Vasculitis

Question 1

How is the artery affected in giant cell arteritis?

Answer 1

patchy infiltration of lymphocytes, macrophages and multinucleated giant cells
causing inflammation in intima, media and adventitia

Question 2

How does giant cell arteritis result in distal ischeamia?

Answer 2

Infiltration and inflammation&raquo_space; thickened vessel walls&raquo_space; luminal narrowing&raquo_space; inadequate blood flow

Question 3

How does GCA present?

Answer 3

Jaw claudication
Visual disturbance
Headache
Scalp tenderness
Systemic symptoms

Question 4

How is GCA investigated

Answer 4

Inflammatory markers
MR angiography
Temporal artery biopsy

Question 5

How is GCA treated?

Answer 5

Prednisolone 40mg with no visual impairment

60mg with visual impairment

Question 6

How long does GCA take to resolve?

Answer 6

Resolves generally over 2 years

Question 7

Which age group does GCA affect?

Answer 7

Over 50

Question 8

Which age group does Takayasu vasculitis affect?

Answer 8

Younger patients, rarely over 50

Question 9

What is small vessel vasculitis split into?

Answer 9

ANCA pos and neg

Question 10

How does a small vessel vasculitis generally present?

Answer 10

Non-blanching purpuric rash

Fever, weight loss, arthralgia

Question 11

What is GPA?

Answer 11

Granulomatous vasculitis which generally involves the resp tract

Question 12

How does GPA present?

Answer 12

Resp and ENT symptoms

Question 13

Which antibodies are associated with GPA?

Answer 13

PR3, c-ANCA

Question 14

Which type of vasculitis is pulmonary capillaritis associated with?

Answer 14

Microscopic polyangiitis

Question 15

What is renal limited vasculitis?

Answer 15

Pauci-immune necrotising glomerulonephritis

No extra-renal features

Question 16

What is EGPA?

Answer 16

Same as GPA but associated with eosinophilia

Question 17

What condition is EGPA associated with?

Answer 17

Asthma

Question 18

How is small vessel vasculitis generally treated?

Answer 18

IV steroids and cyclophosphamide

Question 19

What is HSP mediated by?

Answer 19

IgA

Question 20

Which vessels does HSP affect?

Answer 20

Those in skin, GI, kidneys and joints

Question 21

What is HSP associated with?

Answer 21

Recent viral(?) URTI

Question 22

How does HSP present?

Answer 22

Purpuric rash over buttocks and lower limbs with abdo pain, vomiting and joint pain