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MSK Continued > Vasculitis (cortex) > Flashcards

Vasculitis (cortex) Flashcards

1
Q

Inflammation of blood vessels may result in?

A

Vessel wall thickening
stenosis
occlusion with subsequent ischaemia

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2
Q

What does large vessel vasculitis refer to?

A

Vasculitis that causes chronic granulomatous inflammation

mostly in the aorta and its major branches

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3
Q

What are the two subtypes of large vessel vasculitis?

A

Takasayu arteritis 

Tenporal/giant cell arteritis

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4
Q

Which type of large vessel vasculitis
occurs mostly >50yrs old?
occurs mostly <50 yrs old?

A

> 50yrs old temporal/giant cell arteritis

<50yrs old takasayu arteritis

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5
Q

25 Year old japanese woman with malaise, night sweats, weight loss, arthralgia and fatigue
claudicant symptoms in upper and lower limb

A

Takasayu

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6
Q

In GCA ESR PV and CRP are elevated

A

T

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7
Q

If GCA is left untreated what can occur?

A

Vascular stenosis, aneurysms

resulting in bruit and reduced pulses

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8
Q

what is the treatment for large vessel vasculitis?

A

Prednisolone starting at 40-60mg and gradual reduction

steroid sparing agents such as methotrexate ir azathioprine may be added

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9
Q

How can small vessel vasculitis be grouped?

A

Antineutrophil cytoplasmic antibodies positive or negative

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10
Q

Small vessel vasculitis’ conditions have simmilar presenting features

A

T

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11
Q

What are the small vessel vasculitis presenting symptoms?

A

Fever, Wight loss, raised non blanching purpuric rash. arthralgia/arthritis

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12
Q

What are the main complications of small vessel vasculitis?

A

Pulmonary vasculitis - leading to lung opacities on X ray
mononeuritis multiplex
glomerulonephritis

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13
Q

ANCA +ve small vessel vasculitis with no granulomas present

A

Microscopic polyangitis

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14
Q

ANCA +ve small vessel vasculitis with granulomas present

A

Wegner’s granulomatosis/ polyangitits

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15
Q

ANCA +ve small vessel vasculitis with granulomas present and asthma and eosinophilia

A

Churg-Strauss syndrome

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16
Q

Anca -ve vasculitis with IGA

A

Honoch Schnein purpura

17
Q

Anca -ve with serum crygoglobulin

A

cryoglobulinaemia

18
Q

What are the features of Wegner’s granulomatosis/ polyangititis?

A 
Granulomatous inflammation 
ENT and Resp symptoms
Necrotising vasculitis of small/medium vessels
glomerulonephritis common
Cavitating lesions on X ray
19
Q

What are the features of Microscopic polyangitis?

A

Necrotising vasculitis with few or no immune deposits
pulmonary capilliaritis and glomerulonephritis is common
pulmonary caprillitis often occurs

20
Q

What is renal limited vasculitis?

A

Necrotizing glomerulonephritis with no extra renal features at presentation

21
Q

What is the main difference between Churg Strausss/EGPA syndrome and Wegner’s/granulomatosis with polyangitis?

A

Churg Strauss is associated with asthma and eosinophilia

Necrotizing glomerulonephritis is more common in W/GPA

22
Q

What are the features of Churg Strass syndrome?

A

Eosinophil-rich granulomatous inflammation involving resp tract
Necrotizing vasculitis involving small to medium sized vessels
assoc asthma and eosinophilia

23
Q

What are the symptoms of Granulomatosis with polyangiitis or Wegeners?

A 
ENT SYMPTOMS
-nose bleeds
-deafness
-recurrent sinutitis
-nasal crusting 
Resp symptoms 
- Haemoptysis
24
Q

Which antibodies are GPA/Wegners assoc with?

A

Proteinase 3 antibodies

Cytoplasmic antineutrophil cytoplasmic antibodies

25
Q

What are symptons of churg strauss/ egpa?

A

late on set asthma

rhinitis/coryza: stuffy nose, sneezing etc.

26
Q

Glomerulonephritis occurs in 90% in patients with which condition

A

Microscopic polyangiitis

27
Q

ANCA is negative in proportion of egpa, gpa and Mpa so it cannot be relied upon to confirm the diagnosis.

A

T

28
Q

What investigations should be done in a suspected vasculitis?

A 
Bloods
- ESR, PV and CRP are raised
- Anaemia common
-ANCA
Renal involvement
- urinalysis 
- U+Es
  • CXR
  • Biopsy (skin or kidney)
29
Q

How are ANCA associated vasculitis managed?

A

IV steroids and cyclophosphamide - a chemotherapy drug

30
Q

What is Henoch-Schonlein purpura?

A

IgA mediated generalised vasculitis affecting small vessels in skin, GI tract, kidneys, joints

31
Q

Henoch-Schonlein purpura rarely affects lungs and cns

A

T

32
Q

Henoch-Schonlein purpura commonly affects CHILDREN

A

T

33
Q

What is the common history of people affected by Henoch-Schonlein purpura?

A

URTO predates by few weeks

34
Q

What are symptoms of Henoch-Schonlein purpura?

A

purpuric rash over the buttocks and lower limbs, abdominal pain and vomiting and joint pain.

35
Q

Treatment Henoch-Schonlein purpura?

A

self limiting condition not requiring specific treatment. It usually settles over the course of weeks to months

MSK Continued (10 decks)

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