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rheumatology medicine > Vasculitis > Flashcards

Vasculitis Flashcards

1
Q

What is vasculitis?

A

Inflammation of blood vessels

Clinical features arise from damage to blood vessel walls

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2
Q

What can cause vasculitis?

A 
Idiopathic
Infection 
Inflammatory disease
Drug induced
Neoplastic
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3
Q

What are symptoms of vasculitis?

A 
Fever 
Malaise 
Weight loss 
Arthraligia 
Hameopytsis 
Epistaxis
GI bleeding 
Haematuria 
Visual changes
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4
Q

What investigations are done for suspected vasculitis?

A

Urine dip

Bloods

  • FBC
  • U+Es
  • CRP
  • LFTs
  • Coag
  • ANA
  • ANCA
  • Anti-GBM

CXR

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5
Q

How is vascilitis classified?

A

Small vessel
Medium vessel
Large vessel

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6
Q

What are small vessel vasculitides?

A 
Henoch-schonlein purpura 
Collagen vascular disease
Microscopic polyangitis 
Wegener's 
Churg-strauss
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7
Q

What are medium vessel vasculitides?

A

Polyarteritis nodosa

Kawaski disease

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8
Q

What are large vessel vasculitides?

A

Takayasu arteritis

Giant cell arteritis

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9
Q

What is Henoch-schonlein purpura?

A

IgA vasculitis

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10
Q

How does Henoch-schonlein purpura present?

A

Purpura ( purple marks that don’t disappear when pressed) over legs and buttocks

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11
Q

What are collagen vascular disease?

A

RA
Sjogren’s syndrome
SLE

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12
Q

What is microscopic polyangitis?

A

ANCA associated vasculitis

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13
Q

What is Wegener’s?

A

Granulomatosis with polyangitis

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14
Q

What are the symptoms of Wegener’s?

A

ELK classification

ENT
- sinusitis

Lungs

  • dyspnoea
  • haemopytisis
  • wheeze

Kidneys

  • haematuria
  • proteinuria
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15
Q

What proteins are associated with Wegeners?

A

PR3

C-ANCA

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16
Q

How do you induce remission in Wegener’s?

A

Cyclophoshamide OR rituximab
+
Prednisolone

17
Q

How do you maintain remission in Wegener’s?

A

Azathioprine/methotrexate

18
Q

What is Churg-Strauss?

A

Eosinophilic granulomatosis with polyangitis

19
Q

What are the 6 criteria of Churg-Strauss?

A 
Asthma 
Eosinophilia
Paranasal sinusitis
Pulmonary infiltrates
Histological confirmation 
Mononeuritis/polyneuropathy
20
Q

How many of the Churg-Strauss criteria do you need to make a diagnosis?

A

4

21
Q

What proteins are associated with Churg-Strauss?

A

MPO

P-ANCA

22
Q

How do you induce remission in Churg-Strauss?

A

Cyclophosamide OR rituximab
+
prednisolone

23
Q

How do you maintain remission in Churg-Strauss?

A

Azathioprine/methotrexate

24
Q

What is polyarteritis nodosa?

A

Necrotising vasculitis that causes aneurysms and thrombosis

25
Q

What are the symptoms of polyarteritis nodosa?

A 
Weight loss
Livedo reticularis 
Testicular pain/tenderness
Myalgias
Mononeuropathy 
Polyneuropathy
Hypotension <90
26
Q

What are the diagnostic criteria for polyarteritis nodosa?

A 
Weight loss >4kg
Livedo reticularis 
Testicular pain/tenderness
Myalgias
Mononeuropathy or polyneuropathy
Hypotension <90
Elevated kidney blood tests (urea >14.3)
Evidence of hep B 
Presence of granulocyte or mixed leukocyte infiltrate in arterial wall biopsy
27
Q

How many diagnostic criteria do you need for polyarteritis nodosa?

A

3

28
Q

What infection is associated with polyarteritis nodosa?

A

Hepatitis B

29
Q

How do you investigate suspected polyarteritis nodosa?

A

Hep B antigen
ESR
FBC - neutrophilia
Biopsy arteries

30
Q

How is polyarteritis managed?

A

Steroid + cyclophoshamide to induce remission

Azathioprine for maintenance

31
Q

What is Kawasaki disease?

A

Autoimmune vasculitis affecting children

32
Q

What are the symptoms of Kawasaki disease?

A

Fever
Swollen neck glands
Chest rash
Red peeling skin on palms and soles

33
Q

How is Kawasaki disease managed?

A

Gamma globulin

Aspirin

34
Q

What is Takayasu arteritis?

A

Systemic vasculitis affecting aorta and its branches

35
Q

What are the symptoms of Takayasu arteritis?

A

Depend on arteries involved

Aortic arch

  • dizziness
  • visual changes
  • weak arm pulses

Raised BP
Fever
Malaise

36
Q

What are complications of Takayasu arteritis?

A

Aortic regurg
Aortic aneurysm
Aortic dissection
Ischaemic stroke

37
Q

How is Takayasu arteritis managed?

A

Prednisolone

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