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Musculoskeletal > Vasculitis Nicholls > Flashcards

Vasculitis Nicholls Flashcards

1
Q

What are some signs and symptoms of vasculitis in general?

A

Fever, myalgia, arthralgia, malaise

  • Also palpable Purpura (these are just erythematous tender skin nodules), focal skin necrosis and ulceration
  • Livedo reticularis (this is a purplish discoloration of the skin due to dilation of the blood vessels,
  • Urticaria
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2
Q

What is the key to diagnosis of vasculitis?

A

Distribution of organ involvement and histopathologic features

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3
Q

What are the common causes of infectious vasculitis?

A

Fungal (aspergillus)
Bacterial (Pseudomonas)
Viral (cytomegalovirus)

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4
Q

In temporal giant cell arteritis, what are the Giant cells doing?

A

THey attack the internal elastic Lamina and destroy it.

- You get intimal thickening that can lead to stenosis

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5
Q

Clinical manifestations of TGCA

A
  • headache in 75% of pts
  • swollen tender artery
  • scalp tenderness
  • visual disturbances
  • jaw claudication
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6
Q

Peripheral neuropathy most common with

A

polyarteritis nodosa

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7
Q

Nodular pulmonary infiltrates most associated with

A

Granulomatosis with polyangiitis

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8
Q

Infectious vasculitis may cause

A

mycotic aneurysm

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9
Q

Inflammation in TGCA is

A

Segmental, Transmural, granulomatous

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10
Q

TGCA affects arteris of what size?

A

Medium

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11
Q

Why is it important that TGCA is segmental?

A

Biopsies may be false negatives

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12
Q

Why is is important that TGCA is transmural?

A

More easily narrows the lumen…..whereas atherosclerosis takes 50 years to narrow your coronary, TGCA takes just a few years.

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13
Q

Describe the inflammation of Takayasu Arteritis

A

Segmental, Transmural, loosely grnulomatous, and …..Necrotizing

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14
Q

Takayasu Arteritis can involve the aorta and cause

A

dissection–> rupture –> hemopericardium– > DEAD

Basically Cardiac Tamponade (bunch of blood in the pericardium)

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15
Q

Polyarteritis Nodosa inflammation is:

A

Segmental, transmural, NODULAR

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16
Q

What is the most characteristic feature of polyarteritis nodosa

A

Fibrinoid necrosis

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17
Q

Acute phase of PN

A
  • neutrophils, intimal thickening, cell proliferation and degeneration, luminal stenosis
  • Also may see: thrombosis, occlusion, rupture…all of which occur at BRANCHPOINTS of the artery
18
Q

Later phases of PN

A

Chronic inflammation, fibroblasts, scarring

19
Q

Unlike temporal arteritis, aneurysms are …. in PN

A

fairly common

20
Q

Lesions are at………..phases at the same time in PN

A

DIFFERENT

21
Q

Livedo reticularis can be a feature of

A

PN….basically just looks like a net like rash…its dilated blood vessels so that makes sense

22
Q

Kawasaki disease features

A

Endothelial necrosis + transmural inflammation with neutrophils, lymphocytes, wall necrosis,and aneurysms

23
Q

Aneurysms are most characteristic of which vasculitis?

A

Kaawasaki

24
Q

What tests do we use for Kawasaki disease?

A

There is no blood test. It is a clinical diagnosis based on history and physical

25
Q

Kawasaki’s disease is most common at what age?

A

1

26
Q

Describe Granulomatosis with polyangiitis

A

Necrotizing granulomatous vasculitis of both ARTERIES AND VEINS in the UPPER AND LOWER RESP TRACT ANS KIDNEYS

27
Q

Histology of granulomatosis with polyangiitis looks like

A

Geographic areas of necrosis with basophillic debris, BLUED

28
Q

ANCA-PR3

A

Granulomatosis with Poly

29
Q

Signs and symptoms of granulomatosis with Poly

A

Mucosal ulcers, necrotizing lesions, Nasal cartillage destruction

30
Q

Most common site of involvement on presentation with GP

A

URT

31
Q

GP in the kidney?

A

Can have severe necrotizing vasculitis of the interlobar arteries

May also have glomerulonephritis

32
Q

What is Churg Strauss?

A

Allergic granulomatosis with polyangitis

33
Q

Churg Straus Triad

A

Asthma , eosinophilia, vasculitis

34
Q

Pathology of Churg Strauss?

A

Wegeners + Eosinophils

35
Q

Brueger dz

A

Acute buergers: segmental transmural acute inflammation without necrosis + thromboses
+ granulomas + giant cells

Chronic: organization of the thromous and fibrosis

36
Q

Beurgers is related to?

A

Smoking!! They must stop to prevent progression

37
Q

Hypersensitivity angiitis

A

Affects VERY SMALL vessels

- Neutrophils infiltrate and break down dispersing nuclear dust

38
Q

In Hypersensitivity angiitis, pts have leasions that are…..

A

ALL in the same phase

39
Q

Most common cause of Hypersensitivity angiitis in kids?

A

URT…skin involvement, joint involvement, GI involvement, Renal involvement

40
Q

In adults the most common cause of hypersensitivity vasculitis is?

A

DRUGS…Sulfas, penicillin, cephalosporins, diuretics, phenytoin, allopurinol

Musculoskeletal (23 decks)

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