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MSK Exam 2 Spring 2015 > Vasculitis - Darrow > Flashcards

Vasculitis - Darrow Flashcards

1
Q

vasculitis

A

immune complex deposition**

activation of complement**

leukocytoclstic changes - remnants of WBC lying around

get necrosis and thrombosis

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2
Q

classifiction of vasculitis

A

based on vessel size

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3
Q

large vessel

A

limb claudication
absent pulses
bruits
aortic dilation

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4
Q

medium vessel

A

livedo reticularis
cutaneous nodules
arthritis

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5
Q

small vessel

A

purpura - small spots

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6
Q

mononeuritis multiplex

A

medium vessel disease**

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7
Q

behcets

A

variable vessel vasculitis

-hits small, medium, and large vessels

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8
Q

takayasu arteritis

A

large vessel

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9
Q

giant cell arteritis

A

large vessel

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10
Q

polyarteritis nodosa

A

medium vessel

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11
Q

kawasaki disease

A

medium vessel

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12
Q

cogans syndrome

A

IgG4 related disease

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13
Q

single organ vasculitis

A

only involve one organ

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14
Q

ANCA vasculitis

A

small vessel

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15
Q

immune complex

A

small vessel

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16
Q

ischemic necrosis

A

in vasculitis

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17
Q

palpable purpura

A

presentation of vasculitis syndrome

cutaneous manifestation**

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18
Q

inflammatory palpable purpura

A

leukocytoclastic vasculitis

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19
Q

tx of vasculitis

A

start with steroids

-to bigger guns eventually

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20
Q

large vessel vasculitis

A

takayasu arteritis

temporal arteritis

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21
Q

granulomatous or giant cell arteritis

A

temporal arteritis

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22
Q

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

women most likely has?

A

takayasus arteritis

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

EQ**

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23
Q

fever of undetermined origin

A

temporal arteritis

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24
Q

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

A

temporal arteritis

may have subclavian stenosis**

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25
Q

subclavian stenosis

A

with temporal arteritis

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26
Q

polymyalgia rheumatica**

A

aches pains in shoulder, neck, hips

  • stiff in morning
  • limited ROM

check for temporal arteritis

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27
Q

proximal muscle pain and stiffness with no weakness

A

giant cell (temporal) arteritis

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28
Q

giant cell temporal arteritis

A

can have increased alk phosphate

-because hepatic artery obstruction

29
Q

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

A

polyarteritis nodosa**

30
Q

wrist and foot drop

A

medium vessel

31
Q

microaneurysms

A

polyarteritis nodosa

32
Q

polyarteritis nodosa

A 
HTN
livedo reticualris
abdominal pain
testicle pain/tender**
foot drop or polyneuropathy
33
Q

livedo reticularis

A

PAN
cryoglobulinemia
anti-phospholipid Ab syndrome

34
Q

polyarteritis nodosum association

A

hepatitis B
-not so much anymore - because of vaccine

but its on boards

35
Q

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

A

kawasakis**

fever 5 days
cervical lymphadenopathy
strawberry tongue
conjunctivitis
rash
acral - palm and sole edema
36
Q

strawberry tongue

A

kawasakis

37
Q

buergers disease

A

smokers
askanazi jews

not on test

38
Q

immune complex small vessel vasculitis

A

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

39
Q

urticarial vasculitis

A

anti-complement vasculitis

get urticaria >24 hours**

C3a and C5a - produce leukocytoclastic nuclear debris

ecchymosis after it clears up**

40
Q

urticarial vasculitis

A

with lupus** - high association

41
Q

anti-CD20

A

rituximab

42
Q

18yo viral prodrome, fever, palpable skin lesions

A

IgA immunoglobulin

-henoch scholnien purpura

43
Q

IgA

A

henoch schonlein purpura

-activates alternative complement pathway

44
Q

henoch schonlein purpura

A

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

45
Q

hematuria, raynauds, hepatosplenomegaly, sat on cold bleacher

A

cryoglobulinemia
-cold exposure**

should evaluate for hepatitis C and sjogrens

46
Q

mixed cryoglobulinemia

A

hep C and sjogrens associations

polyclonal mixed IgG-IgM complexes

47
Q

anti-glomerular BM disease

A

goodpastures

48
Q

ANCA associated small vessel vasculitis

A

wegeners granulomatosis
microscopic polyangiitis
churg-strauss disease

49
Q

eosinophilic granulomatosis with polyangiitis

A

churg strauss disease

50
Q

granulomatosis with polyangiitis

A

wegeners granulomatosis

51
Q

anti-PR3

A

C-ANCA - granulomatosis with polyangiitis

cytoplasm distribution

52
Q

anti-MPO

A

P-ANCA - churg strauss and microscopic polyangiitis

around nucleus distribution

53
Q

ANCAs

A

activate neutrophils
-activate alternate complement pathway

granulomatous rxn to extravascular necrosis

54
Q

microscopic polyangiitis

A

no granulomas

55
Q

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

A

microscopic polyangitis

56
Q

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

A

conductive hearing loss - upper respiratory

granulomatous polyagiitis - wegeners

57
Q

eosinophilia

A

churg strauss

58
Q

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

A

behcets disease

59
Q

oral lesions, genital lesions, ocular involvement

A

behcets disease

60
Q

behcets

A

multi vessel vasculitis

61
Q

HLA-B51

A

behcet syndrome

62
Q

strep sanguis and heat shock protein

A

behcet syndrome

63
Q

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

A

familial mediterranean fever

64
Q

familial mediterranean fever

A

get a cytokine storm
-IL-1 beta

get lots of inflammation

65
Q

lack of pyrin

A

normally inactivates IL8 and C5a

familial mediterranean fever

66
Q

recurrent fever and hot ankle rash

A

familial mediterranean fever

67
Q

string of beads

A

single organ vasculitis

skin - cutaneous leukocytoclastic vasculitis - only have palpable purpura

drug reaction

68
Q

tx of SLE

A

arthritis and dermatitis**
NSAIDs
corticosteroids
hydroxychloroquine - prevents flares

get a flare - tx with corticosteroids**

MSK Exam 2 Spring 2015 (10 decks)

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