Vasculitis

Question 1

Name subtypes of large vessel vasculitis

Answer 1

Giant cell arteritis
Takayaso

Question 2

Name subtypes of medium vessel vasculitis

Answer 2

PAN
Kawasaki

Question 3

Name types of Small/ Medium vessel vasculitis:

Answer 3

• Wegener’s granulomatosis
• Churg-Strauss syndrome
• Microscopic polyangiitis

Question 4

Name subtypes of small vessel vasculitis

Answer 4

*Henoch Schonlein Purpura
• Essential mixed cryoglobulinaemia

Question 5

Management of polymyalgia rheumatica

Answer 5

– Prednisolone 15 mg od
– Bone protection (bisphosphonate, Calcium and vitamin D)
– GI protection (e.g. PPI)

Question 6

Management of GIANT cell arteritis

Answer 6

Prednisolone 40-80 mg od
• 40 mg if no visual/ocular symptoms
• 60-80 (1mg/kg) if suspect visual/ocular involvement
– Bone protection (bisphosphonate, Calcium and vitamin D)
– GI protection (e.g. PPI)

Question 7

Management of Takayaso arteritis

Answer 7

Prednisolone +/- steroid sparing agents
– Monitor and treat cardiovascular risk factors
– Surgery – reconstructive/angioplasty

Question 8

Pt comes with
. Claudication of extremities
. Decreased pulsations of one or two limbs
. Difference of 10 mmhg in systolic pressure betwen both arms
. Bruit ober the subclavian arteries

Diagnosis?

Answer 8

Takayaso’s arteritis

Question 9

Pt. Comes with
Triad of systemic necrotising vasculitis affecting
• Upper airway (ENT)
• Lung
• Kidney
– cANCA (anti-PR3) positive

Diagnosis

Answer 9

Wegener’s granulomatosis

Question 10

Pt comes with Triad of
Asthma
• Eosinophilia
• Systemic vasculitis involving >2 extrapulmonary organs

Diagnosis?

Answer 10

Churg Strauss Syndrome
(Eosinophilic Granulomatosis with Polyangiitis (EGPA)

Question 11

Pt comes with Symmetrical purpura
• GI – colic, maelena, haematemesis
• Joints – arthritis/arthralgia
• Renal – haematuria, proteinuria

He recently recovered from upper resp. Infection

Diagnosis?

Answer 11

HSP

Question 12

Management of HSP

Answer 12

Usually self-limiting
– Supportive
– Corticosteroid, immunosuppressants, plasma exchange in severe

Question 13

Patient comes with – Palpable purpura (esp exposed areas, extremities)
– Arthritis/arthralgia
– Weakness
– Peripheral neuropahty
– Subclinical alveolitis
– Low C4

Diagnosis?

Answer 13

Essential mixed cryoglobulinaemia
Cryoglobulinemic Vasculitis

Question 14

Management of essential mixed cryoglobulinaemia

Answer 14

Immunosuppression
• Plasma exchange