Vasculitides Flashcards
(144 cards)
1
Q
Gaint cell (temporal) arteritis: who and what age?
A
Female >50
2
Q
Gaint cell (temporal) arteritis: symptoms? (3)
A
unilateral headache
jaw claudication
possible temporal artery tenderness
3
Q
Gaint cell (temporal) arteritis: important complication?
A
irreversible blindness die to AION (anterior ischemic optic neuropathy)
4
Q
irriversible blindness in Gaint cell (temporal) arteritis: cause?
A
anterior ischemic optic neuropathy (AION)
= interruption of blood flow to the front (anterior) of the optic nerve
5
Q
Gaint cell (temporal) arteritis: associated with which other disease?
A
polymyalgia rheumatica
6
Q
which arteritis is associated with PMG?
A
Gaint cell (temporal) arteritis
7
Q
which arteritis is most common in female >50?
A
Gaint cell (temporal) arteritis
8
Q
unilateral headache, tenderness of temporal artery, jaw claudication
what can it be?
A
Gaint cell (temporal) arteritis
9
Q
which arteritis may lead to irreversible blindness due to AION?
A
Gaint cell (temporal) arteritis
10
Q
Gaint cell (temporal) arteritis: which artery branches most commonly affected?
A
carotid branches
11
Q
Gaint cell (temporal) arteritis: what kind of inflammation?
A
focal granulomatous
12
Q
Gaint cell (temporal) arteritis: which inflammation marker very high?
A
ESR
13
Q
Gaint cell (temporal) arteritis: levels of which cytokine correlate with disease activity?
A
IL-6
14
Q
Gaint cell (temporal) arteritis: treatment?
A
high dose glucocorticocoids
15
Q
Gaint cell (temporal) arteritis: when to apply treatment, before or after biopsy?
A
before
16
Q
Gaint cell (temporal) arteritis: diagnosis?
A
temporal artery biopsy
17
Q
Gaint cell (temporal) arteritis: why start treatment before biopsy?
A
to prevent blindness
18
Q
Takayasu arteritis: in who and what age?
A
asian female <40
19
Q
Takayasu arteritis: symptoms?
A
weak upper extremity pulses
fever, night sweats, arthritis, myalgias
skin nodules and ocular disturbances
20
Q
other name for Takayasu arteritis?
A
pulselessness disease
21
Q
pulselessness disease: what is this?
A
takayasu
22
Q
takayasu arteritis: pathophysiology?
A
granulomatous thickening/narrowing of aortic arch and proximal great vessels
23
Q
35 y/o chinese woman
weak upper extremity pulses,
night sweats, myalgias, skin nodules
elevated ESR
suggestive of?
A
takayasu
24
Q
takayasu: which inflammation marker elevated?
A
ESR
25
takayasu: treatment?
glucocorticoids
26
granulomatous thickening/narrowing of aortic arch and proximal great vessels
which disease?
takayasu
27
what are the large vessel vasculitides?
giant cell arteritis
takayasu
28
what are the medium vessel vasculitides?
Buerger, Kawasaki, polyarteritis nodosa
29
Buerger: in who?
males <40
heavy tabacco smoking
30
Buerger: other name?
thromboangiitis obliterans
31
Buerger: symptoms?
intermittent claudication
may lead to gangrene, autoamputation of digits, superficial nodular phlebitis
Raynaud phenomen often present
32
man 35, heavy tobacco smoking history
intermittent claudication, gangrene toe, Raynaud phenomen
suggestive of?
Buerger
33
Buerger: pathophysiology?
segmental thrombosing vasculitis
vein and nerve involvement
34
Buerger: treatment?
smoking cessation
35
segmental thrombosing vasculitis
vein and nerve involvement
what is this?
Buerger
36
Kawasaki: in who?
Asian kids <4
37
vasculitis common in asian kids <4?
kawasaki
38
kawasaki: symptoms?
CRASH and burn
Conjunctivitis
Rash
Adenopathy
Strawberry tongue
Hand and foot changes
and burn: fever
39
3 y/o japanese kid
fever, cervical adenopathy, desquamating rash, red and swollen feet and hands
suggestive of which vasculitis?
kawasaki
40
rash in kawasaki?
polymorphous, desquamating (shedding/scraping off)
41
what kind of adenopathy in kawasaki?
cervical
42
hand and foot changes in kawasaki?
swollen and erythema
43
conjunctivitis in kawasaki?
bilateral non-exudative (no fluids) bulbar
44
is the conjunctivitis in kawasaki unilateral or bilateral?
bilateral
45
what was kawasaki formerly called?
mucocutaneous lymph node syndrome
46
kawasaki: complications?
coronary artery aneurysms; thrombosis or rupture can cause death
47
what can cause death in kawasaki?
coronary artery aneurysms
48
kawasaki: treatment?
IVIG and aspirin
49
polyarteritis nodosa: in who?
middle-aged males
50
polyarteritis nodosa: seropositive for what in 30% of the cases?
Hepatitis B
51
in which arteritis 30% of patients seropositive for Hep B?
polyarteritis nodosa
52
polyarteritis nodosa: involvement of which systems?
cardiovascular, GI, neuro, skin, renal
53
polyarteritis nodosa: symptoms?
