Vasculitides

Question 1

Define vasculitides

Answer 1

Primary vasculitides are classified based on MAIN VESSEL SIZE affected
- Large, medium, small

Question 2

Define vasculitis

Answer 2

Inflammation & necrosis of blood vessels

Question 3

Types of vasculitides - large vessel

2

Answer 3

Giant cell arteritis

Takayasu’s aortitis

Question 4

Types of vasculitides - medium vessel

2

Answer 4

Polyarteritis nodosa

Kawasaki’s disease

Question 5

Types of vasculitides - small vessel

6

Answer 5

Churg-Strauss syndrome
Microscopic polyangiitis 
Wegner’s granulomatosis
Henoch-Schonlein purpura
Mixed essential cryoglobinaemia (MEC)
Relapsing polychondritis

Question 6

Aetiology of vasculitides

3

Answer 6

UNKNOWN
Suggested autoimmune origin
Immune complex deposition in the walls of blood vessels leads to inflammation

Question 7

Risk factors for vasculitides

4

Answer 7

Hepatitis B - polyarteritis nodosa
Hepatitis C - mixed essential cryoglobinaemia
pANCA - microscopic polyangitis & Churg-Strauss
c-ANCA - Wegner’s granulomatosis

Question 8

Epidemiology of vasculitides

prevalence, Takayasu group

Answer 8

RARE

Takayasu’s arteritis is most common in japanese females

Question 9

Presenting symptoms & signs of vasculitides - general

2 general + 4

Answer 9

Large vessel vasculitides have a classic clinical pattern based on the vessels affected
Medium & small vessel vasculitides are characterised by multi organ involvement & have less specific clinical features

Fever
Malaise
Night sweats
Weight loss

Question 10

Presenting symptoms & signs of vasculitides - skin

Answer 10

Rash

Question 11

Presenting symptoms & signs of vasculitides - joint

2

Answer 11

Arthralgia

Arthritis

Question 12

Presenting symptoms & signs of vasculitides - GI

3

Answer 12

Abdo pain
Haemorrhage
Diarrhoea

Question 13

Presenting symptoms & signs of vasculitides - kidney

2

Answer 13

Glomerulonephritis

Renal failure

Question 14

Presenting symptoms & signs of vasculitides - lungs

5

Answer 14

Dyspnoea
Cough
Chest pain
Haemoptysis
Haemorrhage

Question 15

Presenting symptoms & signs of vasculitides - CVS

3

Answer 15

Pericarditis
Coronary arteritis
Myocarditis

Question 16

Presenting symptoms & signs of vasculitides - CNS

2

Answer 16

Mononeuritis multiplex

Infarction

Question 17

Presenting symptoms & signs of vasculitides - eyes

2

Answer 17

Retinal haemorrhage

Cotton wool spots

Question 18

Presenting symptoms & signs of vasculitides - GCA

4

Answer 18

Loss of vision
Jaw claudication
Headache
Scalp tenderness

Question 19

Presenting symptoms & signs of vasculitides - polyarteritis nodosa
(5)

Answer 19

Micro aneurysms
Thrombosis 
Infarctions
Hypertension
Testicular pain

Question 20

Presenting symptoms & signs of vasculitides - Henoch-Schonlein purpura
(5)

Answer 20

Purpura
Arthritis
Gut symptoms 
Glomerulonephritis 
IgA deposition

Question 21

Presenting symptoms & signs of vasculitides - Wegner’s granulomatosis
(7)

Answer 21

Granulomatous vasculitis of upper & lower respiratory tract
Nasal discharge 
Ulceration & deformity
Haemoptysis 
Sinusitis
Glomerulonephritis 
Saddle nose

Question 22

Investigations for vasculitides

6 types

Answer 22

Bloods

Autoantibodies

Urine

CXR

Biopsy

Angiography

Question 23

Investigations for vasculitides - bloods

2

Answer 23

FBC - normocytic anaemia, high platelets, high neutrophils

High ESR/CRP

Question 24

Investigations for vasculitides - autoantibodies

Answer 24

e.g. cANCA in Wegner’s

Question 25

Investigations for vasculitides - urine

3

Answer 25

Haematuria
Proteinuria
Red cell casts (if glomerulonephritis)

Question 26

Investigations for vasculitides - CXR

2

Answer 26

Diffuse, nodular or flitting shadows

Atelectasis

Question 27

Investigations for vasculitides - biopsy

3

Answer 27

Renal
Lung
Temporal artery (in GCA)

Question 28

Investigations for vasculitides - angiography

Answer 28

To identify aneurysms (in PAN)