Vasculitis Flashcards

1
Q

Infectious causes of vasculitis

A

Fungal (Aspergillus), Bacterial (Pseudomonas), Viral (CMV)

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2
Q

Epidemiology of Temporal (Giant Cell) Arteritis

A

Elderly (>50) white females of Northern European ancestry

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3
Q

Why must you be elderly to get Temporal (Giant Cell) Arteritis?

A

Giant cells attack only CALCIFIED internal elastic lamina in arteries

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4
Q

Most severe complication of Temporal (Giant Cell) Arteritis?

A

Blindness (why you must make the dx)

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5
Q

Symptoms/Signs of Temporal (Giant Cell) Arteritis?

A

Headache, Swollen tender artery, visual disturbances, jaw claudication

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6
Q

Main immune cells involved in Temporal Arteritis?

A

Dendritic Cells and Th1 cells

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7
Q

Tx for Temporal Arteritis?

A

Corticosteroids and anti-TNF therapy, almost complete reduction in Th17 cells

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8
Q

MMPs up-regulated in Temporal Arteritis?

A

MMP-2 and MMP-9, destroy the elastin

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9
Q

What must you know about doing a biopsy for Temporal Arteritis?

A

The disease can be segmental so false negatives are possible (commonly only lymphocytic on biopsy)

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10
Q

Blood test important for dx of Temporal Arteritis?

A

ESR, normally >100

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11
Q

Epidemiology of Takayasu Arteritis?

A

Young east Asian females and children

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12
Q

Most important clinical manifestations of Takayasu Arteritis?

A

Pulseless upper extremity, difference in bilateral blood pressures, visual defects

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13
Q

Pathogenesis of Takayasu Arteritis?

A

Necrotizing granulomatous vasculitis of the Aortic Arch and its vessels–> Aortic tear, dissection, or rupture

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14
Q

Cardiac complication of Takayasu Arteritis?

A

Cardiac Tamponade

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15
Q

Tx for Takayasu Arteritis?

A

Corticosteroids and Cytotoxic immunosuppression

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16
Q

Epidemiology of Polyarteritis Nodosa?

A

White males in their 40s

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17
Q

Important presentation of Polyarteritis Nodosa?

A

Neuropathy (sensory or motor like wrist/foot drop), Renal involvement with HTN

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18
Q

Effect of Polyarteritis Nodosa on the Lungs?

A

None

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19
Q

Skin change seen with Polyarteritis Nodosa?

A

Livedo Reticularis (mottled discoloration of the skin)

20
Q

Most distinguishing microscopic characteristic of Polyarteritis Nodosa?

A

Fibrinoid Necrosis, neutrophilic in the acute phase

21
Q

HBsAg (Hepatitis B) is associated with? (not diagnostic)

A

Polyarteritis Nodosa

22
Q

Tx of polyarteritis Nodosa?

A

Corticosteroids and cytotoxic immunosuppression (if necessary)

23
Q

Angiogram appearance of Polyarteritis Nodosa?

A

“Beads on a String”, focal vasculitis producing nodular lesions

24
Q

Epidemiology of Kawasaki Disease?

A

East Asian children < 5 (usually presents around age 1)

25
Q

Symptoms/Signs of Kawasaki Disease?

A

Polymorphous rash, cervical lymphadenopathy, erythema/edema/desquamination of hands and feet (KNOW THIS), and “strawberry tongue” glossitis (KNOW THIS)

26
Q

Pathophysiology of Kawasaki Disease?

A

Necrotizing vasculitis of the coronary arteries, patients get coronary aneurysms, MIs, and SCD if untreated

27
Q

Tx for Kawasaki Disease?

A

ASA and IVIG

28
Q

What is Reye syndrome?

A

Rare condition causing cerebral edema and hepatic steatosis when taking ASA for viral illness (he didn’t teach us this, but “Reye Syndrome” is in his slides)

29
Q

Prognosis for Kawasaki Disease?

A

Good if treated, most aneurysms resolve

30
Q

Pathophysiology of Microscopic Polyangiitis?

A

Necrotizing fibrinoid vasculitis of capillaries, small arterioles, and venules (mostly glomeruli and pulmonary capillaries)

31
Q

How can you differ Microscopic Polyangiitis from Wegner’s granulomatosis?

A

Microscopic Polyangiitis has no nasopharyngeal involvement

32
Q

Antibodies seen in Microscopic Polyangiitis?

A

p-ANCA (anti-Myeloperoxidase)

33
Q

Epidemiology of Wegner’s Granulomatosis?

A

Whites in their 40s, men and women equally affected

34
Q

Pathophysiology of Wegener’s Granulomatosis?

A

Necrotizing granulomatous vasculitis of arteries and veins in the respiratory tract (+ hemoptysis) and kidneys

35
Q

Common findings of physical exam for Wegener’s Granulomatosis?

A

Mucosal ulcers, nasal septal cartilage destruction, and other nasopharyngeal lesions (distinguishes it from micorscopic polyangiitis)

36
Q

Tx of Wegener’s Granulomatosis?

A

Corticosteroids and Rituximab (B cell involvement)

37
Q

Triad seen in Churg Strauus Syndrome?

A

Asthma, Vasculitis, and Eosinophila (KNOW THIS)

38
Q

Antibody seen in Churg Strauss Syndrome?

A

p-ANCA (not dx)

39
Q

Epidemiology of Buerger Disease?

A

Young male smokers of Middle Eastern and South Asian ancestry

40
Q

Pathophysiology of Buerger Disease?

A

inflammatory thrombosing vaso-occlusive disease of arteries/veins of the limbs

41
Q

Tx for Buerger disease?

A

Stop smoking and amputation for gangrene

42
Q

Pathophysiology of peripheral arterial disease?

A

Chronic atherosclerotic occlusive disease of large/medium arteries of the legs

43
Q

Symptoms of peripheral arterial disease?

A

Intermittent claudication (leg pain with exercise, relieved by rest). Mainly in the calf muscles (femoral/popliteal arteries). Ulcers and pain at rest–> severe disease

44
Q

The signs/symptoms of peripheral arterial disease (the 5 Pee Pees)

A

Pain, pallor, paralysis, paresthesia, and pulselessness

45
Q

Tx for peripheral arterial disease?

A

Exercise, especially walking. Helps to develop collateral perfusion

46
Q

Tx for acute arterial occlusion?

A

Emergency surgery