Vasculitis

Question 1

How can vasculitis be classified?

Answer 1

large, medium, and small vessel

Question 2

Provide an example of large, medium, and small vessel vasculitis

Answer 2

Large Vessel
 Giant Cell Arteritis
 Takayasu’s Arteritis

Medium Vessel
 Polyarteritis Nodosa
 Kawasaki Disease

Small Vessel 
  pANCA  
  cANCA: Wegener’s Granulomatosis 
  ANCA –ve :
Henoch-Schonlein Purpura 
Goodpasture’s Disease 
Cryoglobulinaemia 
Cutaneous Leukocytoclastic Vasculitis

Question 3

HSP is an example of which type of vasculitis?

Answer 3

small vessel, ANCA negative

Question 4

Three differentials for cutaneous/small vessel vasculitis

Answer 4

idiopathic, drugs, infection, secondary- RA, malignancy

Question 5

What is the most common primary cause of cutaneous vasculitis?

Answer 5

IgA vasculitis=HSP

Question 6

What is another name for Henoch-SCHnolein purpura/HSP?

Answer 6

IgA vasculitis

Question 7

How is HSP diagnosed?

Answer 7

purpuric rash, immunological test for IgA deposition in blood vessels. Rule out other causes!!

Question 8

Name one complication of HSP

Answer 8

renal nephropathy

Question 9

Which infection can trigger HSP?

Answer 9

strep sore throat

Question 10

What are the three types of ANCA associated small vessel vasculitis?

Answer 10

1. Microscopic polyangiitis MPA 2. Granulomatosis with polyangiitis GPA 3. Eosinophilic granulomatosis with polyangiitis

Question 11

Which enzymes are pANCA and cANCA associated with?

Answer 11

pANCA- MPO, cANCA- PR3

Question 12

Which disease is commonly associated with MPO antibodies?

Answer 12

MPA

Question 13

What about PR3?

Answer 13

GPA

Question 14

Patient with cANCA with strong PR3 is suggestive of which disease?

Answer 14

GPA

Question 15

Patient with pANCA with strong MPO is suggestive of which disease?

Answer 15

MPA

Question 16

What is another name for good pastures?

Answer 16

anti-GBM

Question 17

Two features of HSP?

Answer 17

  Children 3-8yrs 
  Post-URTI 
  Palpable purpura on buttocks 
  Colicky abdo pain 
  Arthralgia 
  Haematuria

Question 18

What is the best treatment for organ-threatening ANCA associated vasculitis?

Answer 18

prednisolone plus rituximab or cyclophosphamide (example of MCQ where the longest answer is correct!)