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Basic Pathology > Vasculitis > Flashcards

Vasculitis Flashcards

1
Q

Inflammation of the blood vessels

A

vasculitis

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2
Q

What is primary vasculitis caused by? What percent of cases are primary vasculitis?

A

Unknown cause
80% of cases

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3
Q

What can cause secondary vasculitis? What percent of cases are secondary vasculitis?

A

Autoimmune diseases, infections
20% of cases

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4
Q

Is Behcet’s disease primary or secondary arteritis? What percent of cases does Behcet’s make up?

A

Secondary arteritis
Less than 1 percent of cases.

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5
Q

You are talking to your staff doctor and they tell you that the patient may have Behcet’s disease. When you walk into the room to see the patient, what SYSTEMIC signs/symptoms would you expect to see from the patient?

A

You would expect to hear that the patient has:

Canker sores (most common)
Pain/swelling/stiffness in their joints
Genital sores/ulcerations
Acne-like skin sores
Headaches
Possible stroke
GI ulcerations

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6
Q

You have a 30-year-old Middle eastern male come in and complain of having mouth sores, stiffness, swelling of joints, genital sores, and acne-like sores. You look at his eye and see retinal phlebitis and iritis with hypopyon. What disease/ syndrome would you suspect this patient has?

A

Behcet’s Disease

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7
Q

You are talking to your staff doctor and they tell you that the patient may have Behcet’s disease. When you walk into the room to see the patient, what OCULAR signs/symptoms would you expect to see from the patient?

A

You would expect that the patient has:

Iritis with hypopyon
Retinal phlebitis (82%)(Most common)
Uveitis/Iritis (63%)

Complain of:
Blurry vision
pain
redness
photophobia

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8
Q

What gene is present in 72-79% of patients with Behcet’s disease?

A

HLA-B51

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9
Q

What test would you give when testing for Behcet’s? How effective is this test?

A

Behcetine pathergy test
79% effective

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10
Q

What is the ocular triad for Behcet’s disease?

A

Iritis with Hypopyon
Mouth sores
Genital sores

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11
Q

What is another name for Behcet’s disease?

A

Oculo-oro-genital syndrome

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12
Q

What ethnicities are more likely to get Behcet’s disease? What sex is more likely to get it? What age range? What is the 7 year mortality rate? What is the treatment?

A

Middle eastern, Turkish, Asain
20-40 years old
Male more often than female
20% mortality rate over 7 years
Immunosuppression as treatment

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13
Q

What is the most common complication of large cell vasculitis?

A

Stroke

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14
Q

What is the most common complication of small cell vasculitis?

A

Renal failure

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15
Q

Since vasculitis causes a weakening of the blood vessels, what can that lead to?

A

thrombosis, aneurysms, ischemia, or hemorrhages

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16
Q

You see a patient that has dark red/purple raised bumps on their skin, what is this called? What disease is this associated with?

A

Palpable purpura
Vasculitis

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17
Q

You have a patient and suspect vasculitis, what lab tests might you run? (8)

A

Anti-neutrophil cytoplasmic antibody test (ANCA)
Sedimentation Rate (ESR)
C-reactive protein (CRP)
Anti-nuclear antibody (ANA)
CBC w differential
Biopsy
Angiography
Urinalysis

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18
Q

What treatment would you give to a patient with vasculitis?

A

Steroids/NSAIDs
Immunosupressants

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19
Q

What is the most common vasculitis?

A

Giant cell vasculitis (temporal arteritis)

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20
Q

A patient comes in with giant cell arteritis. The patient has become blind due to this disease. What artery was affected that led to the blindness?

A

Ophthalmic artery

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21
Q

A patient comes in with giant cell arteritis. The patient has developed Ischemic optic neuropathy due to this disease. What artery was affected that led to the blindness?

A

Posterior Ciliary Arteries

22
Q

Who is most likely to get Giant cell arteritis?

A

Elderly, white, females

23
Q

Where does giant cell arteritis affect most?

A

Head, arms, neck, aorta.
Large and Medium vessels

24
Q

You are speaking to your older patient and the patient tells you that they’ve been experiencing headaches, jaw pain, and scalp tenderness. What is this a classic sign of?

A

Giant cell arteritis

25
Q

What lab tests would you run for giant cell arteritis for diagnosis?

