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Vasculitis (Postlew) Flashcards

This is not all-encompassing, just tried to hit some high points

1
Q

Primary finding in vasculitis

A

inflammation within blood vessel walls

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2
Q

What arteries does Polyarteritis Nodosa affect?

A

medium-sized

spares arterioles, venules, capillaries

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3
Q

Polyarteritis Nodosa is associated with…

A

Hep B (30% of patients)

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4
Q

Polyarteritis Nodosa: epidemiology

A

slight male predominance

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5
Q

Polyarteritis Nodosa: Clinical Manifestations

A
  • -neuropathy
  • -kidney involvement (= HTN and renal failure)
  • -testicular tenderness
  • -cardiac involvement (MI, CHF, pericarditis)
  • -skin (livedo reticularis)
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6
Q

Polyarteritis Nodosa: lab findings

A

↑ESR, ↑CRP, hematuria, ↑creatinine

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7
Q

Cutaneous Polyarteritis Nodosum is associated with…

A

Hep C

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8
Q

How is Buerger’s Disease characterized?

A

Granulomatous inflammation, which predominantly affects vascular supply to the lower limbs

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9
Q

Buerger’s Disease: epidemiology

A

young adult M, tobacco smokers

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10
Q

Which CT disorders can be associated with IC-mediated vasculitis?

A

SLE, Sjögren’s syndrome, and RA

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11
Q

What is the most prominent feature in Immune Complex-Mediated Small Vessel Vasculitis?

A

Cutaneous involvement of small blood vessels

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12
Q

What is the classic cutaneous symptom associated with Immune Complex-Mediated Small Vessel Vasculitis?

A

palpable purpura

pustules, vesicles, urticaria, small ulcerations may also be found

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13
Q

Hypersensitivity Vasculitis usually occurs secondary to…

A

drug exposures or infections

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14
Q

How is Hypersensitivity Vasculitis characterized?

A

IC deposition in capillaries, postcapillary venules and arterioles

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15
Q

Clinical manifestations of Hypersensitivity Vasculitis?

A
  • -purpura
  • -arthritis
  • -glomerulonephritis
  • -colicky abdominal pain
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16
Q

Henoch-Schonlein Purpura: epidemiology

A

90% in children

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17
Q

What vessels does Henoch-Schonlein Purpura affect?

A

small vessels, primarily postcapillary venules

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18
Q

What is characteristically present in Henoch-Schonlein Purpura?

A

IgA

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19
Q

Henoch-Schonlein Purpura: classic tetrad

A

purpura, arthritis, abdominal pain, GN

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20
Q

Henoch-Schonlein Purpura: lab findings

A

↑ESR, ↑CRP, hematuria, ↑creatinine, RBC casts present (if renal involvement)

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21
Q

Cryoglobulinemia Vasculitis is most often associated with…

A

long-standing hep C infection

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22
Q

How are types II/III of Cryoglobulinemia Vasculitis different than type I?

A

IgM and IgG (polyclonal)
associated with hep C, Sjogrens, SLE
result in IC-mediated vasculitis

23
Q

Cryoglobulinemia Vasculitis: clinical manifestations

A
  • -palpable purpura with ulcers
  • -systemic symptoms
  • -neurological involvement, peripheral neuropathy
  • -Raynaud’s
  • -Digital ischemia (often secondary to cold_
  • -Secondary Sjogren’s
24
Q

Cryoglobulinemia Vasculitis: lab findings

A

↑ESR, ↓C4, (+) RF

25
What happens if heparin is in collection tubes when trying to dx Cryoglobulinemia Vasculitis?
can → false (+) cryofirinogen
26
Cryoglobulinemia Vasculitis: pathology
leukocytoclastic vasculitis with IgM + C3 deposits in/around small and medium sized vessels
27
What vessels does Giant Cell Arteritis (Temporal) affect?
large sized arteries originating from the arch of the aorta
28
How is Giant Cell Arteritis characterized?
Granulomatous inflammation
29
Giant Cell Arteritis: epidemiology
Age >50, Females 3:1, Northern European ancestry
30
Giant Cell Arteritis: potentially serious complication
thoracic aortic aneurysms
31
Clinical Manifestations of GCA?
- -Systemic symptoms (fever, weight loss, fatigue) - -Temporal headaches - -Visual disturbances (can progress to sudden blindness; due to ↓blood to ophthalmic a) - -Jaw or tongue claudication - -Arthralgias - -Tender, swollen temporal artery
32
GCA: lab findings?
markedly elevated ESR
33
If you think a patient may have Giant Cell Arteritis, what is the first thing you should do?
begin trx to prevent blindness; do NOT wait for biopsy
34
What vessels does Takayasu’s Arteritis affect?
large-sized arteries + involvement of aortic arch + branches (+ coronary/pulm arteries)
35
How is Takayasu’s Arteritis characterized?
Granulomatous inflammation
36
Takayasu’s Arteritis: epidemiology
adolescent girls and young women of Asian descent
37
What vessels does Kawasaki Disease affect?
small and medium-sized muscular arteries, especially coronary arteries
38
Kawasaki Disease: epidemiology
Children, Asian ancestry
39
Kawasaki Disease is known to cause...
acquired heart disease (**esp in US and Japan)
40
What causes most of the mortality in Kawasaki Disease?
Coronary lesions | diseases causes pericardial effusion, myocarditis, aneurysms, MI
41
Clinical Manifestations of Kawasaki Disease?
fever, rash, strawberry tongue, erythema of palms/soles, edema of hands/feet, conjunctival injection...
42
What occurs in the second week of Kawasaki Disease?
profound lymphocytosis
43
Cutaneous vasculitis in Connective Tissue Diseases is associated with...
hypocomplementemia and ↑↑ANAs
44
Pathology associated with Connective Tissue Disease Associated Vasculitis?
IgG and C3 deposition in/around dermal blood vessels +/- IgM
45
What are the hallmarks of Rheumatoid Vasculitis?
- -Pupuric lesions +/- concomitant medium vessel vasculitis | - -Deep cutaneous ulcer over malleoli
46
Rheumatoid Vasculitis typically occurs in patients with what condition?
nodular, joint-destructive, RF(+) RA
47
Clinical manifestations associated with Microscopic Polyangiitis?
- -glomerulonephritis - -lung involvement + pulm hemorrhage - -skin involvement - -systemic symptoms
48
Microscopic Polyangiitis: lab findings
``` ↑ ESR ↑ CRP RBC casts in urine ↑creatinine ANCA positive (usually p-ANCA) ```
49
Granulumatosis With Polyangiitis: Clinical Manifestations (classic triad?)
**ENT, respiratory tract and kidney involvement glomerulonephritis, sinusitis, nasal ulcerations, saddle nose, +/- pulm infiltrates or nodules
50
Most notable lab finding associated with Granulumatosis with Polyangiitis?
C-ANCA
51
Allergic Granulomatosis With Polyangiitis: lab findings
↑ESR, eosinophilia, eosinophiluria, RBC casts, proteinuria
52
Allergic Granulomatosis With Polyangiitis: Clinical manifestations
Systemic symptoms (fever, weight loss, fatigue) Lungs: dyspnea, cough Neurological: peripheral neuropathy GU: eosinophilic granulomas of urinary tract and/or prostate
53
Bechet’s Disease: clinical manifestations
- -Oral and genital ulcers - -ocular lesions - -Cutaneous lesions (pyoderma gangrenousum-like lesions, pathergy lesions) - -arthritis
54
Bechet’s Disease: epidemiology
20’s and 30’s, M=F | in US/Korea/China F>M, in Middle East M>F

MS/Rheum (23 decks)

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