Vasculitis Flashcards

1
Q

Define Vasculitis.

A

inflammation and destruction of the blood vessel walls leading to impaired blood flow.

  • Split into Large, Medium and Small vessel vasculitis.
  • Small vessel is split into ANCA +ve and ANCA -ve
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2
Q
Give examples of the different types of vaculitis:
Large vessel?
Medium vessel?
anca +ve small vessel?
anca -ve small vessel?
A

large = GCA, takayasu’s (temporal and arota)
Medium = polyarteritis nodosa (renal and heart) and kawasaki’s (<5s)
ANCA +ve = wegner’s, churg-struass, microscopic polyangitis (ALL AFFECT LUNG AND KIDNEY)
ANCA -ve = Henoch-Schonlein purpura

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3
Q

clinical presentation of vasculitis?

A

DEPENDS ON VESSELS AFFECTED

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4
Q
Tell me more about Giant Cell Arteritis:
Vessels affected?
associated condition?
Importance?
Symptoms?
investigations?
Treatment?
A
  • Affected vessels = temporal, aorta, extra-cranial branches of carotid
  • associated with Polymyalgia Rheumatica
  • CAN GO PERMANENTLY BLIND IF UNPROMPTED TX
  • <1 month onset, headaches, scalp tenderness, jaw claudication, visual disturbances, Sx of polymyalgia rheumatica
  • Ix - temporal artery biopsy, ESR >50, age >50, pulseless temporal artery, new onset headache
  • GIVE ORAL PRED IMMEDIATELY biopsy later - High Dose preed 48hrs = should be good repsonse OR wrong diagnosis
  • URGENT ophthalmology r/v
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5
Q

Tell me more about Wegner’s granulomatous?

A
  • preferred name = granulomatosis with polyangiitis
  • anca +ve small vessel vasculitis
  • affected URT, lungs and kidneys
  • raised ESR and CRP
  • take renal biopsy
  • CXR for lung involvement
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6
Q

Sx of granulomatosis with polyangitis?

A

FUCKS EVERYWHERE

  • URT - sinusitis, otisis, saddle shape nose deformity
  • Lungs - nodules, haemoptysis, dyspnoea
  • kidney - rapidly progressive glomerulonephritis
  • CNS - MMX, CN lesions
  • all sorts of eye shit
  • skin - purpuric/vasculitis rash
  • GU/GI sx, pericarditis, synovitis
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7
Q

Tx for granulomatosis with polyangitis?

A
  • severe disease - high dose steroids + immunosuppressant drugs (cyclophosphamide)
  • non-end organ damage less heavy shit - MTX, mycophenolate, azathioprine
  • plasma exchange
  • biologics - rituximab
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8
Q

HSP tell me?

A

HSP

  • IgA immune complexes deposited about
  • seen mainly in children
  • palpabe purpuric rash on legs and buttocks
  • abdo pain, arthritis, nephritis/haematuria
  • kidney biopsy - diagnosis
  • usually preceded by an URTI
  • spontaneous resolution
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