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
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
3
Q
clinical presentation of vasculitis?
A
DEPENDS ON VESSELS AFFECTED
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
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
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
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
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