Vasculitis Pathophys

Question 1

Polyarteritis Nodosum is a vasculitis of what size vessels

Answer 1

Medium mostly. Spares the Large elastic arteries like the aorta and also spares small vessels such as arterioles, venules, capillaries.

Question 2

Does PAN cause Glomerulonephritis

Answer 2

Nope…SO no RBC casts in the urine

Question 3

What disease predisposes to PAN in 30% of pts

Answer 3

Hepatitis B

Question 4

What is the cousing of Polyarteritis Nodosum that affects very small vessels?

Answer 4

Microscopic polyangittis

Question 5

Polyarteritis tends to affect which sex

Answer 5

Male (2:1)

Question 6

What is one symptom that should automatically make you think PAN

Answer 6

Peripheral neuropathy….thes patients may have involvement of the peroneal, tibial, ulnar, or radial nerve). Sensory dysthesias may dominate the clinical picture. WRIST DROP OR FOOT DROP

Question 7

What are some other clinical signs and symptoms of Polyarteritis Nodosum

Answer 7

Kidney involvement, GI involvement, cardiac,

Question 8

What ORgan system does PAN spare

Answer 8

THE LUNGS!!!!

Question 9

Diagnosis of PAN

Answer 9

biopsy

Question 10

What will you see on PAN biopsy

Answer 10

Fibrinoid Necrosis!

Question 11

Treatment plan for PAN?

Answer 11

Treat the underlying Hep B if it exists
Also treat with steroids and cytotoxic agents.
THey will probably die

Question 12

What makes Microscopic polyangitis different from PAN

Answer 12

It affects very small vessels
It DOES cause Glomerulonephritis
It DOES cause lung involvement
ANd it is way more common than PAN

Question 13

Granulmoas associated with PAN or Microscopic Poly

Answer 13

Trick question, NEither

Question 14

Is microscopic polyangiitis associated with anti-nbeutrophil antibodies>?

Answer 14

Yeah… P-ANCA

Question 15

Granulomatosis with polyangiitis definition?

Answer 15

Focal necrotizing vasculitis of medium and small vessels

Question 16

What is teh prototypical Pauci Immune vasculitis?

Answer 16

Granulomatosis with Polyangiitis

Question 17

Classic triad of P w/G

Answer 17

ELK (ENT, Lung, Kidney)

Question 18

Other Pw/G signs and symptoms

Answer 18

Systemic like fever, wt loss, malaise

Question 19

Describe the ELK signs

Answer 19

E: Nasal ulcerations, mucosal ulcerations, saddle nose

L: Pulmonary infiltrates and nodules

K: Glomerulonephritis

Question 20

SADDLE NOSE=

Answer 20

WEGNERS

Question 21

Allergic Granulomatosis with polyangitis is also called

Answer 21

Henoch Schonlein Purpura

Question 22

HSP genearlly follows

Answer 22

exposure to a specific drug

Question 23

HSP is more common in?

Answer 23

Kids

Question 24

IgA is high in what disease?

Answer 24

HSP!!!

Question 25

HSP tetrad

Answer 25

Purpura, arthritis, abdominal pain, Glomerulonephritis (PAAG)

Question 26

Skin involvement in HSP is usually where?

Answer 26

Lower extremities and buttocks

Question 27

PAAG tetrad of HSP broken down

Answer 27

Purpura, Arthritis, Abdominal Pain, Glomerulonephritis

Question 28

HSP prognosis

Answer 28

GOOD! usually just goes away

Question 29

Buerger’s disease usually affects what first

Answer 29

vascular supply to the lower limbs

Question 30

Signs and symptoms of Buerger’s

Answer 30

Bilateral pain and ischemia in the lower limbs, though upper extremities may be affected first in the cold

Question 31

Cogan’s Syndrome?

Answer 31

rare form of vasculitis in young adults presented with red and painful eyes.

Question 32

Susac’s syndrome

Answer 32

Rare as shit. Presents with onset of hearing loss with encephalopathy and branch retinal occlusions

Question 33

Cryoglobulinemic Vasculitis?

Answer 33

Palpable purpura with ulcers, Neuropathy, Raynaud’s, Digital Ischemia, Secondary Sjogrens

Question 34

Allergic Granulomatosis with Polyangiitis is also called

Answer 34

Churg Strauss syndrome

Question 35

Churg Strauss syndrome and glomerulonephritis

Answer 35

yes…remember, it is just allergic P w/G and P w/ G involves glomerulonephropathy

Question 36

Is churg Strauss associateed with granuloma formation

Answer 36

DUh. It is just allergic P W/ G.

Question 37

What antibody is Churg Strauss associated with

Answer 37

P- anca

Question 38

Two big symptoms to connect Churg Strauss with?

Answer 38

Asthma and Eosinophilia

Especially eosinophilia of teh urinary tract or prostate

Question 39

Giant Cell arteritis Definition

Answer 39

Necrotizing inflammation of the large sized arteries originating from the arch of the aorta

Question 40

Is Giant cell arteritis associated with granulomas?

Answer 40

YUP

Question 41

Is it associated with glomerulonephritis?

Answer 41

Nopw

Question 42

What is polymyalgia rheumatic and what is it associated with?

Answer 42

a clinical syndrome characterized by AM stiffness, pain in the pelvic girdle, shoulder. It is sometimes associated with Temporal arteritis. May also lead to Giant Cell temporal arteritisTa

Question 43

Takayasu’s arteritis definition

Answer 43

Necrotizing inflammation of large arteries with involvement of the aortic arch and its branches

Question 44

Granulomas?

Answer 44

check

Question 45

Glomerulonephritis in Takaysu

Answer 45

Nope

Question 46

Who does Takayasu’s arteritis usuallly affect?

Answer 46

Girls and young women of asian descent

Question 47

Clinical manifestations of Takaysu?

Answer 47

Renal involvement, GI involvement (nausea, diarrhea, ischemic bowel disease), Cardiac symptoms with angina pectoris, musculoskeletal

Question 48

Bechet’s Disease

Answer 48

Look at Kenny’s sheet