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Rheumatology > Vasculitis > Flashcards

Vasculitis Flashcards

1
Q

What is the most common vasculitis in adults over 50

A

Giant Cell Arteritis

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2
Q

What is the mainstay treatment for large vessel vasculitis

A

Glucocorticoids–high dose

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3
Q

What is GCA jr?

A

Polymyalgia rheumatica

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4
Q

Symptoms of Polymagia rheumatica PMR

A

pain and stiffness in shoulders and hips/upper thighs.

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5
Q

Differentiate symptoms of PMR and inflammatory myopathies.

A

PMR shoulders/hips/upper thighs, pain & stiffness worse in AM, gets better as day progresses.
Inflammatory myopathies: proximal weakness, generally painless.

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6
Q

What inflammatory disorder often coincides with GCA?

A

Giant cell arteritis and polymyagia rheumatic.

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7
Q

GCA is seen in what age group?

A

above 50.

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8
Q

Takayasu’s Arteritis is seen in which age group

A

between teens and 30s

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9
Q

What are first symptoms of Takayasu’s Arteritis?

A

nonspecific: malaise, fevers, joint pains similar to a prolonged viral illness.

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10
Q

What exam and diagnosis should you consider for any young female with unexplained fever or other systemic signs and symptoms?

A

Listen for bruits
Obtain bilateral blood pressures
Consider Takayasu’s Arteritis

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11
Q

What areas are usually involved in Takayasu’s Arteritis compared to Giant cell arteritis

A

Takayasu’s Arteritis usually involves aorta and its main branches such as (left) subclavian, carotids, renal and iliac arteries.

GCA involves arteries in the head and occasionally aortic.

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12
Q

What is a 1) medium vessel disease that classically involves the 2) mesenteries blood vessels.

A

2 characteristics of polyarteris nodosa.

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13
Q

What disease is polyarteris nodosa associated with?

A

Hepatitis B

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14
Q

What can cause sensory and motor loss to an affected limb, possibly with foot drop?

A

Polyarteris nodosa can cause narrowing of medium arteries – ischemia to peripheral and motor nerves.

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15
Q

CNS vasculitis usually presents as:

A

headaches or ischemic stroke caused by inflammation within the cerebral blood vessels.

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16
Q

What should you consider when a young person shows stroke-like symptoms and brain imaging shows ischemia in multiple areas of the brain?

A

CNS vasculitis.

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17
Q

Name two causes of stroke in a young person and how to differentiate?

A

CNS vasculitis may show diffuse narrowing of blood vessels in the brain.
Antiphospholipid syndrome should NOT have narrowing of blood vessels in the brain on imaging.

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18
Q

Severe, sudden thunderclap headache. What should you ask for history?

A

caffeine
strenuous activity
exposure to decongestants
RCVS reversible cerebral vasoconstriction syndrome.

19
Q

Ulcers, oral and genital, after herpes simplex virus has been ruled out.

A

Behcet’s disease, initial complaints.

20
Q

What ocular disease is common in Behcet’s disease.

A

anterior and posterior uveitis. Can cause blindness in 25% of patients if not treated.

21
Q

What vasculitis can involve medium-size arteries in lung, causing aneurysms?

A

Behcet’s disease can cause what in lungs?

22
Q

Ask patient suspected of having Behcet’s disease if they have experienced this after a break in the skin.

A

Pathergy.

23
Q

What is pathergy?

A

raised red lesion where the skin was broken, such as from needle stick.

24
Q

How would you treat oral sores of Behcet’s disease in mild illness?

A

topical or oral glucocorticoids and colchicine.

Apremilast has been effective in treating ulcers.

25
Q

What is overall name for small vessel vasculitis with a positive anti-neutrophilic cytoplasmic antibody?

A

ANCA associated vasculitis.

26
Q

What three diseases are examples of ANCA vasculitis?

A

Granulomatosis with Polyangiitis GPA
microscopic polyangiitis
Eosinophilic granulomatosiswith polyangiitis

27
Q

Three most common areas with blood vessel affected by GPA?

A

Sinus, lungs, and kidney.

28
Q

Saddle nose deformity or septal perforation are associated with what disease?

A

GPA, affecting sinuses.

29
Q

When GPA causes a glomerulonephritis, what lab should you order?

A

Creatinine–elevated.

Urine to be centrifuged for “active sediment” red blood cell casts.

30
Q

ESR is most useful test for this vasculitis.

A

GCA, and this lab is usually higher than for other vasculidites.

31
Q

What are the catastrophic outcomes for GCA?

A

blindness and aortic aneurysm or dissection.

32
Q

What steroid-sparing drug is indicated by FDA for GCA?

A

Tocilizumab.

33
Q

What is “pulseless disease?”

A

Takayasu arteritis’ nickname.

34
Q

What disease should be considered in any noninfected, systemically ill patient who has multiple organ involvement including the peripheral nerves, skin, gut, and/or kidney?

A

Polyarteritis nodosa.

35
Q

What medium vessel vasculitis is associated with smoking?

A

Thromboangiitis obliterans, occurs in both sexes equally.

Beurger’s disease.

36
Q

Claudication begins distally and progresses proximally in what disease?

A

Thrombangiitis obliterans.

37
Q

PR3-ANCA is associated with what?

A

Disease relapse. More important than clinical designation of GPA or MPA.

38
Q

Small vessel vasculitis affecting middle age males with sinusitis, ulcers in nasopharynx, and lung/kidney problems.

A

Granulomatosis with polyangiitis

39
Q

Small vessel vasculitis that affected lungs and kidneys, but not nasopharynx.

A

Microscopic polyangiitis.

40
Q

Small vessel vasculitis with p-ANCA and no granulomas.

A

Microscopic polyangiitis.

41
Q

Small vessel vasculitis that causes lung, kidney and sinus problems, associated with p-ANCA.

A

Eosinophilic granulomatosis with polyangiitis.

42
Q

Small vessel vasculitis that affects GI, skin, nerve, and heart along with sinus, lungs, and kidneys.

A

Eosinophilic granulomatosis with polyangiitis.

43
Q

What small vessel vasculitis is often confused with asthma and allergies?

A

Eosinophilic granulomatosis with polyangiitis.

Rheumatology (6 decks)

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