Vasculitis

Question 1

Elderly female with uniltateral HA, jaw claudication, blindness?

Answer 1

Temporal arteritis–may also see scalp ulcers and skin infarction

Question 2

Most commonly affected vessel in temporal arteritis?

Answer 2

Branches of carotid artery

Question 3

Cause of blindness in temporal arteritis?

Answer 3

Ophthalmic artery occlusion

Question 4

Assoc with polymyalgia rheumatica?

Answer 4

Temporal arteritis

Question 5

Temporal arteritis tx?

Answer 5

High-dose corticosteroids

Question 6

Young adult female Asian?

Answer 6

Takayasu’s

Question 7

Granulomatous thickening of aortic arch, proximal great vessels?

Answer 7

Takayasu’s

Question 8

Weak UE pulses?

Answer 8

Takayasu’s–“pulseless dz”

Question 9

S/S of Takayasu’s?

Answer 9

Weak pulses in arms, fever, NIGHT SWEATS, arthritis, myalgias, skin nodules, ocular disturbances

Question 10

Tx for Takayasu’s?

Answer 10

Corticosteroids

Question 11

Which hepatitis is polyarteritis nodosa assoc with?

Answer 11

Hep B

Question 12

S/S of polyarteritis nodosa?

Answer 12

1) Fever, weight loss, malaise, HA
2) GI = abdominal pain and melena
3) HTN, neuro sxs, cutaneous eruptions (livido reticularis), renal damage

Question 13

What vessels are involved in polyarteritis nodosa?

Answer 13

Visceral and renal (spares LUNGS)

Question 14

Transmural inflammation of arterial wall with fibrinoid necrosis?

Answer 14

Polyarteritis nodosa

Question 15

Many aneurysms and constrictions on arteriogram?

Answer 15

Polyaritis nodosa

Question 16

Tx for polyarteritis nodosa?

Answer 16

Corticosteroids, cyclophosphamide

Question 17

Asian children <4 years?

Answer 17

Kawasaki’s

Question 18

S/S of Kawasaki’s (mucocutaneous LN syndrome)?

Answer 18

Fever for >4 days, cervical LAD, conjunctival injection, cracked lips, strawberry tongue, hand-foot erythema/swelling and desquamation

Question 19

Major risk in Kawasaki’s?

Answer 19

Coronary aneurysms causing MI

Question 20

Tx for Kawasaki’s?

Answer 20

IVIG and aspirin

Question 21

Heavy smokers?

Answer 21

Buerger’s

Question 22

Gangrene, amputation of digits, superficial nodular phlebitis, Raynaud’s?

Answer 22

Buerger’s

Question 23

Tx for Buerger’s?

Answer 23

Smoking cessation

Question 24

p-ANCA +?

Answer 24

Microscopic polyangiitis, Churg-Strauss

Question 25

Microscopic polyangiitis has necrotizing vasculitis affecting what organs?

Answer 25

1) Lungs
2) Kidneys
3) Skin
4) With pauci-immune glomerulonephritis and palpable purpura

Question 26

Tx for microscopic polyangiitis?

Answer 26

Cyclophosphamide, corticosteroids

Question 27

Triad in Wegener’s?

Answer 27

1) Focal necrotizing vasculitis
2) Necrotizing granulomas in lungs and upper airway
3) Necrotizing glomerulonephritis

Question 28

c-ANCA?

Answer 28

Wegener’s

Question 29

CXR in Wegener’s?

Answer 29

Large nodular densities

Question 30

Asthma, sinusitis, palpable purpura and peripheral neuropathy (e.g. wrist and foot drop)?

Answer 30

Churg-Strauss

Question 31

Granulomatous, necrotizing vasculitis with eosinophilia?

Answer 31

Churg-Strauss

Question 32

Elevated IgE?

Answer 32

Churg-Strauss

Question 33

Most common childhood systemic vasculitis?

Answer 33

Henoch-Schonlein

Question 34

Due to IgA complex deposition?

Answer 34

Henoch-Schonlein

Question 35

Port-wine stain (nevus flammeus) on face, ipsilateral leptomeningeal angiomatosis, seizures and early-onset glaucoma?

Answer 35

Sturge-Weber

Question 36

Granulomas?

Answer 36

1) Temporal arteritis
2) Takayasu’s
3) Wegener’s
4) Churg-Strauss

Question 37

Anti-myeloperoxidase Ab?

Answer 37

Microangiopathic polyangiitis

Question 38

Anti-proteinase 3 Ab?

Answer 38

Wegener’s

Question 39

Which vasculitis is type III HSR?

Answer 39

Polyarteritis nodosa

Question 40

Polymyalgia tx?

Answer 40

Low-dose corticosteroids

Question 41

Dx for temporal arteritis?

Answer 41

Temporal artery biopsy

Question 42

Where do you see high ESR?

Answer 42

1) Temporal arteritis

2) Takayasu’s

Question 43

Histo in Buerger’s?

Answer 43

Segmental thrombosing vasculitis affecting arteries, veins and nerves