Vasculitis

Question 1

What is vasculitis.

Answer 1

Vasculitis is defined as an inflammatory disorder of blood vessel walls, causing destruction (aneurysm/rupture) or stenosis.

Question 2

What does the presentation of vasculitis depend on.

Answer 2

The organs involved.

Question 3

What organs can be affected by vasculitis.

Answer 3

Any organ can be affected.

Question 4

What are the causes of vasculitis. (2)

Answer 4

Primary.

Secondary (eg SLE, RA, hepatitis B/C, HIV).

Question 5

How is vasculitis classified. (3)

Answer 5

According to the size of the vessel damaged.
Large.
Medium.
Small.

Question 6

What are some conditions that cause large vessel vasculitis. (2)

Answer 6

Giant cell arteritis.

Takayasu’s arteritis.

Question 7

What are some conditions that cause medium vessel vasculitis. (2)

Answer 7

Polyarteritis nodosa.

Kawasaki disease.

Question 8

What are the subsets of small vessel vasculitis. (2)

Answer 8

ANCA positive.

ANCA negative.

Question 9

What are the features of small vessel ANCA positive vasculitis.

Answer 9

It has a predilection for respiratory tract and kidneys.

Question 10

What are some conditions that are small vessel ANCA positive vasculitis. (3)

Answer 10

Glomerulonephritis.
Churg-Strauss syndrome.
Wegener’s granulomatosis.

Question 11

What are some conditions that are small vessel ANCA negative vasculitis. (3)

Answer 11

Henoch-Schonlein purpura.
Goodpasture’s syndrome.
Cryoglobulinaemia.

Question 12

What are the symptoms vasculitis. (2)

Answer 12

Different vasculitides affect different organs, causing different patterns of symptoms.
Overwhelming fatigue.
Raised ESP/CRP.

Question 13

Is a severe vasculitis flare an emergency.

Answer 13

Yes.

Question 14

When should you consider vasculitis.

Answer 14

In any unidentified multisystem disorder.

Question 15

What is often seen on the blood results of a patient with vasculitis. (3)

Answer 15

Raised ESR/CRP.
ANCA may be positive.
Raised creatinine if renal failure.

Question 16

What is seen on a urine test of a patient with vasculitis. (3)

Answer 16

Proteinuria.
Haematuria.
Casts on microscopy.

Question 17

What are the systemic features of vasculitis. (5)

Answer 17

Fever. 
Malaise. 
Weight loss. 
Arthraligia. 
Myalgia.

Question 18

What are the skin features of vasculitis. (5)

Answer 18

Purpura. 
Ulcers. 
Livedo reticularis. 
Nailbed infarcts. 
Digital gangrene.

Question 19

What are the eye features of vasculitis. (3)

Answer 19

Episcleritis.
Scleritis.
Visual loss.

Question 20

What are the ENT features of vasculitis. (4)

Answer 20

Episataxis.
Nasal crusting.
Stridor.
Deafness.

Question 21

What are the pulmonary features of vasculitis. (2)

Answer 21

Haemoptysis and dyspnoea (due to pulmonary haemorrhage).

Question 22

What are the cardiac features of vasculitis. (3)

Answer 22

Angina or MI (due to coronary arteritis).
Heart failure.
Pericarditis.

Question 23

What are the GI features of vasculitis. (2)

Answer 23

Pain or perforation (infarcted viscus).

Malabsorpton (chronic ischaemia).

Question 24

What are the renal features of vasculitis. (5)

Answer 24

Hypertension.
haematuria. 
Proteinuria. 
Casts. 
Renal failure.

Question 25

What are the neurological features of vasculitis. (7)

Answer 25

Stroke. 
Fits. 
Chorea. 
Psychosis. 
Confusion. 
Impaired cognition. 
Altered mood.

Question 26

What are the GU features of vasculitis.

Answer 26

Orchitis - testicular pain or tenderness.