vasculitis from FA

Question 1

temporal arteritis presentation

Answer 1

old lady

headache on one side

jaw pain(claudication)

blindness(opthalmic occlusion)

polymyalgia rheumatic assn. – pain or stiffness, usually in the neck, shoulders, upper arms and hips

Question 2

pathophysiology of temporal arteritis

Answer 2

focal granulomatous inflammation

affects branches of carotid artery

Question 3

treatment for temporal arteritis

Answer 3

corticosteroids

Question 4

takayasu arteritis presentation

Answer 4

young asian female(<40)

weak upper extremity pulses

visual/neuro disturbances – lack of blood flow

arms have different pressures(by at least 10 mmHg)

constitutional symptoms: fever, night sweats, arthritis, myalgias, skin nodules, ocular disturbances

Question 5

takayasu pathophysiology

Answer 5

granulomatous thickening/narrowing of aortic arch and its branches

increased ESR due to inflammation

Question 6

treatment for takayasu arteritis

Answer 6

corticosteroids

Question 7

polyarteritis nodosa presentation

Answer 7

young adult

w/fevere, wt loss, malaise, HA,

abdominal pain and melena(black stool)

HTN

neuro dysfunction

skin lesions

renal damage

HBV+ in 30%

Question 8

pathophysiology for polyarteritis nodosa

Answer 8

medium/small vessel vasculitis

immune complex mediated

transmural inflammation of arterial wall

w/ fibrinoid necrosis inolving

multiple organs(lungs spared)

Question 9

treatment for polyarteritis nodosa

Answer 9

corticosteroids and cyclophosphamdie

Question 10

kawasaki disease presentation

Answer 10

young asian child

mucocutaneous lymph node syndrome: red eyes, red feet, red hands, red tongue, adenopathy, fever

Question 11

pathophysiology of kawasaki disease

Answer 11

medium vessel vasculitis

autoimmune mediated vasculitis

commonly affects coronary vessels

can cause aneurysms, thrombosis, rupture leading to death

Question 12

treatment for kawasaki disease

Answer 12

IVIG

aspirin

Question 13

buerger disease presentation

Answer 13

young smoking male

autoamputation of fingers

ulceration/gangrene of fingers/toes

raynaud phenomenon

Question 14

pathophysiology of buerger’s disease

Answer 14

segmental thrombosing/necrotizing vasculitis

involves digits!

Question 15

treatment of buerger’s disease

Answer 15

STOP SMOKING DUMMY

Question 16

causes of medium-vessel vasculitis

Answer 16

polyarteritis nodosa

kawasaki disease

buerger disease

Question 17

presentation of wegener’s disease

Answer 17

upper respiratory problems: sinusitis, otitis media, saddle nose

lower respiratory problems: hemoptysis, cough, dyspnea

kidney problems: - RPGN! – hematuria, red cell casts

Question 18

pathophysiology of wegener’s disease

Answer 18

Triad:

focal necrotizing vasculitis

necrotizing granulomas of lung and upper airway

necrotizing glomerulonephritis

C-ANCA(PR3) mediated

Question 19

treatment for wegener’s disease

Answer 19

cyclophosphamide and corticosteroids

Question 20

microscopic polyangiitis presentation

Answer 20

lung and kidney problems; no nasopharynx(wegener)

palpable purpura

differentiated from wegeners pathologically

Question 21

pathophysiology of microscopic polyangiitis

Answer 21

small vessel necrotizing vasculitis

no granulomas

P-ANCA(MPO) present

Question 22

treatment for microscopic polyangiitis

Answer 22

corticosteroids and cyclophosphamide

Question 23

churg-strauss presentation

Answer 23

small vessel vasculitis presenting with:

asthma, sinusitis

skin nodules, purpura

peripheral neuropathy(writs, foot drop)

heart, GI, kidney involvement

Question 24

churg strauss pathophysiology

Answer 24

granulomatous, necrotizing vasculitis with eosinophilia

p-ANCA

Question 25

henoch-schonlein purpura presentation

Answer 25

most common childhood systemic vasculitis

kid with:

palpable purpura on leg and butt

arthralgia

abdominal pain

Question 26

henoch-schonlein purpura pathophysiology

Answer 26

vasculitis secondary to IgA immune complex deposition

associated with IgA nephrophaty(berger disease)