vasculitis

Question 1

what are large cell vasculitis?

Answer 1

Takayusa arteritis

giant cell arteritis

Question 2

what are medium cell vasculitis?

Answer 2

polyarteritis nodosa

Kawarsaki disease

Question 3

what are small cell vasculitis

Answer 3

granulomatosis with polyangitis
eosinophilic granulomatosis with polyangitis
henoch Schonlein purpura

Question 4

who is takayusa arteritis most common in?

Answer 4

Japanese females <40

Question 5

what is takayusa arteritis?

Answer 5

vasculitis of the aorta and its main branches

Question 6

how does takayusa present?

Answer 6

hypertension
claudication
weak arm pulses

Question 7

what are you at risk of with takayusa arteritis?

Answer 7

stroke

dissection

Question 8

what are the symptoms of giant cell arteritis?

Answer 8

bruit (carotid)
blood pressure difference of extremities
temporal arteritis - headache, scalp tenderness, jaw claudication, risk of blindness

Question 9

what investigation can be done for giant cell arteritis?

Answer 9

temporal artery biopsy

raised inflammatory markers

Question 10

why by temporal artery biopsy be negative?

Answer 10

skip lesions

Question 11

how does polyarteritis nodosa (PAN) present?

Answer 11

purpura
punched out ulcers
renal failure

Question 12

what is polyarteritis nodosa associated with?

Answer 12

hep b

Question 13

what is Kawasaki disease?

Answer 13

PAN in children

Question 14

how does Kawasaki disease present?

Answer 14

children with strawberry tongue

Question 15

how does granulomatous with polangitis (GPA) present?

Answer 15

sadle nose (due to nasal cartilage collapse)
chronic sinusitis
epitaxis
deafness
joint pain
haematuria and proteinuria due to rapid glomerulonephritis

Question 16

what immunological findings are in GPA?

Answer 16

c-ANCE & PR3 positive

Question 17

what investigation are done for GPA?

Answer 17

urinalysis (+/- renal biopsy)

Question 18

how does EGPA present?

Answer 18

late onset asthma
high eosinophil count
sinusitis
mononeuritis multiplex - foot drop

Question 19

what immunology is seen with EGPA?

Answer 19

p-ANCE & MPO positive

Question 20

what does microscopic polyangitis typically result in?

Answer 20

rapidly progressive glomerulonephritis

Question 21

what is the treatment for early/localised vasculitis?

Answer 21

methotrexate + steroids

Question 22

what is the treatment for generalised/systemic vasculitis?

Answer 22

cyclophosphamide + steroids

plasma exhchange if creatinine >500

Question 23

what it the treatment for refractory vasculitis?

Answer 23

IV immunoglobulins

rituximab

Question 24

what is henoch schonlein purpura?

Answer 24

acute IgA mediated diorder
generalised vasculitis of small vessels of skin, GI tract kidney and joints
not associated with ANCA

Question 25

who is hence schonlein purpura most common in ?

Answer 25

children 2-11

Question 26

what is often associated with HSP?

Answer 26

URTI/pharyneal infection/GI infection
1-3 weeks before
most commonly strep pyogenes

Question 27

what are the symptoms of HSP?

Answer 27

non blanching purpuric rash
buttock and lower limbs
colicky abdo pain
bloody diahorrea
joint pain/swelling
renal involvement

Question 28

what it the treatment for HSP?

Answer 28

self limiting
usually resolves in 8 weeks
can relapse
hospital admittance for supportive therapy