Ch 3 - Rheumatology: Vasculitides

Question 1

What does Takayasu Arteritis affect?

Answer 1

Large arteries—aorta

Question 2

Who does Takayasu Arteritis affect?

Answer 2

Asian females

40 years old

Question 3

What are clinical features of Takayasu Arteritis?

Answer 3

– Erythema nodosum on the legs

– Pulselessness, arm claudication

Question 4

What does Temporal Arteritis (giant cell arteritis) affect?

Answer 4

Large arteries

Question 5

Who does Temporal Arteritis (giant cell arteritis) affect?

Answer 5

More common in females >50 years old

Question 6

What are symptoms of Temporal Arteritis (giant cell arteritis)?

Answer 6

– Tenderness of the scalp and in the muscle of mastication
– Headaches
– Abrupt visual loss in 15% of patients

Question 7

What is Temporal Arteritis (giant cell arteritis) associated with?

Answer 7

polymyalgia rheumatica

Question 8

How is Temporal Arteritis (giant cell arteritis) diagnosed?

Answer 8

Elevated ESR

Temporal artery biopsy

Question 9

What are treatments of Temporal Arteritis (giant cell arteritis)?

Answer 9

High dose steroids ASAP imperative to preventing permanent vision loss
ASA 325 mg daily—improves prognosis

Question 10

Describe the association of Polymyalgia Rheumatica with temporal arteritis.

Answer 10

16% of PMR patients develop temporal arteritis, and 50% of temporal arteritis patients have PMR symptoms

Question 11

What are symptoms of Polymyalgia Rheumatica?

Answer 11

– Fever, weight loss, malaise
– Proximal muscles
– Morning stiffness/ muscle tenderness
– Abrupt myalgias/arthralgia

Question 12

How is Polymyalgia Rheumatica diagnosed?

Answer 12

ESR > 50

Question 13

What are treatments of Polymyalgia Rheumatica?

Answer 13

Steroids

Question 14

What is Polyarteritis Nodosa?

Answer 14

Systemic necrotizing vasculitis involving small/ medium-sized arteries

Question 15

Who is affected by Polyarteritis Nodosa?

Answer 15

2:1 male:female ratio

Question 16

What are clinical features of Polyarteritis Nodosa?

Answer 16

• Glomerulonephritis—#1 cause of death
• Lungs spared
• Skin—palpable purpura
• Mononeuritis multiplex, arthritis

Question 17

What disorders are associated with Polyarteritis Nodosa?

Answer 17

• RA
• SLE
• Sjögren’s syndrome

Question 18

What are types of Anti-neutrophil cytoplasmic Ab (ANCA) associated vasculitides?

Answer 18

Granulomatous vasculitis (Formerly Wegener’s Granulomatosis)
Microscopic Polyarteritis
Churg–Strauss Syndrome

Question 19

What is affected in Granulomatous vasculitis (Formerly Wegener’s Granulomatosis)?

Answer 19

Small-to-medium-sized artery involvement

Question 20

Who is affected in Granulomatous vasculitis (Formerly Wegener’s Granulomatosis)?

Answer 20

More common in middle-aged males

Question 21

What are clinical features of Granulomatous vasculitis (Formerly Wegener’s Granulomatosis)?

Answer 21

• Necrotizing granulomatous vasculitis involving:
– Upper/lower respiratory tract
– Focal segmental glomerulonephritis
• “Saddle-nose” deformity
• Pulmonary, tracheal, ocular, and cutaneous manifestation

Question 22

What is affected in Microscopic Polyarteritis?

Answer 22

Small-to-medium arteries involved

Question 23

What are clinical features of Microscopic Polyarteritis?

Answer 23

• Few or no immune deposits seen

* Renal and pulmonary involvement

Question 24

What is affected in Churg–Strauss Syndrome?

Answer 24

Small-to-medium arteries involved

Question 25

What are clinical features of Churg–Strauss Syndrome?

Answer 25

• Eosinophil-rich and granulomatous inflammation
• Respiratory tract involvement predominates:
– Associated with asthma, eosinophilia
• Neuropathy common

Question 26

What are clinical features of Behçet’s Syndrome?

Answer 26

• Small vessels involved
• Oral and genital skin ulcers
• 20% of patients experience venous thrombosis

Question 27

What are clinical features of Goodpasture’s Syndrome?

Answer 27

Pulmonary and kidney involvement

Question 28

What is the cause of Goodpasture’s Syndrome?

Answer 28

Abs to glomerular basement membrane