Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Senoir 21-2 > VASCULITIS > Flashcards

VASCULITIS Flashcards

1
Q

What is the vasculitis most common to Turkey

A

Behcets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the vasculitits most common to japan

A

Kawasakis syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What vasculitis is most common with Hep C

A

Cryoglobulinemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What vasculitis is most common with Hep B

A

Polyarteritis Nodosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What separates Giant Cell and Takayasu

A

If older than 50 = giant cell

If younger than 50= takayasu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

50 % of Giant cell pts present with what other vasculitis

A

Polymyalgia Rheumatica : Aching and stiffness of the shoulders, neck and hip-girdle area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When should Bx be done for Giant Cell arteritis

A

Needs to be done within 2 weeks of steroids before biopsy results will be altered

Consider second biopsy if clinical suspicion is high after initial negative biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If a pt with Giant cell arteritis develops transient vision loss

What should be done

A

Patients with suspected GCA who have experienced transient visual loss for a few hours should be admitted and given high-dose intravenous methylprednisolone (eg, 1000 mg/day) for 3–5 days.

Then transitioned to oral prednisone 40-60mg daily.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If a pt has giant cell without vision loss

What is the Tx?

A

Prednisone 1mg/kg max;60mg/ day

X 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When can steroid taper start in pts with giant cell

A

After the first month of treatment, almost all patients will have a normal ESR

  • At this point, the prednisone can begin to be tapered by 10% every week or two
  • When patients reach 10 mg, decrements of 1 mg every 2 or so weeks may reduce the chance of flare

Consideration of addition of low dose aspirin 81mg may reduce chance of associated visual loss or stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How old is the Dx for Polymyalgia Rheumatica

A

50 and older

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A 50 year old pt report morning MUSCLE stiffness and aching that last longer than 30 minutes (not in the joint)

Think

A

Polymyalgia Rheumatica

Stiffness involves at least two of the following three areas:

  • Neck or torso
  • Shoulders or proximal regions of the arms
  • Hips or proximal aspects of the thighs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment appraoch to polymaylagia Rheumatica

A

PMR alone is usually treated with 10–20 mg/day of prednisone.
-If the patient does not improve within the first week, doubt should be cast on the diagnosis of PMR.

Prolonged corticosteroid taper. Most patients require treatment for 1-2 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the important late complications of giant cell arteritis

A

Thoracic aortic aneurysms and aortic dissection are important late complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define Takayasu’s Arteritis

A

Granulomatous Vasculitis of the Aorta and its major branches

Preferentially affects young women

Distinguishing characteristics related to aorta/branch involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A 20 year old woman presents with absent pulse or bruit, Claudication, or HTN +/- fever of unknown origin

Think what vasculitis

A

Takayasu’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A 20 year old woman that complains of Claudication while drying her hair
.. think

A

Takayasus

Look for abNML pulses or unequal BP
Bruits, or HTN

Murmurs: AR
Or Angina from stenosis of the ostia of the coronary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the tx approach to Takayasu’s

A

High dose prednisone 1mg/kg/day x 1 month -> Taper to 10mg/day over 4-6 months
-Very effective but relapse is common

Addition of Methotrexate or Mycophenolate Mofetil to prednisone may provide added benefit

May require Surgical intervention for heart conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the vasculitis associated with HLA B51

A

Behcets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What types of vessels does Behcets affect?

A

Inflammatory vasculitis that affects large, medium, and small blood vessels.

Affects both arteries and veins

Arterial inflammation leads to occlusion, aneurysm, or rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the hallmark sign of Behcets

A

painful aphthous ulcers in the mouth and genitalia

  • Tongue, gums, oral cavity
  • Genital lesions –similar, but don’t occur in all pts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the major difference in the lesions of Behcets and sarcoidosis or IBD ?

A

Erythema nodosum–like lesions that tend to ulcerate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the 4 major S/s of Behcets

A

Painful apthous ulcers

Erythema Nodusom like lesions that then ulcerate

Anterior or posterior Uvetitis

And neurologic lesions than mimic MS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Define Polyartetits Nodosa

