PATH Vasculitis

Question 1

Most common symptom in Temporal Arteritis.

Answer 1

Headache

Question 2

Who gets GCA?

Answer 2

Elderly white females of Northern European ancestry

Question 3

Half of patients with GCA have what disesae?

Answer 3

Polymyalgia Rheumatica

Question 4

What are the three components of polymyalgia rheumatica?

Answer 4

(1) proximal muscle aches and stiffness
(2) elevated erythrocyte sedimentation rate
(3) rapid resolution of symptoms with
low-dose corticosteroid therapy

Question 5

What words describe the inflammation of temporal (giant cell) arteritis?

Answer 5

(1) Segmental
(2) Transmural
(3) Granulomatous with multinucleated giant cell centering on internal elastic lamina (destroying it)

Question 6

If you biopsy an artery to test for GCA, what do you do if it is negative?

Answer 6

Don’t rule it out! Segmental so false negatives are common

Question 7

Why is the fact that GCA is transmural important?

Answer 7

causes lumen narrowing (the big danger)

Question 8

How do you treat GCA?

Answer 8

High dose steroids (prednisone)

Question 9

GCA is pathologically similar to what disease?

Answer 9

Takayasu Arteritis

Question 10

What are the fatal components of Kawasaki disease?

Answer 10

aneurysms and thrombosis

Question 11

Who gets Kawasaki disease?

Answer 11

Asian children less than 4

Question 12

Describe the pathogenesis of hypersensitivity angiitis.

Answer 12

Neutrophils are the initial infiltrate that break down and cause leukocytoclasia (dispersing nuclear dust)

Question 13

What vessels are affected by hypersensitivity angiitis?

Answer 13

capillaries and post-capillary venules

Question 14

What is a characteristic finding of hypersensitivity angiitis?

Answer 14

all in the same phase!

Question 15

What are the characteristics of polyarteritis nodosa pathology?

Answer 15

Nodular feature in pathology + fibrinoid nicrosis

Question 16

Where in the medium sized vessels does polyarteritis nodosa occur?

Answer 16

artery branchpoints

Question 17

Why are the lesions in polyarteritis nodosa all at different stages?

Answer 17

they do NOT present early, they present once the disease has been progressing longer (because early lesions have started to heal and later lesions have just begun_

Question 18

Who gets takayasu arteritis?

Answer 18

young (<40), Asian females

Question 19

What arteries are affected by takayasu arteritis?

Answer 19

aorta or major branches

WILL NOT GO BELOW THE CHEST

Question 20

What vessels are affected mosly by Buerger disease?

Answer 20

radial and tibial (medium and small sized aretery)

Question 21

Who gets Buerger disease?

Answer 21

SMOKERS around 35 years old, south Asia

Question 22

True or false: Wegener’s also involves veins.

Answer 22

TRUE!

Question 23

What ANCA is associated with Wegener’s?

Answer 23

PR3 (C-ANCA)

Question 24

What disease has increased ACE and also has Lupus-like qualities?

Answer 24

Sarcoidosis