Vasculitis

Question 1

Mention causes if immune complex mediated vasculitis

Answer 1

SLE
Drug hyoersensitvity
Vasculitis secondary to infection w/ ag-ab complex

Question 2

Mention ANCA P-assocites types of vasculitis

Answer 2

Wegener grnulomatosis
Churg-Strauss syndrome
Microscopic polyangitis

Question 3

Mention causes of infectious vasculitis

Answer 3

Direct infection
Hematogenius spread
Embolization of IE

Question 4

GR, It is critical to distinguish between infectious and immunogenic vasculitis

Answer 4

Because immunesuppressive therapy is appropriate in immunogenic vasculitis but could execerbate infectious vasculitis

Question 5

Mention effect of vasculitis

Answer 5

Ischemic changes and infarction whether acute or chronic can lead wall thickening, luminal marrowing and thrombosis
Rupture & 2ry hemorrhage
Mycotic aneurysms

Question 6

Mention the tyoes of large vessel vasculitis

Answer 6

Giant cell arteritis

Takayasu arteritis

Question 7

Describe microscopic picture & symptoms of giant cell arteritis
Mention affected arteries

Answer 7

Granulomatous infection with chronic inflammatory cells, fibrosis within the inner media & fragmentation of internal elastic lamina. T-cell mediated immune response to arterial wall antigen.
Facial pain or headache ( esp along course of superficial temoral with painful palpation) and occular symptoms
Temporal, vertebral, ophthalamic, aorta

Question 8

Describe microscopic picture & symptoms of Takayasu arteritis
Mention affected arteries

Answer 8

Granulomatous inflammation of the media with fibrosis
Reduced UL blood pressure and pulse strength
Aortic arch & its branches

Question 9

Compare age group of giant cell & takayasu arteritis

Answer 9

G, over 50

T, under 50

Question 10

Mention anti-endothelial antibody disease (2 names)

Answer 10

Kawasaki disease (mucocutaneous lymph node syndrome)

Question 11

Mention types of medium-sized vasculitis

Answer 11

Polyarteritis nodosa

Kawasaki diease

Question 12

Decsribe cause, path features & symptoms of PAN

Answer 12

Immune complex reaction against Hb ag
Segmental transmural necrotizing vasculitis. Early fibrinoid necrosis with PNL then chronic inflammation with fibrosis & aneurysm formation.
Fever of unknown cause, HTN, abdominal pain, bloody stool & rupture leading to hemorrhage.
Affect GIT & Renal art sparing pulmonary.

Question 13

Decsribe feature and age if kawasaki

Answer 13

Segmental necrotizing vasculitis. Arteritis with skin and mucous membrane manifestations and cervical LN enlargement. May affect coronary art with aneurysm & thromus formation.
Microscopically as PAN but fibrinoid necrosis is less prominent.
Young children & infants

Question 14

Mention example of immunogenic small vessel vasculitisb

Answer 14

Wegener granulomatosis
Churg-Strauss syndrome
Microscopic polyangitis

Question 15

Mention features of granulomatosis with polyangitis

Answer 15

Necrotizing granulomas, necrotizing granulomatous vasculitis of respiratory tract & necrotizing glomeruloneohritis. C-ANCA assocites

Question 16

Mention features of allergic granulomatosis and angiitis

Answer 16

Eosinophil-rich extravascular necrotizing granuloma, necrotizing vasculitis of RT, blood eosinophilia, asthma, allergic rhinitis.
P-ANCA associated

Question 17

Mention features of microscopic polyangitis

Answer 17

Nectrotizing glomerulonephritis and pulmonary capillaritis are common also necrotizing vasculitis
P-ANCA associated

Question 18

Mention arts commonly affected by Buerger’s disease

Answer 18

Tibial and radial arts

Question 19

Describe microscopic picture & etiology of thromangitis obliterans

Answer 19

1. Acute iand chronic inflammation with thrombosis which can be later organized & recanalized.
2. Microabscesses and granulomatous inflammation
3. The inflammatory process extends to contiguous veins & nerves and finally all structures become encased within fibrous tissue.
   Associated with heavy tobacco smokers

Question 20

Mention clinical features and effects of Buerger’s disease

Answer 20

The early mainfestations are cold sensitivity in hands and instep foot pain with exercise. Pain at rest indicates neural involvement.
Chronic skin ulcers
Gangrene if the limbs

Question 21

Compare primary & secondary Raynaud phenomenon

Answer 21

P, exaggerated central and lical vasomotor response of digital arteries & arterioles
S, due to arterial disease as in SLE, sclerderma, Buerger’s disease or atherosclerosis

Question 22

Define glomangioma

Answer 22

Benign painful tumour arising from glomus body, usually occur under finger nails

Question 23

Mention common sites of angisarcoma

Answer 23

Skin, soft tissue, breast & liver

Question 24

Mention gross & microscopic of Kaposi sarcoma

Answer 24

G, cutaneous lesions appear as multiple red-purple patches, plaques or nodules that may disseminate.
M, spindle shoed endothelial cells with slit like vascular soaces and extravasated RBCs

Question 25

Kaposi sarcoma is associated with ….

Answer 25

HHV-8