Vasculitis

Question 1

Elderly female with unilateral headache, jaw claudication, blindness w/ESR>100?

Answer 1

Temporal (giant cell) arteritis

Question 2

Temporal (giant cell arteritis) is a disease of branches of which artery?

Answer 2

Granulomatous inflammation of carotid artery

Question 3

Tx for Temporal arteritis? The tx is to prevent what specific disease?

Answer 3

High Dose corticosteriods=>to prevent blindness

Question 4

30 y/o Asian Female with weak upper extremity pulses, arthritis, ocular disturbances?

Answer 4

Takayasu Arteritis (pulseless disease)

Question 5

MOA of Takayasu Arteritis?

Answer 5

Granulomatous Vasculitis of the aortic branches

Question 6

3 y/o Asian Child who presents with Flu-like symptoms, maculopapular rash on the hands and a red tongue (oral mucositis)?

Answer 6

Think Kawasaki Disease

Question 7

Symptoms of Kawasaki Disease

Answer 7

Conjunctival Infection, 
Rash, 
Adenopathy (Cervical), 
Strawberry tongue, 
Hand and foot changes (Edema), 
Fever (CRASH and Burn)

Question 8

Most feared complication of Kawasaki Disease?

Answer 8

Crash and Burn the Coronary Arteries (i.e. aneurysms)=>rupture

Question 9

When is the only time you give aspirin to a kid?

Answer 9

Kawasaki Disease

Question 10

Young adult with Hx of Hep B infection complains of diffuse pain everywhere but the lungs are spared What will be seen in imaging on this patient? MOA? HSR?

Answer 10

Polyarteritis Nodosa
MOA: Necrotizing vasculitis in all areas except the lungs
HSR: Type 3 HSR
Imaging: String of Pearls appearance

Question 11

A 35 y/o male with a hx of heavy smoking whose hand blanch white=> then blue and red again?

Answer 11

Buerger’s Disease (thromboangiitis obliterans)

Question 12

What is the most common complication of Buerger’s Disease?

Answer 12

amputation of digits and phlebitis

Question 13

A 40 y/o patient with a hx of URI within the past week, chronic sinuitis, hemopytsis and hematuria with red blood cell cast. Dx? Lab finds?

Answer 13

WeCener’s (Granulomatosis with polyangiitis
)c-ANCA/PR3-ANCA;
antiproteinase 3 (third letter of alphabet)

Question 14

What are triad of symptoms you see in Wegener’s?

Answer 14

Necrotizing Vasculitis/Granulomas of nasopharynx, Lungs and Kidney

Question 15

Tx of WeCener’s

Answer 15

Cyclophosphamide and Corticosteriods

Question 16

A 45 y/o white female with hemopytsis and glomerulonephritis is found to have no granulomas. Dx? Lab finds?

Answer 16

Dx: Microscopic Polyangiitis
Labs: mPo-ANCA, P-ANCA

Question 17

50 y/o female with a one month history of progressive dyspnea, productive cough, pain of elbows and knees, and 40°C fever despite antibiotic treatment. She complains of a wrist drop. She was dx with asthma for 25 years. Dx? Labs?

Answer 17

Eosinophilic granulomatosis with polyangiitis

Labs: P-ANCA, Elevated IgE levels (eosinophilia)

Question 18

A 5 year old boy complains of stomach hurting. PE shows rash on the buttocks/legs, lower extremity stiffness. Threeweeksago,hesuffered from anupperrespiratoryinfectionwhichhassinceresolved spontaneously. MOA of this disease? What disease is it most associated with?

Answer 18

Henoch-Scholein purpura
MOA: IgA deposition

IgA nephropathy (Berger's disease)
Lower extremity stiffness=arthralgia
Rash=palpable purpura

Question 19

Microscopic Polyangiitis vs WeCener’s?

Answer 19

Microscopic Polyangiitis has

1. NO granulomas
2. No Nasopharyngeal involvement

Question 20

Henoch-Scholein Purpura has classic triad. What is it?

Answer 20

1. Skin=>palpable purpura
2. Arthralgias
3. GI abdominal pain

Question 21

30 year old Caucasian female has chewing difficulties and persistent headaches and tenderness over the patient’s temples? Dx?

Answer 21

Takayasu arteritis

Question 22

30 year old Male asthmatic that develops a wrist drop and has elevated eosinophils. Dx?

Answer 22

Churg-Strauss

Question 23

7 year old male who has colicky abd. pain, arthralgias and palpable lesion? What is the etiology?

Answer 23

Henoch-Scholein Purpura

Circulating immune complexes

Question 24

MC vasculitis in kids?

Answer 24

Henoch-Schonlein purpura

Question 25

White Female with sudden onset of blindness think?

Answer 25

Temporal (giant cell) arteritis