed in advanced cases

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14
Q

Polyarteritis Nodosa (PAN)
Associated to:
Severity:
Treatment:

A

-Associated with Hepatitis B
-Necrotizing vasculitis in different organs, killing walls of the artery
-fatal if untreated, curative with steroids and cyclophosphamide

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15
Q

PAN characteristic symptoms:

A

Symptoms everywhere but kidneys are the most commonly affected (glomerulonephritis)
-coronary arteritis with angina/MI
-skin: purpura, gangrene
Myalgia+ arthraigas
Or hit is & epididymitis

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16
Q

If you have kidney damages in PAN, lab will show

A

Hematuria and proteinuria

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17
Q

Treatment of PAN

A

Corticosteroids + cyclophosphamide in severe cases

Hepatitis B related: antiviral, plasma exchange + corticosteroids

18
Q

Kawasaki disease is AKA
Common in:
Consequence of”
Most severe complication:

A

“Mucocatenous lymph node syndrome”

Young children

Consequence of abnormal response to an infection, is usually self limited

Complication: involvement of coronary arteries can cause inflammation of heart

19
Q

Kawasaki common symptoms

A

Painful cervical lymphadenopathy: enlargement of lymphatic syndrome is shown after infection and fever of 1-2 weeks

Bilateral conjunctival congestion

Strawberry tongue: dry + red, fissured lips

Athritis/ hand edema

20
Q

Redness of palms and soles is seen in what disease?

A

Kawasaki disease

Rash that doesn’t respect palms and soles like other infections in children

Exanthema is seen in trunk, palms/soles as well as hand edema

21
Q

How can Kawasaki can have effect on the heart

A

Carditis, heart murmurs, CAD

22
Q

Kawasaki treatment includes

A

Supportive treatment since it is self limited

High does IV gamma globulin

23
Q

What disease shows elevated c-ANCA

A

Wegener Granulomatosis

24
Q

Wegener granulomatosis triad

A

Respiratory tract necrotizing granulomas
Renal disease (focal necrotizing GN)
Systemic vasculitis

25
Q

c-ANCA positive and T cell mediated hypersensitivity response

A

Wegener granulomatosis

26
Q

What diseases have necrotizing granulomas

A

PAN and wegener

27
Q

Saddle nose deformity

A

Cartilage destruction affecting the nose is seen in wegener

28
Q

Ocular manifestations of Wegner

A

Can affected any part of the eye
Conjunctivitis m Episcleritis, uveitis, retinal vasculitis

Anterior segment might be resistant to the anti inflammatory therapy

Decompressive surgery might be needed when ON is compromised

29
Q

Lab data seen in wegener

A

C anca
3 antibodies (PR3)
Biopsy

30
Q

Treatment of wegner

A

Cyclophosphamide + prednisone + methotrexate + azathioprine

31
Q

Churn Strauss syndrome is similar to wegener but it has

A

Milder renal disease
And is associated with allergies

32
Q

Vasculitis that is associated with allergies

A

Churg Strauss syndrome

33
Q

Unique characteristic of this disease is Peripheral neuropathy

A

Charge Strauss syndrome
Shown in 70% of patients

34
Q

p-ANCA positive

A

Charg Strauss

35
Q

Diagnosis and treatment of charg Strauss

A

P-anca
Elevated ESR
Anemia, eosinophilia

36
Q

Treatment of churg Strauss

A

Prednisone if mild

If severe a more potent immune suppressant

37
Q

What is the difference between p-ANCA and c-ANCA

A

Different kinds of antibody deposition
P anca show a perinuclear stain
C anca show a diffusely granular, cytoplasmic stain

38
Q

Most common hypersensitivity vasculitis in childhood and young adults

A

Henoch- Schonlein purpura

39
Q

Vasculitis more commonly found in kids

A

Kawasaki and Henoch

40
Q

Vasculitis that is preceded by an upper respiratory tract infection

A

Henoch-schonlein purpura
(Usually self limiting)

41
Q

Henoch triad

A

Palpable purpura: Lower extremities + buttocks NOT DUE TO THROMBOCYTOPENIA
Abdominal pain (colicky/ GI bleeding)
Athritis + fever (knees and ankles)

Organ Pathology Exam 2 (8 decks)

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