Vasculitis Flashcards
بسم الله توكلنا عليك وأنت خير الناصرين و انت سميع الدعاء مجيبه فلا تحرمنا من فضلك وأنزل علينا رحماتك تترا يارب العالمين
التهابات الشرايين تشترك جميعها في ؟
1-Thickening of the wall
2-Shedding of endothelium forming thrombosis
3-Weakness of wall and Aneurysm formation may rupture forming Hge
قال معاذ الله إنه ربي أحسن مثواي إنه لا يفلح الظالمون
دور الأجسام المضادة في التهاب الشرايين اذكره
1-ممكن تهاجم الخلايا الطلائية علي طول وده في مرض اسمه Kawaski disease
2-ممكن تكون معقدات مناعية من انتيجينات وينشط المكملاتcomplemets وتعمل التهابات
في مرض الذئبة SLE
3-ANCA :Antinuclear cytoplasmic antibody
ودي تضرب في الاوعية الصغيرة وتعمل فيها مشاكل !
______________
Granuloma due to inflammation in wall of large blood vessels
Large to small vessel vasculitis (Khalifs describe)
Aorta , branches, opthalmic , temporal — Migarane Old males
1-Temporal arteritis ! Giant cell arteritis granulomatous inflammation and giant cell
صداع temp وزغللة في العين opthalmic
2-Takayaso arteritis aorta and its branches to upper limb
radial arteritis pulsless disease granulomatous giant cells
Ischemia in upper limb and giant cell
complications
يطخن الجدار
يعمل جلطات
يعمل توسعات في الشريان
Giant cell TEMORAL ARETRITID depends on …… immunity
T cell mediated immuinty
Giant cell ARTERITIS affect which arterires ?
Temporal and opthalamic samll arteries
Why it is called giant cell arteritis ?
Because it is mechnism is by granuloma formation and giant cells are present
Takayso desvribe
In large to small arteries aortic arch and its branches to the upper limb middle age > granuloma
Mention Medium vessel arteritis .
1-Polyarteritis nodosa
2-Kawaski
strawberry tongue
appear in ?
Kawasaki arteritis
Polyateritis nodosa mostly appear in and rescpect ?
Mostly in kidney cauisng renal arteristsis nodosa and renal failure \
Respect The pulmonary arteries
The basis of Polayarteriris nodosa is ?
The formation of Immune complexes due to Hepatitis B virus
The most common pathogen casuing the Polyarteritis nodosa?
Hepatitis B virus
Describe the gross morph of the PAN .
multiple nodules - multiple aneurisms
describe Microscopic appearance of the PAN .
Necrotizing inflammation+ Neutrophils and Fibrosis !
Clinical picture of the PAN ?
Fever +HTN+ abdominal pain
Poly Arteritis Nodosa PAN
Description !
Multiple arteries mostly renal (not affecting pulmonary
vessels)
Immune complex reaction , may be associated with HBV
infection
gross: multiple nodules - multiple aneurisms
micro: necrotizing inflammation + excess neutrophils →
chronic & fibrosis
Clinical: (Fever + hypertension + abdominal pain)
Arteritis causing MucoCutanuous and LN syndrome involvement
Kawasaki
Kawaski decribe
ركز في اسئلة هوار ولو سألك قله ربنا يعين الجميع ولو قالك يعني ايه قوله معلش مش عايز اقولك لحد بيني وبينه !
Medium arteitis
Multiple vessels children
Necrotizing inflammation with Mucocuatnous and LN syndrome
cassuing Strawberry tongue
ALL OF small arteritis is characterized by ?>
ANCA
cANCA appear in ?
Wegner granulomatosis .
Wegner granulomatosis is chararterizd by
?
العجب فقد جمع بين التهابات الشرايين الكبيرة في تكوين الجرانيولوما والتهابات الشرايين المتوسطة في انها
necrotizing
كمان تجرأ علي مالم تتجرأ عليه الالتهابات المتوسطة وهي الرئة والجهاز التنفسي بالإضافة إلي الكلية
Wegner granulomatosis وصف
respiratory tract & Kidney
– cANCA -
granuloma & necrotizing vasculitis
pANCA appar in
Charug -straus
Charug-Straus disease is characterized by :-
Asthma +Eosinophils
Chrug straus describe .
Affect respiratory aretries forming granuloma and is necrotizing and there is Asthma and eosinopilhs +pANCA
ايه الفرق بين
Microscopic polyanigitis
وغيرها ؟
انه بعض الحالات مفيش فيها ترسيبات مناعية من ANCA
Microscopic polyangitis briefly
It is Respiratory and renal disease and is not granulomatous and necrotizing with ANCA and There may be no immune deposits in some cases
disease appear in male somkers due to genetic immune and tobacco effect on the endothelium
in small and medium vvessels of limbs
it is burger disease
thromboangitis obliterans
segemtnal inflammation and necrosis
thrombosis gangrerne
Complications of Burger’s disease
Caludications تشنجات في عضلات الساق لنقص التروية
trophic ulcer
gangrene
Complications of Renayd disease mention
Cyanosis of
finger
nose
ear
Renayd disease appear mostly in ?
Females due to cold and stress and emotions
Mostly in small arteries
Causes of Renayd disease ?
1ry due to Vasospasm due to cold and emotions
2ry to DISEASE SLE Burger’s disease
Mechanism of burger’s diease ?
It is due to granulomatus inflammation in the veins and arteris and nervers causing thrombosis Microabscesses Fibrosis and aneurysm .
SVC syndrome mean ?
This occure due to obstruction of the SVC due to ?
Lung carcinoma or Mediastinal lymphoma
this lead to congestion and cyanosis of head and upper limbs
IVC Syndrome mean
this obstruction of the IVC due to TUMORS OR enlarged LN
and this leads to LL and Renal congestion + proteinuria and
dilated abdominal veins
Lymphangitis mean ?
It is inflammed lymph vessesl due to infection filaria or radiation appearing as Red streaks and causing obstruction leading to lymphedema
suppurative or tb
Chylus effusion defintion .
it is effusiion of milky lymph from the lymphatic vessels due to its obsetcuton or rupture into the serous sacs
Congenital Vascular disease :
AV SHUNT
Berry aneurysm
Fibromusclar dysplasia
وهو استبدال الجزء العضلي في جدار الشريان بنسيج ليفي
thick wall of large and medium sized arteries
Monckberge disease >
it is senile idiopathic disease
hyalinosis and thickening and dystrophic calcification and ossification of ( M)edia of
(M)usclar (M)deium sized artery like feomral discoverd by (M)onckeberge
مزودتش نسيج جديد بس عملية استبدال
Monckeberge is asymptomatic due to ?
No Narrowing of the Wall of the blood vessel
الحــمــدلله الذي أنزل علي عبده الكتاب لم يجعل له عوجا !
تبارك الذي نزل الفرقان علي عبده ليكون للعالمين نذيرا !
pathogensis of vasculitis
• Immunological
o Immune complex type III hypersenset.(e.g. SLE, PAN,
drug)
o Anti-neutrophil cytoplasmic Ab ANCAs (e.g. Wegener)
o Anti endothelial Ab (e.g. Kawasaki)
• Infections
o Direct by organism
o Indirect → immune mediated reaction
• Other causes (e.g. radiation, Trauma, Chemicals)
Complications: of vasculitis
Ischemia –
Thrombosis -
Ruptured vessels →
hemorrhage
