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Rheumatology > Vasculitis > Flashcards

Vasculitis Flashcards

1
Q

What is vasculitis?

A

Inflammation of blood vessel walls with narrowing and occlusion leading to tissue or organ damage. Most forms of vasculitis have no known cause

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2
Q

What can trigger vasculitis?

A

Infection - Hep B, C, HIV, Staph aureus

Drugs - Antithyroids, cocaine, levamisole

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3
Q

What are the main large vessel vasculitidies?

A
  • Giant cell arteritis
  • Takayasu’s arteritis
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4
Q

What are the main medium vessel vasculitidies?

A
  • Kawasaki’s Disease
  • Polyarteritis nodosa
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5
Q

What are the main small vessel vasculitidies?

A
  • Granulomatosis with polyangitis (Wegener’s)
  • Eosinophilic granulomatosis with polyangitis (Churg Strauss)
  • Microscopic polyangitis
  • HSP
  • Goodpasture’s syndrome
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6
Q

What is the typical renal lesion that occurs in small vessel vasculitis?

A

Focal segmental necrotizing glomerulonephritis

Focal because it affects only a few glomeruli, not all of them; segmental because it may affect only a part of the glomerulus; and necrotizing implying tissue destruction

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7
Q

What are the ANCA positive small vessel vasculites?

A
  • Microscopic polyangitis
  • Eosinophilic granulomatosis with polyangitis
  • Granulomatosis with polyangitis
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8
Q

What are the ANCA negative small vessel vasculites?

A
  • HSP
  • Goodpastures
  • Cryoglobulinaemia
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9
Q

What is c-ANCA associated with?

A

Granulomatosis with polyangitis - Wegeners GRanulomatosis

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10
Q

What is p-ANCA associated wtih?

A
  • Microscopic polyangitis
  • Eosinophilic granulomatosis with polyangitis - Churg-Strauss
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11
Q

What is the significance of ANCA testing?

A

ANCA defines a subgroup of patients with small-vessel vasculitis who have a predilection for renal disease (typically GPA and microscopic polyangiitis) and who require similar treatment.

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12
Q

When would you consider vasculitis as part of your differential diagnosis?

A

If someone was presenting with any multisystem disorder

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13
Q

What are systemic features of vasculitis?

A
  • Fever
  • Malaise
  • WEight loss
  • Arthralgia
  • Myalgia
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14
Q

What are skin features of vasculitis?

A
  • Purpura
  • Ulceration
  • Livedo reticularis
  • Nailbed infarcts
  • Digital gangrene
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15
Q

What eye features can present in vasculitis?

A
  • Episcleritis
  • Scleritis
  • Visual loss
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16
Q

What ENT features can present in vasculitis?

A
  • Epistaxis
  • Nasal crusting
  • Stridor
  • Deafness
17
Q

What pulmonary features can present in vasculitis?

A

Haemoptysis and dyspnoea - pulmonary haemorrhage

18
Q

What cardiac features can present in vasculitis?

A
  • Angina
  • MI
  • Heart failure
  • Pericarditis
19
Q

What GI features can present in vasculitis?

A
  • Pain/perforation
  • Malabsorption - due to chronic ischaemia
20
Q

What renal features can occur in vasculitis?

A
  • Hypertension
  • Haematuria
  • Proteinuria
  • Casts
  • Renal failure
21
Q

What are neurological features of vasculitis?

A
  • Stroke
  • Seizures
  • Chorea
  • Psychosis
  • Confusion
  • Impaired cognition
  • Altered mood
  • Mononeuritis multiplex
  • Sensorimotor polyneuropathy
22
Q

What GU features can occur in vasculitis?

A
  • Orchitis
  • Testicular pain/tenderness
23
Q

How would you investigate someone with suspected vasculitis?

A
  • Bloods - ESR/CRP, ANCA, U+E’s, serum creatinine
  • Urinalysis
  • CXR
  • Angiography
  • Biopsy
24
Q

What results might you see on bloods for vasculitis?

A
  • Increased ESR/CRP
  • ANCA positive
  • Raised creatinine if renal failure
25
Q

What is the general management for Large vessel vasculitidies?

A

Steroids

26
Q

What is the main treatment for small vessel vasculitidies?

A

Steroids + IV cyclophosphamide

Azathiprine - steroid sparing drugs

Rheumatology (20 decks)

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