R/O - Vasculitis and fibromyalgia Flashcards Preview

Year 2 Specialty Medicine > R/O - Vasculitis and fibromyalgia > Flashcards

Flashcards in R/O - Vasculitis and fibromyalgia Deck (23):
1

takayasu arteritis classification

3/6 of:
- age under 40
- claudication of extremities
- decreased brachial artery pulse
- BP difference over 10 mm Hg between arms
- bruit over subclavian or aorta
- arteriogram abnormality: occlusion or narrowing

2

what is the gold standard diagnostic test for takayasu arteritis?

angiogram

3

classic PAN affects what sized vessels?

small and medium

4

wegeners granulomatosis affects what sized vessels?

small and medium

5

churg strauss affects what sized vessels?

small and medium

6

kawasaki syndrome affects what sized vessels?

small and medium

7

takayasu affects what sized vessels?

large

8

HSP affects what sized vessels?

small

9

cryoglobulinemia affects what sized vessels?

small

10

what conditions can mimic systemic vasculitis?

- atheroembolic disease
- cardiac myxoma
- thrombotic disorders (anti phospholipid antibody syndrome, TTP)
- drug induced vascular damage (ergot, cocaine, amph)
- infective endocarditis

11

how is PAN differentiated from polyangiitis?

PAN:
- small and medium muscular artery
- renal vascular nephropathy
- no lung involvement
- ANCA NEGATIVE

POLYANGIITIS:
- small and medium arteries, arterioles, venules, capillaries
- glomerulonephritis
- lungs involved (33%)
- ANCA POSITIVE

12

wrist drop is seen in what vasculitis disorder?

PAN

13

subcutaneous nodules in hand - which vasculitis?

PAN

14

what is cryoglobulinemia?

immunoglobulins that undergo reversible precipitation in the cold

15

what are the clinical features related to immune complex deposition in cryglobulinemia?

- purpura
- arthralgia
- nephritis
- neuropathy

16

wegeners granulomatosis with polyangiitis classification

2/4 of:
- nasal or oral inflammation (ulcers, bloody nasal drainage)
- abnormal chest radiograph (nodules, fixed infiltrates, cavities)
- urinary sediment
- granulomatous inflammation on biopsy (wall of artery or arteriole, perivascular, or extravascular)

17

polymyalgia rheumatica: clinical features

- pelvic and shoulder girdle aching
- morning stiffness
- rapid response to low doses of corticosteroids****
- anemia

18

polymyalgia rheumatica: lab features

- anemia
- elevated ESR and CRP

19

giant cell arteritis: lab features

- elevated ESR
- elevated CRP
- anemia
- elevated alk phos

20

what is the first manifestation of giant cell arteritis?

PMR symptoms

21

definition: fibromyalgia

chronic pain disorder with unknown etiology and unclear pathophysiology

22

what is the (proposed) pathogenesis of fibromyalgia?

- temporal and spatial pain summation
- decreased endogenous pain inhibition
- unique to temporal brain activation of frontal cortex, motor cortex, and cingulate cortex in anticipation of pain
- significant reduction in total gray matter volume suggesting premature aging
- higher levels of glutamine in right posterior insula

23

what are the clinical manifestations of fibromyalgia?

- widespread musculoskeletal pain
- paresthesias
- fatigue
- cognitive and mood disturbances
- depression and/or anxiety
- headache