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Rakeem's MSK > vasculitis > Flashcards

vasculitis Flashcards

1
Q

define vasculitis

A

inflammation of blood vessels

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2
Q

general presentation of vasculitis

A

Joint/muscle pain
Peripheral neuropathy
Renal impairment
Purpura
Necrotic skin ulcers
GI symptoms

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3
Q

associated systemic symptoms with general vasculitis

A
  • Fatigue
  • fever/night sweats
  • weight loss
  • anorexia
  • anaemia
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4
Q

investigations for general vasculitis

A

Inflammatory markers high (CRP + ESR)

ANCA is associated with some types - ones that have polyangitis in the name

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5
Q

general treatment for vasculitis

A

corticosteroids

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6
Q

what are large vessel vasculitis

A
  • giant cell ateritis
  • Takayasu’s Arteritis
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7
Q

what are medium level vasculitis

A
  • Polyarteritis Nodosa
  • Kawasaki Disease
  • buergers disease
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8
Q

what are small level vasculitis

A
  • Eosinophilic Granulomatosis with Polyangiitis
  • Granulomatosis with Polyangiitis
  • Microscopic Polyangiitis
  • Henoch-Schonlein Purpura
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9
Q

what is Henoch-Schonlein Purpura

A
  • an IgA vasculitis
  • common in children
  • occurs due to IgA deposits in small blood vessels causing inflammation.
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10
Q

what does HSP affect

A

affects the skin, kidneys, and GI tract.

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11
Q

what triggers HSP

A

upper airway infection or gastroenteritis

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12
Q

features of HSP

A
  • Purpura
  • Joint pain
  • Abdominal pain
  • Renal involvement (IgA nephritis)
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13
Q

how to manage HSP

A
  • Supportive with analgesia
  • Monitor urine dipstick and BP
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14
Q

can HSP cause renal failure

A

Patients without renal involvement recover in 4-6 weeks, however, the disease can result in renal failure.

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15
Q

what is microscopic polyangitis

A

a small-vessel vasculitis that mainly affects the kidneys and lungs.

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16
Q

features of MP

A
  1. renal failure due to the vasculitis causing glomerulonephritis.
  2. lso affects the lungs by causing diffuse alveolar haemorrhage, leading to haemoptysis (coughing up blood).
17
Q

treatment for MP

A

Usually involves administering corticosteroids (prednisone) to manage the inflammation.

18
Q

what is Granulomatosis with Polyangiitis

A

GPA is a small-vessel vasculitis that primarily affects the respiratory tract and kidneys.

19
Q

what does GPA affect

A
  1. Ears –hearing loss
  2. Sinuses –sinusitis
  3. Kidneys –glomerulonephritis
  4. Nose –nose bleeds, crusting in the nose and nasal secretions, saddle-shaped nose, due to nasal bridge collapse.
  5. lower respiratory tract, it can cause cough, wheeze, and haemoptysis.
20
Q

treatment for GPA

A

Corticosteroids
Immunosuppression

21
Q

what is Eosinophilic Granulomatosis with Polyangiitis

A

a small-vessel vasculitis that primarily affects the lungs and skin but can affect other organs such as the kidneys.

22
Q

features of EGPA

A

presents with severe asthma, sinusitis, and allergic rhinitis.

Raised eosinophils on blood counts is a characteristic finding

23
Q

treatment of EGPA

A

Corticosteroids
Immunosuppression (severe cases)

24
Q

what is Polyarteritis Nodosa

A

a medium-vessel vasculitis that is caused idiopathically or secondary to an infection (esp. hep B)

25
Q

features of PAN

A

Renal impairment
Hypertension
Tender, erythematous skin nodules
Myocardial infarction
Stroke
Mesenteric arteritis (causing intestinal symptoms)

26
Q

treatment of PAN

A

Corticosteroids
Immunosuppression (severe cases)

27
Q

what is KAWASAKI disese

A

a medium-vessel vasculitis that typically affects children under the age of 5. There is no clear cause.

28
Q

features of kawasaki disease

A
  • Persistent high fever (>5 days)
  • Widespread erythematous maculopapular rash
  • Desquamation (skin peeling) of palms and soles
  • Bilateral conjunctivitis
  • Strawberry tongue
29
Q

treatment of kawasaki disease

A

High-dose IV aspirin
IVIG (IV immunoglobulins

30
Q

what is Takayasu’s Arteritis

A

a large-vessel vasculitis that mainly affects the aorta and its branches but can also affect the pulmonary arteries.

31
Q

pathophysiology of takayasus arteritis

A

The vessels swell and form aneurysms or become narrowed and blocked. Stenosis or occlusion reduces pulses and BP in the limbs, leading to the name or “pulseless disease”.

32
Q

presentation of takayasus arteritis

A

usually present before the age of 40 with non-specific systemic symptoms:
Fever
Malaise
Muscle aches
Claudication symptoms (pain and fatigue that worsen using the limb).

33
Q

treatment of takayasus arteritis

A

Corticosteroids

34
Q

what is giant cell artirits

A

GCA (also known as temporal arteritis) is a medium- and large-vessel vasculitis that has a strong link with polymyalgia rheumatica.

35
Q

features of GCA

A

Unilateral headache
Scalp tenderness
Jaw claudication (pain/fatigue/discomfort while chewing)
Blurred/double vision or loss of vision (if untreated)
Tender and inflamed temporal artery
Systemic symptoms (weight loss, fatigue, fever)
Carpel tunnel syndrome
Peripheral oedema

36
Q

how to diagnose GCA

A
  • Clinical presentation
  • Raised inflammation markers (esp. ESR)
  • Temporal artery biopsy and ultrasound
37
Q

treatment of GCA

A
  • Corticosteroids (started immediately, before diagnosis
  • Other (if needed) – aspirin, PPI
  • Bisphosphonates, calcium/vit
38
Q
A

Rakeem's MSK (23 decks)

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