Vasculitis Pathophys Flashcards
Polyarteritis Nodosum is a vasculitis of what size vessels
Medium mostly. Spares the Large elastic arteries like the aorta and also spares small vessels such as arterioles, venules, capillaries.
Does PAN cause Glomerulonephritis
Nope…SO no RBC casts in the urine
What disease predisposes to PAN in 30% of pts
Hepatitis B
What is the cousing of Polyarteritis Nodosum that affects very small vessels?
Microscopic polyangittis
Polyarteritis tends to affect which sex
Male (2:1)
What is one symptom that should automatically make you think PAN
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
What are some other clinical signs and symptoms of Polyarteritis Nodosum
Kidney involvement, GI involvement, cardiac,
What ORgan system does PAN spare
THE LUNGS!!!!
Diagnosis of PAN
biopsy
What will you see on PAN biopsy
Fibrinoid Necrosis!
Treatment plan for PAN?
Treat the underlying Hep B if it exists
Also treat with steroids and cytotoxic agents.
THey will probably die
What makes Microscopic polyangitis different from PAN
It affects very small vessels
It DOES cause Glomerulonephritis
It DOES cause lung involvement
ANd it is way more common than PAN
Granulmoas associated with PAN or Microscopic Poly
Trick question, NEither
Is microscopic polyangiitis associated with anti-nbeutrophil antibodies>?
Yeah… P-ANCA
Granulomatosis with polyangiitis definition?
Focal necrotizing vasculitis of medium and small vessels
What is teh prototypical Pauci Immune vasculitis?
Granulomatosis with Polyangiitis
Classic triad of P w/G
ELK (ENT, Lung, Kidney)
Other Pw/G signs and symptoms
Systemic like fever, wt loss, malaise
Describe the ELK signs
E: Nasal ulcerations, mucosal ulcerations, saddle nose
L: Pulmonary infiltrates and nodules
K: Glomerulonephritis
SADDLE NOSE=
WEGNERS
Allergic Granulomatosis with polyangitis is also called
Henoch Schonlein Purpura
HSP genearlly follows
exposure to a specific drug
HSP is more common in?
Kids
IgA is high in what disease?
HSP!!!
HSP tetrad
Purpura, arthritis, abdominal pain, Glomerulonephritis (PAAG)
Skin involvement in HSP is usually where?
Lower extremities and buttocks
PAAG tetrad of HSP broken down
Purpura, Arthritis, Abdominal Pain, Glomerulonephritis
HSP prognosis
GOOD! usually just goes away
Buerger’s disease usually affects what first
vascular supply to the lower limbs
Signs and symptoms of Buerger’s
Bilateral pain and ischemia in the lower limbs, though upper extremities may be affected first in the cold
Cogan’s Syndrome?
rare form of vasculitis in young adults presented with red and painful eyes.
Susac’s syndrome
Rare as shit. Presents with onset of hearing loss with encephalopathy and branch retinal occlusions
Cryoglobulinemic Vasculitis?
Palpable purpura with ulcers, Neuropathy, Raynaud’s, Digital Ischemia, Secondary Sjogrens
Allergic Granulomatosis with Polyangiitis is also called
Churg Strauss syndrome
Churg Strauss syndrome and glomerulonephritis
yes…remember, it is just allergic P w/G and P w/ G involves glomerulonephropathy
Is churg Strauss associateed with granuloma formation
DUh. It is just allergic P W/ G.
What antibody is Churg Strauss associated with
P- anca
Two big symptoms to connect Churg Strauss with?
Asthma and Eosinophilia
Especially eosinophilia of teh urinary tract or prostate
Giant Cell arteritis Definition
Necrotizing inflammation of the large sized arteries originating from the arch of the aorta
Is Giant cell arteritis associated with granulomas?
YUP
Is it associated with glomerulonephritis?
Nopw
What is polymyalgia rheumatic and what is it associated with?
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
Takayasu’s arteritis definition
Necrotizing inflammation of large arteries with involvement of the aortic arch and its branches
Granulomas?
check
Glomerulonephritis in Takaysu
Nope
Who does Takayasu’s arteritis usuallly affect?
Girls and young women of asian descent
Clinical manifestations of Takaysu?
Renal involvement, GI involvement (nausea, diarrhea, ischemic bowel disease), Cardiac symptoms with angina pectoris, musculoskeletal
Bechet’s Disease
Look at Kenny’s sheet
