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ICM II > Vasculitis > Flashcards

Vasculitis Flashcards

1
Q

Two types of symptoms with vasculitis?

A
  • Non-specific systemic symptoms

* Symptoms of organ ischemia

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2
Q

Large vessel vasculitis involves what

A

Aorta and major branches

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3
Q

Two main types of large vessel vasculitis

A

Temporal (giant cell) arteritis

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4
Q

Most common vasculitis in adults?

A

Temporal arteritis

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5
Q

Temporal arteritis most commonly affects what?

A

Branches off the carotid artery

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6
Q

Symptoms of temporal arteritis?

A
  • HA
  • Visual disturbances
  • Jaw claudication
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7
Q

Common lab finding in ESR

A

Very high ESR > 100

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8
Q

What are two ways that you can get ischemia secondary to vasculitis?

A
  1. Disrupt the endothelium → coagulation → thrombus

2. Injure wall → heal wall → fibrosis and narrowing

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9
Q

What will biopsy of temporal cell arteritis show?

A

Granulomatous inflammation (which shows giant cells) and intimal fibrosis (healing response)

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10
Q

What is the distribution of inflammation in giant cell arteritis?

A

It is segmental

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11
Q

How does Takayasu’s compare to giant cell arteritis?

A

Its almost the same except:
• Adults < 50 y/o (young Asian female)
• More proximal (aortic arch at branch points)
• Weak or absent pulses in upper extremity
• (will have elevated ESR and treat with steroids)

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12
Q

What arteries are involved in medium vessel vasculitis?

A

Muscular arteries supplying organs

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13
Q

What is polyarteritis nodosa?

A

A NECROTIZING vasculitis that involved MOST organs but spares the LUNGS

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14
Q

Symptoms of polyarteritis nodosa?

A
  1. HTN (renal arteries)
  2. Abdominal pain with melena (mesenteric artery)
  3. Neurological distrubances
  4. Skin lesions
  5. Associated with serum HBsAG
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15
Q

What type of necrosis is involved with polyarteritis nodosa?

A

Transmural fibrinoid necrosis

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16
Q

What is the common radiological finding in polyarteritis nodosa?

A

String of pearls appearance due to alternating segments of early fibrinoid necrosis and areas of fibrosis

17
Q

What disease commonly affects Asian children less than 4 years of age?

A

Kawasakis

18
Q

What are early symptoms of Kawasaki’s disease?

A 
Vague symptoms:
• Fever
• Conjunctivitis
• Erythematous rash on palms and soles
• Enlarged cervical lymph nodes
19
Q

What artery is preferentially involved with Kawasaki’s?

A

Coronary artery (can lead to MI or aneurysm

20
Q

What is Buerger disease?

A

Medium vasculitis involving the arteries of the hands which will present with ulceration, gangrene, and autoamputation of the hands.

21
Q

What is the treatment for Buerger disease

A

Stop smoking

22
Q

What is Wegener’s granulomatosis?

A

Necrotizing granulomatous vasculitis of the nasopharynx, lungs, and kidneys

23
Q

Treatment for Wegeners

A

Cyclophosphamide

24
Q

High risk population for Wegeners

A

Middle aged male

25
Q

Kidney involvement with Wegeners

A

Rapidly progressive glomerulonephritis

26
Q

Serology for Wegeners

A

Elevated C-ANCA

27
Q

What is microscopic polyangiitis?

A

Like Wegners but without nasopharyngeal involvement or granulomas

28
Q

Serology for Microscopic polyangiitis?

A

Elevated P-ANCA

29
Q

What is Churg-Strauss syndrome?

A

Necrotizing granulomatous vasculitis with eospinophilia which involved multiple organs including lungs and heart (differentiate this from microscopic polyangiitis)

30
Q

How can you differentiate Churg-Strauss from microscopic polyangiitis since they both have p-anca

A
  • Not granulomas with microscopic polyangiitis

* Churg-Strauss typically has asthma and eosinophilia

31
Q

What is HSP?

A

Vasculitis from IgA and ICs deposition

32
Q

What is most common vasculitis in kids?

A

HSP

33
Q

What is rash like in HSP?

A

Palpable purpura in buttocks and legs

34
Q

What are non-skin findings in HSP?

A
  • Hematuria from IgA nephropathy

* GI pain and bleeding

35
Q

When does HSP usually occur?

A

After a URI type infection (because you will get IgA production during URIs)

36
Q

What is treatment for HSP?

A

Generally self-limited but can treat with steroids

ICM II (10 decks)

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