17.Αγγείτιιδες (εκτός πορφύρα, δικτυωτή πελίδνωση) [550-569] Flashcards

(31 cards)

1
Q

Name three clinical findings commonly associated with temporal (giant cell) arteritis

A

Unilateral headache (temporal artery), jaw claudication, and impaired vision/irreversible blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which MPO-ANCA/p-ANCA7#8211;positive vasculitis is a granulomatous vasculitis with eosinophilia?

A

Churg-Strauss syndrome (also called eosinophilic granulomatosis with polyangiitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A 60-y/o woman with polymyalgia rheumatica has a unilateral headache and jaw claudication. What disease process may cause blindness in her?

A

She is most likely experiencing temporal arteritis, in which occlusion of the ophthalmic artery can result in irreversible blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Patients with temporal arteritis may also have which rheumatologic condition? What population is the most commonly affected?

A

Polymyalgia rheumatica; elderly women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In Churg-Strauss syndrome, the patient will test positive for ____ (p-ANCA/c-ANCA) in serum.

A

p-ANCA (MPO-ANCA)—usually has an elevated IgE level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Temporal arteritis is associated with what laboratory test results? What is the treatment?

A

Elevated erythrocyte sedimentation rate; high-dose steroids prior to biopsy prevent blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

All ANCA-positive vasculitides affect ____ (small/medium/large) vessels.

A

Small

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A 78-y/o woman with polymyalgia rheumatica presents with an intense temporal headache. What types of arteries are likely affected?

A

Large arteries, usually branches of the carotid artery (she has temporal arteritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common childhood systemic vasculitis? It often presents after what disease?

A

Henoch-Schönlein purpura; typically follows upper respiratory infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A 7-year-old girl has arthralgias, abdominal pain, and purpura on her legs after an upper respiratory infection. Pathophysiology?

A

Associated with IgA nephropathy (the patient has Henoch-Schönlein purpura, a small-vessel vasculitis 2° to IgA immune complex deposition)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the triad of Henoch-Schönlein purpura?

A

Palpable purpura on the buttocks and legs, arthralgias, and abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Takayasu arteritis is associated with what laboratory finding? What histologic findings are seen on biopsy of affected vessels?

A

An elevated erythrocyte sedimentation rate; one sees granulomatous thickening and narrowing of affected vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the symptoms of Takayasu arteritis? What is the most affected demographic?

A

Fever, night sweats, arthritis, weak upper extremity pulses, myalgias, skin nodules, ocular disturbances; Asian females younger than 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is polyarteritis nodosa?

A

Immune complex–induced necrosis of medium-sized arteries typically involving the renal and visceral vessels (but not pulmonary arteries)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name 10 clinical findings associated with polyarteritis nodosa.

A

Fever, weight loss, malaise, abdominal pain, melena, headache, hypertension, neurologic dysfunction, cutaneous eruption, renal damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Polyarteritis nodosa is strongly associated with which infectious disease?

A

Hepatitis B (30% of patients are seropositive)

17
Q

Polyarteritis nodosa most commonly affects which population? Describe its histologic appearance.

A

Young adults; transmural inflammation of arterial wall with fibrinoid necrosis due to immune complex deposition

18
Q

Fever and which five clinical findings are associated with Kawasaki disease?

A

Conjunctival injection, Rash, cervical Adenopathy, Strawberry tongue (mucositis), Hand/foot changes (edema/erythema), & fever(CRASH & burn)

19
Q

What is Buerger disease?

A

A thrombosing vasculitis affecting the medium-sized peripheral arteries and veins of heavy smokers (usually men &60;40 years of age)

20
Q

Buerger disease goes by what other name?

A

Thromboangiitis obliterans

21
Q

What are three clinical findings associated with Buerger disease? What would a biopsy of an affected artery show?

A

Intermittent claudication, superficial nodular phlebitis, and Raynaud phenomenon; histology shows segmental thrombosing vasculitis

22
Q

What are the two main presentations of microscopic polyangiitis? Treatment?

A

Pauci-immune glomerulonephritis and palpable purpura (involves lungs, kidneys, and skin); treat with cyclophosphamide and corticosteroids

23
Q

What is granulomatosis with polyangiitis (Wegener granulomatosis)?

A

A small-vessel vasculitis characterized by focal necrotizing vasculitis, granulomas in the lung and upper airway, and glomerulonephritis

24
Q

A patient with Wegener granulomatosis may have which upper respiratory tract symptoms? Lower respiratory tract? Renal?

A

Perforation of nasal septum, chronic sinusitis, otitis media, mastoiditis; cough, dyspnea, hemoptysis; hematuria with red blood cell casts

25
In Wegener granulomatosis, x-ray of the chest may reveal what finding?
Large nodular densities
26
Wegener granulomatosis and microscopic polyangiitis have similar presentation. How can you differentiate between the two?
Wegener granulomatosis has nasopharyngeal involvement and necrotizing granulomas, whereas microscopic polyangiitis has neither
27
Η κνιδωτική αγγειτιδα είν
κλινοπαθολογική οντότητα
28
Κνιδωτική αγγείτιδα - κλινική εικόνα
Οι κνιδωτικές βλάβες διάρκούν περισσότερο από 24 ώρες και παρουσιάζουν πορφύρα και μεταφλεγμονώδη υπέχρωση και αίσθημα καύσου παρά κνησμού
29
Κνιδωτική αγγείτιδα - αιτιο
Ιδιοπαθής όταν υπάρχει χαμηλό συμπλήρωμα μπορει να συνυπάρχει άσθμα και συμμετοχή του γες Sjogran k SLE Ορονοσία
30
Κνιδωτική αγγείτιδα - εργαστηριακά
Αυξ. Τ.Κ.Ε | Υποσυμπληρωματία, θετικά αντιπυρηνικά αντισώματα σε χαμηλό τίτλο και αιματουρία
31
Κνιδωτική αγγείτιδα - Tx
``` Αντιισταμινκά για ήπιες περιπτώσεις ΜΣΑΦ Πρεδνιζολόνη Δαψόνη Κολχικίνη +υδροξυχλωροκίνη ```