Vasculitis (R5)

Question 1

What is Vasculitis?

Answer 1

Diseases involving inflammation of blood vessels with subsequent tissue destruction and/or organ failure

A heterogeneous group of diseases, linked by common, clinical, laboratory and pathophysiologic features

Question 2

The endothelium is an active player in inflammatory process, list the 2 possible outcomes of BV inflammation

Answer 2

Question 4

What classification system exists for vasculitis

Answer 4

Chapel Hill 2012 Classification

Question 5

Which blood vessels and organs can be affected in vasculitis?

Answer 5

ANY blood vessel can be affected! (arteries, arterioles, capillaries, venules, veins)

ANY organ can be damaged

Question 6

List 4 possible symptoms a patient may present with that should make you suspect vasculitis

Answer 6

Question 8

As clinicians what steps must we do when treating/consulting a patient with vasculitis/possible vasculitis

Answer 8

Detailed history, meticulous physical examination and appropriate laboratory tests to determine organ systems involved and the extent of involvement are the components of the diagnostic process

Question 10

List some investigations/tests for diagnosis of vasculitis

Answer 10

Question 11

Revise slide on vasculitis

Answer 11

Question 12

What is Giant cell arteritis?

What arteries are affected in cranial vs extracranial

Answer 12

Inflammatory vasculopathy affecting large arteries

Question 13

List 4 clues that indicate the type of vasculitis is most likly ‘Small vessel vasculitis’

Answer 13

1. palpable purpura, ulcers
2. glomerulonephritis
3. GI bleeding
4. pulmonary hemorrhage, infiltrates, cavities, nodules
5. peripheral neuropathy

Question 14

List 4 clues that indicate ‘medium vessel vasculitis’

Answer 14

1. nodules, livedo reticularis,
2. digital ischemia, infarcts, gangrene
3. mesentric ischemia
4. ischemic renal failure
5. testicular pain, tenderness

Question 15

List 4 clues that indicate the type of vasculitis is most likly ‘large vessel vasculitis’

Answer 15

1. stroke
2. blindness
3. jaw claudication, limb claudication
4. reduced/absent pulses, bruits

Question 16

What is polymyalgia rheumatica?

Answer 16

Syndrome of pain and stiffness, affecting proximal muscles of shoulder and pelvic girdle

Question 20

List 4 symptoms of giant cell arteritis

Answer 20

1. Headaches
2. Scalp tenderness
3. Jaw claudication
4. Tongue claudication
5. VISUAL LOSS
6. 50%: PMR

Question 21

What lab findings are indicative of giant cell arteritis?

Answer 21

Increased ESR, CRP, PLT

BIOPSY OF TEMPORAL ARTERY

Question 22

How do we treat giant cell arteritis?

Answer 22

steroids

Question 24

10% of polymyalgia rheumatica patients will develop what?

Answer 24

Giant cell arteritis

Question 25

State the diagnostic criteria for polymyalgia rheumatica (5)

Answer 25

1. Age >50
2. ESR >40 mmHg
3. Pain persisting for > 1 month and involving 2 of the following areas: neck, shoulders, pelvic area
4. EMS >1 H
5. RAPID RESPONSE TO STEROIDS (pathognomic)