Vasculitis Flashcards

1
Q

Which vasculitis have granulomas? (4)

A

GPA
EPG
Takayasu
GCA

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2
Q

What are the small vessel vasculitites?

A
Wegner's 
Churg -Strauss
Microscopic polyangitis
HSP
Hypersensitivity vasculitis
Vasculitis secondary to CTS
Vasculitis secondary to viral infection
Cryoglobulinaemic
Lupus vasculitis
Behcet's
Goodpasture's 
Paraneoplastic
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3
Q

What are the medium vessel vasculitis?

A

Polyarteritis nodosa
Kawasaki
Isolate CNS vasculitis

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4
Q

What are the large vessel vasculitis?

A

GCA

Takayasu

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5
Q

Which vasculitis do you get ANCA in?

A

Wegner’s, MPA, Churg strauss, drug induced, IBD, rheumatoid vasculitis and other CTD associated vasc
PR3 in CF patients

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6
Q

pANCA correlates with

cANCA correlates with

A

pANCA- MPO

cANCA-PR3

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7
Q

MPO associated with?

A

MPA 70%
Wegner’s 10%- haematuria and lower relapse rate
Anti-GBM (40%)

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8
Q

PR3 associated with?

A

Wegner’s - higher relapse rate, more ENT disease

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9
Q

Clinical features when suspect a vasculitis?

A
Palpable purpura
Nose bleeds, sinusitis
Fever
Haemoptysis
Mononeuritis multiplex
Fatigue, weakness, arthralgia
Abdominal pain
Hypertension and renal insuffieciency
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10
Q

What does finding of “atypical” ANCA suggest?

A

Other than vasculitis eg CTD, IBD, autoimmune hepatitis

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11
Q

What proportion of Churg Strauss can be ANCA associated?/

A

50%

Can be MPO or PR3

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12
Q

What do you expect on renal limited vasculitis biopsy?

A

Little or no deposition of immune reactants like Ig and complement proteins.

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13
Q

Classic vasculitis drugs for ANCA positive?

A
Hydralazine
Phenytoin 
PTU
allopurinol
sulfasalazine
minocycline
cipro
clozapine
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14
Q

What is the ANCA positivity rates for UC and Crohn’s?

A

60-80% UC and PSC

10-25% Crohn’s

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15
Q

Do GPA, CSS, MPA have immune deposits?

A

Unlike other causes small vessel vasculitis- no

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16
Q

best way to distinguish churg strauss from MPA

A

asthma and eosinophilia

17
Q

Do you HAVE to get a biopsy?

A

YES!
For god’s sake the toxicity of treatment is too high to get it wrong.
Need a biopsy ?pauci-immune crescentic GN
But don’t wait for results, get

18
Q

True or false- S aureus in the nose increases risk Wegner’s?

A

False

Increases risk relapse but no evidence that it is pathogenic.

19
Q

What test should everyone with Wegner’s have done?

A

Alpha 1 AT genotype

not levels- as is an acute phase reactant

20
Q

Classic Wegner’s symptoms?

A

Upper: Nasal or oral inflammation with bloody discharge, OM, subglottic stenosis
Chest: cough, wheeze, fleeting pulm infiltrates
Migratory arthralgias
Microscopica haematuria
Conjuntivitis, episcleritis, proptosis, diplopia, uveitis
heart: conduction defects, pericarditis, coronary vasculopathy

21
Q

Histopath of Wegner’s

A

pauci-immune crescentic GN or focal and segmental