Vasculitis

Question 1

what is giant cell arteritis

Answer 1

Granulomatous vasculitis of medium to large arteries

Often involves temporal artery (often biopsy this) and ophthalmic arteries

Question 2

typical age for GCA

Answer 2

greater than 50

Question 3

more common features of GCA

Answer 3

• headaches (due to ischemia)
• fever, malaise, weight loss
• markedly elevated sed rate
• tender swollen artery, decreased pulses
  others: possibly vision loss, PMR

Question 4

basic pathogenesis of GCA

Answer 4

basically inflammatory cascade narrow vessel lumen

Question 5

when to dx GCA and what would you see

Answer 5

Biopsy temporal artery-will see lymphocyte infiltration, intimal thickening, multinucleated giant cells, necrosis, “skip lesions”

Question 6

tx for giant cell arteritis

Answer 6

high dose steroids (60 mg)

Question 7

what is PMR

Answer 7

Proximal upper and lower limb myalgias
Present for at least one month
Patients over 50 years of age
Sed Rate over 50 (more like 80-110)

Question 8

how do you know if something is truly PMR

Answer 8

responds VERY well to low/moderate dose of steroids

Question 9

what other vasculitis can PMR be associated with

Answer 9

giant cell arteritis

Question 10

polyarteritis nodosa

Answer 10

Necrotizing panarteritis (involves all three layers of blood vessel)of small to medium sized arteries

Skin, joints, peripheral nerves, gut, and kidney are most commonly involved

Question 11

MC clinical feature of polyarteritis nodosa (labs)

Answer 11

Elevated ESR, Anemia, thrombocytosis

Question 12

Granulomatosis with Polyangiitis:(Wegener’s Granulomatosis) most prominent clinical involvement (3)

Answer 12

Upper respiratory tract (95%) - sinusitis, rhinitis, nasal ulceration, otitis media

Lungs (85%) - nodular densities, infiltrates, cavitary lesions

Kidneys (75%) - hematuria, proteinuria, focal proliferative GN, rapidly progressive GN

Question 13

IgA Vasculitis (IgAV)
Henoch-Schönlein purpura

MC clinical manisfestation

Answer 13

GI - (85%) abdominal pain, GI bleeding (thought to be related to ischemia)

Question 14

vasculitities that have palpable purpura

Answer 14

IgA Vasculitis (IgAV)
microscopic polyangitis
Leukocytoclastic Vasculitis

Question 15

what are vasculitites commonly presenting with

Answer 15

Consider vasculitic syndromes when 2 or more organ systems are involved

Commonly associated with constitutional symptoms: Fever, weight loss, fatigue

Commonly associated with anemia and elevated sed rate