Vasculitis - Darrow

Question 1

vasculitis

Answer 1

immune complex deposition**

activation of complement**

leukocytoclstic changes - remnants of WBC lying around

get necrosis and thrombosis

Question 2

classifiction of vasculitis

Answer 2

based on vessel size

Question 3

large vessel

Answer 3

limb claudication
absent pulses
bruits
aortic dilation

Question 4

medium vessel

Answer 4

livedo reticularis
cutaneous nodules
arthritis

Question 5

small vessel

Answer 5

purpura - small spots

Question 6

mononeuritis multiplex

Answer 6

medium vessel disease**

Question 7

behcets

Answer 7

variable vessel vasculitis

-hits small, medium, and large vessels

Question 8

takayasu arteritis

Answer 8

large vessel

Question 9

giant cell arteritis

Answer 9

large vessel

Question 10

polyarteritis nodosa

Answer 10

medium vessel

Question 11

kawasaki disease

Answer 11

medium vessel

Question 12

cogans syndrome

Answer 12

IgG4 related disease

Question 13

single organ vasculitis

Answer 13

only involve one organ

Question 14

ANCA vasculitis

Answer 14

small vessel

Question 15

immune complex

Answer 15

small vessel

Question 16

ischemic necrosis

Answer 16

in vasculitis

Question 17

palpable purpura

Answer 17

presentation of vasculitis syndrome

cutaneous manifestation**

Question 18

inflammatory palpable purpura

Answer 18

leukocytoclastic vasculitis

Question 19

tx of vasculitis

Answer 19

start with steroids

-to bigger guns eventually

Question 20

large vessel vasculitis

Answer 20

takayasu arteritis

temporal arteritis

Question 21

granulomatous or giant cell arteritis

Answer 21

temporal arteritis

Question 22

fever, malaise, weight loss, easy fatigue, amaurosis, BP difference arms, aortic insufficiency, right brachial index 0.4

women most likely has?

Answer 22

takayasus arteritis

• early inflammatory and late occlusive phase
• aka pulseless disease**
• oriental disease

EQ**

Question 23

fever of undetermined origin

Answer 23

temporal arteritis

Question 24

pain, stiff shoulders and hips, pain with shewing, sed rate elevated (very high)

Answer 24

temporal arteritis

may have subclavian stenosis**

Question 25

subclavian stenosis

Answer 25

with temporal arteritis

Question 26

polymyalgia rheumatica**

Answer 26

aches pains in shoulder, neck, hips - stiff in morning - limited ROM check for temporal arteritis

Question 27

proximal muscle pain and stiffness with no weakness

Answer 27

giant cell (temporal) arteritis

Question 28

giant cell temporal arteritis

Answer 28

can have increased alk phosphate | -because hepatic artery obstruction

Question 29

fever, arthralgia, abdominal pain, left wrist drop and right foot drop, hematuria, hep B positive, medium vessel aneurysm

Answer 29

polyarteritis nodosa**

Question 30

wrist and foot drop

Answer 30

medium vessel

Question 31

microaneurysms

Answer 31

polyarteritis nodosa

Question 32

polyarteritis nodosa

Answer 32

``` HTN livedo reticualris abdominal pain testicle pain/tender** foot drop or polyneuropathy ```

Question 33

livedo reticularis

Answer 33

PAN cryoglobulinemia anti-phospholipid Ab syndrome

Question 34

polyarteritis nodosum association

Answer 34

hepatitis B -not so much anymore - because of vaccine but its on boards

Question 35

fever 5 days, erythema and edema palms and soles, cervical adenopathy

Answer 35

kawasakis** ``` fever 5 days cervical lymphadenopathy strawberry tongue conjunctivitis rash acral - palm and sole edema ```

Question 36

strawberry tongue

Answer 36

kawasakis

Question 37

buergers disease

Answer 37

smokers askanazi jews not on test

Question 38

immune complex small vessel vasculitis

Answer 38

hypocomplementic urticarial vasculitis (anti-C1q vasculitis) henoch schonlein purpura mixed cryoglobulinemia anti-GBM

Question 39

urticarial vasculitis

Answer 39

anti-complement vasculitis get urticaria >24 hours** C3a and C5a - produce leukocytoclastic nuclear debris ecchymosis after it clears up**

Question 40

urticarial vasculitis

Answer 40

with lupus** - high association

Question 41

anti-CD20

Answer 41

rituximab

Question 42

18yo viral prodrome, fever, palpable skin lesions

Answer 42

IgA immunoglobulin | -henoch scholnien purpura

Question 43

IgA

Answer 43

henoch schonlein purpura | -activates alternative complement pathway

Question 44

henoch schonlein purpura

Answer 44

small vessel disease - palpable purpura IgA immune complexes GI sx - gut has lots of IgA

Question 45

hematuria, raynauds, hepatosplenomegaly, sat on cold bleacher

Answer 45

cryoglobulinemia -cold exposure** should evaluate for hepatitis C and sjogrens

Question 46

mixed cryoglobulinemia

Answer 46

hep C and sjogrens associations polyclonal mixed IgG-IgM complexes

Question 47

anti-glomerular BM disease

Answer 47

goodpastures

Question 48

ANCA associated small vessel vasculitis

Answer 48

wegeners granulomatosis microscopic polyangiitis churg-strauss disease

Question 49

eosinophilic granulomatosis with polyangiitis

Answer 49

churg strauss disease

Question 50

granulomatosis with polyangiitis

Answer 50

wegeners granulomatosis

Question 51

anti-PR3

Answer 51

C-ANCA - granulomatosis with polyangiitis cytoplasm distribution

Question 52

anti-MPO

Answer 52

P-ANCA - churg strauss and microscopic polyangiitis around nucleus distribution

Question 53

ANCAs

Answer 53

activate neutrophils -activate alternate complement pathway granulomatous rxn to extravascular necrosis

Question 54

microscopic polyangiitis

Answer 54

no granulomas

Question 55

P-ANCA positive, pauci-immune nongranulomatous necrotizing vasculitiz of arterioles, hematuria and RBC casts, coughing up blood, pulmonary infiltration

Answer 55

microscopic polyangitis

Question 56

hemoptysis, stridor, prior DVT, conductive hearing loss, C-ANCA, granulomatous inflammation

Answer 56

conductive hearing loss - upper respiratory granulomatous polyagiitis - wegeners

Question 57

eosinophilia

Answer 57

churg strauss

Question 58

iranian patient, blurry vision, oral and penile pain, hx of pathergy

Answer 58

behcets disease

Question 59

oral lesions, genital lesions, ocular involvement

Answer 59

behcets disease

Question 60

behcets

Answer 60

multi vessel vasculitis

Question 61

HLA-B51

Answer 61

behcet syndrome

Question 62

strep sanguis and heat shock protein

Answer 62

behcet syndrome

Question 63

pain in right knee, abdominal pain, fever, rub over right chest, rebound tenderness, red raised lesion, CRP elevated, proteinuria

Answer 63

familial mediterranean fever

Question 64

familial mediterranean fever

Answer 64

get a cytokine storm -IL-1 beta get lots of inflammation

Question 65

lack of pyrin

Answer 65

normally inactivates IL8 and C5a familial mediterranean fever

Question 66

recurrent fever and hot ankle rash

Answer 66

familial mediterranean fever

Question 67

string of beads

Answer 67

single organ vasculitis skin - cutaneous leukocytoclastic vasculitis - only have palpable purpura drug reaction

Question 68

tx of SLE

Answer 68

arthritis and dermatitis** NSAIDs corticosteroids hydroxychloroquine - prevents flares get a flare - tx with corticosteroids**