A

Necrotizing inflammatory vasculitis of medium arteries and muscular arterioles

Spares venous circulation and capillaries (confined to arterial circulation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is required for Dx of Polyartertis Nodosa
Angiogram or biopsy of involved organ required for diagnosis - Lung is usually spared - Granulomatous inflammation absent
26
What is the onset of PAN following HEP B infection
Within 6 months
27
A pt presents with severe abdominal pain + peripheral neuropathy and mononerutitis multiplex (wrist/foot drop), Palpable purpura, lívido reticularis, and skin ulcers Think of what condition that is assoc with HEP B infection
PAN
28
What separates polyangitis nodosa from microscopic polyangitis
PAN does not involve the lungs/ Pulm
29
What are the key Lab tests for PAN
HBV testing at time of initial diagnosis True PAN is ANCA-negative And Bx: Characteristic transmural necrosis and a homogeneous, eosinophilic appearance of the blood vessel wall (fibrinoid necrosis)
30
What is the Tx approach to PAN
Prolonged high dosed corticosteroids Cyclophosphamide (Cytoxan) -For patients whose disease is refractory to glucocorticoids or -who have serious involvement of major organs (GI; mononeuritis multiplex)
31
What are the 4 keys to Dx buergers
recognition of clinical findings-digital ischemia without other organ involvement identification of typical pattern in angiography exclusion of diseases that may mimic Buerger confirmation that ongoing tobacco exposure is present
32
What is the age of onset for Kawasakis
Most commonly in kids 3 months to 5 years old | -Typically Asians or native Pacific Islanders
33
A 4 year old pt presents with a fever for 5 days!, with bilateral non exudative conjunctivitis, strawberry tongue/ cracked lips, with erythema to the hands and feet, + a polymorphous rash Think
Kawasaki’s
34
What is the treatment for a child with kawasakis
IVIG within the first 10 days of illness! -Dramatically reduce risk of cardiac morbidity (coronary aneurysms) +Aspirin (low-dose as effective as high-dose) If unresponsive to IVIG, can use cyclosporine Glucocorticoids reserved for salvage therapy in which IVIG and ASA failed
35
What is the classic finding for small vessel vasculitis
Palpable purpura
36
What is the most common vasculitis in children
HENOCH-SCHONLEIN PURPURA
37
What are the hallmarks of HENOCH-SCHONLEIN PURPURA
Pathologic hallmarks of HSP are a leukocytoclastic (neutrophil debris) vasculitis and deposition of IgA in the walls of involved blood vessels. Onset typically ~10 days after a URI
38
What is the tetrad of henoch schonlein purpura
The tetrad of purpura, arthritis, glomerulonephritis, and abdominal pain is often observed. However, this is not required for Dx
39
A child (less than 20 yo) presents with palpable purpura, bowel angina, and vessel wall granuloctyes on BX Think
Henoch Scholein
40
HENOCH-SCHONLEIN PURPURA Tx
NSAIDs -can aggravate GI symptoms and should be avoided with renal disease Dapsone -Antibiotic & anti-inflammatory Glucocorticoids Hospitalization -Severe cases (Renal Failure)
41
What are cryoglobulins
Immunoglobulins (antibodies IgG, IgM) that precipitate out of blood at low temperatures (< 37oC)
42
What is the most common involved organ for Cryoglobulinemia
The skin Other frequently affected organs include the joints, peripheral nerves, and kidneys.
43
What is the most common serum marker found in Cryoglobulinemia
RF postive
44
What is the pt demographic that has the worst prognosis with Cryoglobulinemia
Lower survival rates are observed with age over 60 years, male sex, and renal involvement.
45
What are the diseases that are assoc with Cryoglobulinemia
Associated with malignancy (multiple myeloma), Hepatitis C, Sjogren and systemic lupus erythematosus
46
What are the labs for Cryoglobulinemia
RF present in Types II & III ESR/CRP elevated Complement is decreased (just like in Sjogren)
47
What is the tx for Cryoglobulinemia
Usually focused on the underlying cause (usually hepatitis C) - Ledipasvir/sofosbuvir (Harvoni) - Ribavarin (Copegus) Antiviral strategies are commonly combined with B cell depletion approaches -Rituximab (Rituxan) Some cases can evolve to malignant B cell lymphoma
48
A pt that presents iwth necrotizing vasculitis + upper/ lower resp and renal manifestations Think
GRANULOMATOSIS WITH POLYANGIITIS
49
What is the hallmark of GRANULOMATOSIS WITH POLYANGIITIS
Hallmarks: Granulomatous inflammation, vasculitis, and necrosis Age onset; 50
50
What are the key findings in Granuloatousus with polyangitis
ANCA positive + saddle nose (sinus: rhino, epistaxis) Normochromic normocytic anemia Must get cANCA and BX ( Lung>kidneys>URI) (CT>CXR)
51
What is the most common CXR finding in GPA
Pulm infiltrates and nodules
52
What is the treatment for GPA (severe and Limited)
Severe: life threatening: Rituxiab and steroids Or Cyclophosphamide and steroids Limited: Methotrexate and steroids All should receive Pneumocystis jiroveci pneumonia prophylaxis -Sulfamethoxazole-trimethoprim, Dapsone
53
What are the hallmarks of eosinophila granulomatous polyangitis
Asthma, eosinophilia, and systemic vasculitis are the hallmarks of eosinophilic granulomatosis with polyangitis
54
What are the classic necrotizing features of EGPA
``` Allergic rhinitis and nasal polyposis Reactive airway disease Peripheral eosinophilia Fleeting pulmonary infiltrates and occasional alveolar hemorrhage Vasculitic neuropathy Congestive heart failure ```
55
What is the serum marker for EGPA
Approximately 50% of patients with EGPA have antineutrophil cytoplasmic antibodies (ANCAs), usually with a specificity for myeloperoxidase (MPO). MPO-ANCAs usually produce a perinuclear-ANCA (P-ANCA) pattern on serum immunofluorescence testing
56
What are the three phases of EGPA
Prodromal phase: characterized by allergic disease, (allergic rhinitis, or asthma) Eosinophilic phase: peripheral blood eosinophilia and eosinophilic infiltration of multiple organs, heart, lung, GI tract and others. Vasculitic phase: a life-threatening systemic necrotizing vasculitis of small & medium vessels – wide range of organs including heart, lungs, peripheral nerves and skin
57
What is the key differnce in GPA vs EGPA
ASTHA in EGPA
58
What is the most common cardiac manifestation of EGPA
CHF
59
What is the treatment for EGPA
Steroids to induce remission Azathioprine, methotrexate, or mycophenolate can be added to corticosteroids for moderate cases
60
What is the most common cause of pulmonary renal syndomre of alveolar hemorrhage and Glomerulonephritis
Microscopic polyangitis
61
What are the main differences in microscopic polyangitis and polyarteritis nodosa
Main differences: ANCA positivity, vein AND artery involvement, glomerulonephritis & lung involvement
62
If a pt is on PTU for hyperthyroidism What is the vasculitis d/o that is an increased risk
Microscopic polyangitis
63
What is the treatment of choice in microscopic polyangitis
Traditionally combo therapy with glucocorticoids and cytotoxic agents (cyclophosphamide) Rituximab now preferred over cyclophosphamide due to superior long-term side effect profile. If rituximab cannot be given or if the patient does not respond to regimen, cyclophosphamide is treatment of choice.

Senoir 21-2 (77 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions