Vasculitis

Question 1

What are the 3 primary criteria of vasculitis?

Answer 1

1. Vessel wall necrosis
2. Invasion of vessel walls with polymorphonuclear leukocytes
3. Fibrinoid deposits on vessel wall

Question 2

What are 4 secondary criteria of vasculitis?

Answer 2

1. Perivascular hemorrhage
2. Chronic granulomatous inflammation
3. Perivascular fibrosis
4. Thrombosis of vessel

Question 3

What is humoral-mediated vasculitis the result of?

Answer 3

Circulating Ab-Ag immune complexes –> auto-antibodies

Question 4

What is cell mediated vasculitis the result of?

Answer 4

Lymphocytes and macrophages creating granulomatous reaction

Question 5

What is the name of the auto-antibody that attacks endothelial cells in vasculitis? What are its two forms?

Answer 5

ANCA (anti-neutrophil cytoplasmic antibodies)

Perinuclear (P-ANCA) and cytoplasmic (C-ANCA)

Question 6

Define primary vasculitis.

Answer 6

Idiopathic loss of tolerance to self

Question 7

Define secondary vasculitis.

Answer 7

Occurs in response to infection, tumors, immune complexes, drugs, or toxins

Question 8

What symptoms present with vasculitis affecting vessels of the skin?

Answer 8

Rash, purpura, ulceration, gangrene

Question 9

What symptoms present with vasculitis affecting vessels of the nervous system?

Answer 9

Headache, stroke, peripheral nerve dmg

Question 10

What symptoms present with vasculitis affecting vessels of the airways?

Answer 10

Nosebleeds, pulmonary infiltrates or hemorrhage

Question 11

What symptoms present with vasculitis affecting vessels of the CV system?

Answer 11

Coronary artery disease, MI, pericarditis, claudication

Question 12

What symptoms present with vasculitis affecting vessels of the GI system?

Answer 12

pain, bloody stools

Question 13

What symptoms present with vasculitis affecting vessels of the kidney?

Answer 13

Hematuria, proteinuria, glomerulonephritis, hypertension

Question 14

What symptoms present with vasculitis affecting vessels of the MS system?

Answer 14

arthralgias, myalgias, myositis

Question 15

What symptoms present with vasculitis affecting vessels of the eyes?

Answer 15

Redness w/ edema, pain, blindness

Question 16

What are the large vessel vasculitis diseases?

Answer 16

Takayasu’s disease and giant cell arteritis

Question 17

What are the middle vessel vasculitis diseases?

Answer 17

Kawasaki’s

Question 18

What are the small vessel vasculitis diseases?

Answer 18

Granulomatosis with polyangitis (GPA), Hypersensitivity vasculitis

Question 19

How does vasculitis cause clinical symptoms?

Answer 19

Inflammation leads to endothelial injury and vasospasm that contribute to thrombosis and downstream ischemia

Question 20

How are forms of vasculitis currently classified?

Answer 20

By caliber of vessels involved

Question 21

How do corticosteroids treat vasculitis?

Answer 21

Binds intracellular hormone receptor and inhibits cytokines

Question 22

How does Rituximab treat vasculitis?

Answer 22

Anti-CD20 monoclonal antibody - depletes B cells

Question 23

What cytokine receptors are often blocked as a way to treat vasculitis by preventing recruitment of WBCs and thus inhibiting inflammation?

Answer 23

TNFa and IL-1

Question 24

In small vessel vasculitis, damage starts ____ and move s____.

Answer 24

Inside, moves out

Question 25

In large vessel vasculitis, damage occurs _____ and moves ____.

Answer 25

Outside, moves inside