Vasculitis Flashcards
What is vasculitis?
An inflammatory blood vessel disorder
Clinical features result from the damage of blood vessel walls with subsequent thrombosis, ischemia, bleeding, and/or aneurysm formation.
How is vasculitis classified?
By the predominant size, type, and location of involved blood vessels
It is a large, heterogeneous group of diseases.
What factors should be considered in the history for diagnosing vasculitis?
- age
- gender
- ethnicity
- comprehensive drug history
- family history of vasculitis
- constitutional symptoms
Constitutional symptoms include fever, weight loss, malaise, fatigue, diminished appetite, and sweats.
What is the ‘Glove and sweater’ approach in vasculitis diagnosis?
A series of questions from hands to head and down to trunk
It helps to identify symptoms related to vasculitis.
What are some clinical features to inquire about when diagnosing vasculitis?
Raynaud’s
- musculoskeletal symptoms e.g. arthalgia, myalgia, proximal muscle weakness
- CNS/PNS symptoms e.g. headache, visual loss, tinnitus
- nose bleeds, crusts, ulcers
- heart/lung symptoms: pericarditis, cough, chest pain, haemoptysis
- GI symptoms,
- renal symptoms: haematuria
- limb symptoms: neuropathy, digital ulcers/ischaemia
What vital signs should be checked during a physical exam for vasculitis?
Blood pressure and pulse
Important to assess for hypertension and regularity/rate of pulse.
What skin findings might indicate vasculitis?
- palpable purpura
- livedo reticularis
- nodules
- digital ulcers
- gangrene
- nail bed capillary changes
These findings are crucial for the diagnosis.
What are the primary types of small-vessel vasculitis?
- Microscopic polyangiitis (MPA)
- Granulomatosis with polyangiitis (GPA)
- Eosinophilic granulomatosis with polyangiitis (EGPA)
- IgA vasculitis
GPA was formerly known as Wegener’s granulomatosis and EGPA as Churg-Strauss syndrome.
Name a medium-vessel vasculitis.
Polyarteritis nodosa (PAN)
Kawasaki disease
This is a type of vasculitis affecting medium-sized vessels.
What are examples of large-vessel vasculitis?
- Takayasu arteritis (TAK)
- Giant cell arteritis (GCA)
These conditions primarily affect large blood vessels.
True or False: Secondary vasculitis is less common than primary vasculitis.
False
Secondary vasculitis is much more common than primary.
What initial tests are needed to exclude alternate diagnoses in vasculitis?
- FBC
- U&Es
- LFTs
- CRP
- PV
- ESR
- Specific serology : ANA, ANCA, RF
- hep screen, HIV
- cryoglobulins
- serum and urine protein electrophoresis
What is the first-line treatment for vasculitis?
Corticosteroids
They are essential for managing inflammation.
What are some examples of second-line treatments for vasculitis?
- Cytotoxic medications
- Immunomodulatory agents
- Biologic agents
Examples include cyclophosphamide, methotrexate, azathioprine, and rituximab.
Fill in the blank: Hypersensitivity vasculitis is a common cause of skin vasculitis caused by _______.
[medication]
This condition arises as an adverse reaction to certain drugs.
