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Cardiovascular > Vasculitis > Flashcards

Vasculitis Flashcards

1
Q

What is vasculitis? Does is mainly affect arteries or veins?

A
  • inflammation of the blood vessel wall

- mainly affects arteries

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2
Q

What are the three broad categories of vasculitis?

A
  • large, medium, and small vessel vasculitis

- (there is considerable overlap)

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3
Q

What are the two main types of large vessel vasculitis?

A
  • temporal (giant cell) arteritis

- Takayasu arteritis

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4
Q

What are the three main types of medium vessel vasculitis?

A
  • polyarteritis nordosa
  • Kawasaki disease
  • Buerger’s disease
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5
Q

What are the four main types of small vessel vasculitis?

A
  • Wegener granulomatosis
  • microscopic polyangiitis
  • Churg-Strauss syndrome
  • HSP (Henoch-Schonlein purpura)
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6
Q

Temporal (Giant Cell) Arteritis is most common in what demographic? What about Takayasu Arteritis?

A
  • giant cell: female patients > 50

- Takayasu: patients

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7
Q

What type of vasculitis is Temporal (Giant Cell) Arteritis? Which vessels does it commonly affect?

A
  • large vessel vasculitis

- commonly affects the carotid artery

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8
Q

Why do patients with Temporal (Giant Cell) Arteritis commonly present with headaches?

A
  • because the temporal artery branches from the carotid, and the inflammed artery causes pressure in the head
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9
Q

What is a major potential risk of Temporal (Giant Cell) Arteritis?

A
  • blindness due to the proximity of the ophthalmic artery to the carotid
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10
Q

Pathophysiology of Temporal (Giant Cell) Arteritis; What do we see on histology?

A
  • giant cells attack and fragment the internal elastic lamina of the blood vessel wall
  • on histology, we would see a huge separation between the intima and media as a result
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11
Q

What type of vasculitis is Takayasu Arteritis? Which vessels does it commonly affect?

A
  • large vessel vasculitis

- commonly affects the aortic arch at its branch points

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12
Q

Pathophysiology of Takayasu Arteritis

A
  • essentially the same as temporal arteritis

- giant cells attack and fragment the internal elastic lamina of the blood vessel wall

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13
Q

Medium vessel vasculitis involves which vessels?

A
  • muscular arteries that supply organs
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14
Q

Polyarteritis Nordosa

A
  • a necrotizing (fibrinoid necrosis) arteritis that is systemic (affects most organs)
  • a medium vessel vasculitis
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15
Q

Polyarteritis Nordosa is most common in which demographic?

A
  • young adults
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16
Q

What type of inflammation is involved in Temporal Arteritis and Takayasu Arteritis?

A
  • granulomatous inflammation (hence the giant cells)
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17
Q

What type of necrosis is involved in Polyarteritis Nordosa?

A
  • fibrinoid necrosis
18
Q

Although it is systemic, which organs are NOT affected by Polyarteritis Nordosa?

A
  • the lungs
19
Q

What do we see on histology of Polyarteritis Nordosa?

A
  • a ‘string-of-pearls’ appearance
20
Q

What type of vasculitis is Kawasaki Disease? Which vessels does it usually affect?

A
  • medium vessel vasculitis

- affects the coronary artery

21
Q

Kawasaki Disease is most common in which demographic?

A
  • asian children
22
Q

Kawasaki disease commonly affects the coronary artery, greatly increasing the risk of ___________, despite the patient’s young age. Therefore, we commonly give these patients prophylactic ________.

A
  • increased of MI

- give them aspirin!

23
Q

What type of vasculitis is Buerger’s Disease? Which vessels does it affect?

A
  • a necrotizing medium vessel vasculitis

- affects the arteries in the digits

24
Q

Buerger’s Disease is only seen in which demographic?

A
  • smokers!

- it is totally associated with smoking

25
Q

Patients with Buerger’s Disease commonly present with what symptoms?

A
  • ulceration and gangrene of their fingers and toes

- if untreated, autoamputation can occur

26
Q

Small vessel vasculitis affects which vessels?

A
  • arterioles, capillaries, and venules
27
Q

What type of vasculitis is Wegener Granulomatosis?

A
  • a necrotizing small vessel vasculitis
28
Q

What is the classic triad of affected organs in Wegener Granulomatosis?

A
  • the nasopharynx, lungs, and kidneys
29
Q

Wegener Granulomatosis is most common in which demographic?

A
  • middle aged males
30
Q

Small vessel vasculitis is commonly ANCA related. Is Wegener Granulomatosis ANCA related? If so, what type?

A
  • (anti-neutophril cytoplasmic antibodies)

- Wegener granulomatosis is c-ANCA related

31
Q

What type of vasculitis is Microscopic Polyangiitis?

A
  • a necrotizing small vessel vasculitis
32
Q

Which organs are commonly affected in Microscopic Polyangiitis?

A
  • multiple organs, but especially the skin, lungs, and kidney
33
Q

Microscopic Polyangiitis and Wegener Granulomatosis are both types of necrotizing small vessel vasculitis that affect the kidneys and lungs - how can we tell them apart?

A
  • microscopic polyangiitis does NOT affect the nasopharynx, and is p-ANCA related
  • Wegener granulomatosis DOES affect the nasopharynx, and is c-ANCA related
34
Q

Small vessel vasculitis is commonly ANCA related. Is Microscopic Polyangiitis ANCA related? If so, what type?

A
  • (anti-neutrophil cytoplasmic antibodies)

- microscopic polyangiitis is p-ANCA related

35
Q

Churg-Strauss Syndrome is a type of which vasculitis? Which organs are commonly affected?

A
  • a rare necrotizing small vessel vasculitis with eosinophils
  • several organs affected, but especially the lungs and heart
36
Q

Small vessel vasculitis is commonly ANCA related. Is Churg-Strauss Syndrome ANCA related? If so, what type?

A
  • (anti-neutrophil cytoplasmic antibodies)

- Churg-Strauss syndrome is p-ANCA related

37
Q

Miscroscopic Polyangiitis and Churg-Strauss Syndrome are both types of necrotizing small vessel vasculitis that are p-ANCA related - how can we tell them apart?

A
  • eosinophils are only present in Churg-Strauss

- Churg-Strauss is also associated with asthma, where as microscopic polyangiitis is not

38
Q

HSP

A

Henoch-Schonlein purpura (a small vessel vasculitis)

39
Q

HSP is the MOST common vasculitis in which demographic?

A
  • (Henoch-Schonlein purpura)

- most common vasculitis in kids

40
Q

Patients with HSP commonly present with what symptoms?

A
  • (Henoch-Schonlein purpura)

- palpable purpura on buttocks and legs

41
Q

HSP is due to IgA immune complex deposition in the blood vessel wall, explaining why it is usually seen following a ______________.

A
  • (Henoch-Schonlein purpura)

- usually follows an upper respiratory tract infection

Cardiovascular (11 decks)

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