A

-Duplex sonography of temporal artery
-Sedimentation rate and C-reactive protein test results
-TA biopsy

26
Q

The doctor asks you what medication you would give a patient with giant cell arteritis, what medication would you say?

A

60-100 mg prednisone

or Actemra

27
Q

What percent of patients have some form of vision loss with giant cell arteritis?

A

92%

28
Q

Most common ocular complication from giant cell arteritis?

A

Ischemic optic neuropathy (82%)

29
Q

What kind of ocular complications might you expect from someone who has giant cell arteritis?

A

Some form of vision loss
ischemic optic neuropathy
Cotton wool spots
Amaurosis fugax
Retinal artery occlusions
Diplopia/CN palsies

30
Q

What kind of arteries are affected when someone has polyarteritis nodosa? What effect does the inflammation have on these arteries?

A

small and medium arteries.
makes up full thickness and kills the tissue.

31
Q

What kind of arteritis is possibly related to a Hep B infection?

A

Polyarteritis nodosa

32
Q

Who is more likely to be diagnosed with polyarteritis nodosa?

A

Males, 40-60 years old

33
Q

What is livedo reticularis? What is it associated with?

A

Rashes on the skin of legs that look similar to fish nets.

34
Q

If polyarteritis nodosa is left untreated, what might this lead to?

A

Kidney failure or GI infarct

35
Q

You suspect a patient has arteritis and you run tests on them to figure out what type. All the tests come back negative. What arteritis could it be?

A

Polyarteritis nodosa because it will not show up positive on the tests

36
Q

You have a patient that has polyarteritis nodosa, what systemic complications might he/she have?

A

Peripheral neuropathy
GI discomfort
Myocardial infarction
Stroke
Rashes on legs

37
Q

You go into the exam room and have a patient that has scleritis, peripheral ulcerative keratitis, retinal vasculitis, and an orbital pseudotumor. What disease might this be?

A

Polyarteritis nodosa

38
Q

You are talking to your staff doctor and they tell you that the patient may have polyarteritis nodosa. When you walk into the room to see the patient, what OCULAR signs/symptoms would you expect to see from the patient?

A

Scleritis/Episcleritis
Peripheral ulcerative keratitis
Retinal vasculitis and/or artery occlusion
Orbital pseudotumor

39
Q

What size/location of blood vessels does Granulomatosis with Polyangiitis (GPA) effect?

A

small and medium blood vessels mostly in the upper and lower respiratory tract, and the kidneys

40
Q

What is the most common complication of granulomatosis with polyangiitis?

A

Orbital pseudotumor

41
Q

What ocular complications may a patient have if they have granulomatosis with polyangiitis?

A

Orbital pseudotumor (most common)
Proptosis
double vision
ulcerative keratitis
Episcleritis
Uveitis

42
Q

You walk into the exam room and see butterfly facial rash and rash on their hands. What disease might this be?

A

Systemic Lupus Erythematosus (SLE)

43
Q

Who gets Systemic Lupus Erythematosus (SLE) more often?

A

African Americans, females, 15-40 year olds

44
Q

What lab tests would be positive for Systemic Lupus Erythematosus (SLE)?

A

ANA positive in 95%

45
Q

You are talking to your staff doctor and they tell you that the patient may have Systemic Lupus Erythematosus. When you walk into the room to see the patient, what OCULAR signs/symptoms would you expect to see from the patient?

A

-Dry Eye syndrome (most common)
-Diplopia/ palsy
-Lupus retinopathy (retinal artery occlusion, cotton wool spots, retinal vasculitis)

46
Q

What is the most common ocular complication of Lupus?

A

Dry eye syndrome (33%)

47
Q

What kind of arteritis is Lupus?

A

Secondary arteritis

48
Q

What kind of blood vessels does Behcet’s Disease affect?

A

Veins

49
Q

What are the two types of vasculitis that affect large vessels?

A

Giant cell arteritis
Behcet’s disease

50
Q

What type of vasculitis affects medium vessels?

A

Polyarteritis Nodosa

51
Q

What type of vasculitis affects small vessels?

A

Granulomatosis with Polyangiitis
Systemic Lupus Erythematosus

Basic Pathology (16 decks)

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