GI: abdominal pain, melena
Hypertension, neurologic dysfunction, skin sores, renal damage
54
52 y/o man with hypertension, abdominal pain, melena, skin sores, proteinuria and hematuria
Hep B seropositivity
suggestive of?
polyarteritis nodosa
55
what system is NOT involved in polyarteritis nodosa?
pulmonary
56
which arteries are typically involved in polyarteritis nodosa?
renal and visceral
57
polyarteritis nodosa: renal angiogram/ateriogram findings?
innumerable renal microaneurysms, and spams
'string of pearl' appearance
58
'string of pearl' appearance on renal angiogram
which disease?
polyarteritis nodosa
59
polyarteritis nodosa: treatment?
glucocorticoids
cyclophosphamide
60
polyarteritis nodosa: what is it?
small and medium-sized arteries swollen and damaged
serious vasculitis
61
Behcet syndrome: in who?
people with Turkish and eastern mediterranean descendent
62
Behcet syndrome: symptoms?
aphtous ulcers, genital ulceration, uveitis, erythema nodosum
63
what is erythema nodosum?
tender, red bumps, usually found symmetrically on the shins
64
what kind of small vessel vasculitis can cause uveitis?
behcet
65
what can behcet be precipitated by?
HSV (herpes simplex virus) or parvovirus
66
HSV and parvovirus can trigger which vasculitis?
behcet
67
how long do behcet flares last?
1-4 weeks
68
which vasculitis comes in flares?
behcet
1-4 weeks
69
turkish man with genital ulcers, erythema nodosum and uveitis
suggestive of?
behcet
70
what kind vasculitis is behcet?
immune complex
71
with which HLA type is behcet associated?
HLA-B51
72
which vasculitis is associated with HLA-B51?
behcet
73
cutaneous small vessels vasculitis: when does it occur?
7-10 days after medication or infection
74
cutaneous small vessels vasculitis: which medication can cause it?
penicillins
cephalosporins
sulfonamides
phenytoin
allopurinol
75
penicillins
cephalosporins
sulfonamides
phenytoin
allopurinol
can cause which vasculitis?
cutaneous small vessel vasculitis
76
cutaneous small vessel vasculitis: which infections can cause this?
HCV (hep C), HIV
77
cutaneous small vessel vasculitis: symptoms?
palpable purpura
(7-10 days after certain infection or medication)
78
cutaneous small vessel vasculitis: visceral involvement?
no
79
which small vessel vasculitis has no visceral involvement?
cutaneous small vessel vasculitis
80
person with palpable purpura, no visceral symptoms
8 days after taking antibiotics
which vasculitis?
cutaneous small vessel vasculitis
81
person with palpable purpura
9 days after HCV infection
which vasculitis?
cutaneous small vessel vasculitis`
82
what kind of vasculitis is cutaneous small vessel vasculitis?
immune complex mediated leukocytoclastic
83
leukocytoclastic vasculitis: other name?
cutaneous small vessel vasculitis
84
cutaneous small vessel vasculitis: other name?
leukocytoclastic vasculitis
85
what is leukocytoclasis?
infiltrating neutrophils causing vascular damage
cutaneous small vessel vasculitis
86
churg strauss: other name?
eosinophilic granulomatosis with polyangiitis
87
eosinophilic granulomatosis with polyangiitis: other name?
churg-strauss
88
eosinophilic granulomatosis with polyangiitis: symptoms?
asthma
sinusitis
skin nodules or purpura
peripheral neuropathy (wrist/foot drop)
89
eosinophilic granulomatosis with polyangiitis: which other organs can be involved?
heart, BI, kidney
90
how do call eosinophilic granulomatosis with polyangiitis with renal involvement?
pauci-immune glomerulonephritis
91
eosinophilic granulomatosis with polyangiitis: pathophysiology?
granulomatous, necrotizing vasculitis with eosinophilic involvement
92
eosinophilic granulomatosis with polyangiitis: antibodies?
P-ANCA/MPO-ANCA
IgE increased
93
eosinophilic granulomatosis with polyangiitis: which ANCA?
P-ANCA
94
Churg-strauss: which cells particularly involved?
eosinophilesc
95
churg-strauss: symptoms?
asthma
sinusitis
skin nodules or purpura
foot/wrist drop (neuropathy)
96
person with sinusitis, wrist drop, and skin purpura
P-ANCA positive, elevated IgE
suggestive of?
churg strauss (eosinophilic granulomatosis with polyangiitis)
97
which small vessel vasculitis has increased IgE?
eosinophilic granulomatosis with polyangiitis
98
granulomatosis with polyangiitis: which 3 systems are involved?
upper respiratory tract
lower respiratory tract
renal
99
granulomatosis with polyangiitis: symptoms upper respiratory tract?
perforation nasal septum
chronic sinusitis
otitis media
mastoiditis
100
granulomatosis with polyangiitis: symptoms lower respiratory tract?
hemoptysis
cough
dyspnea
101
granulomatosis with polyangiitis: renal symptoms?
hematuria, red cell clasts
102
person with chronic sinusitis, otitis media, couching, hemoptysis and hematuria
C-ANCA is positive
suggestive of?
granulomatosis with polyangiitis
103
involvement of lower/upper respiratory tract and kidneys
C-ANCA positive
suggestive of which vasculitis?
granulomatosis with polyangiitis
104
pathological triad of granulomatosis with polyangiitis?
focal necrotizing vasculitis
necrotizing granulomas in lung/upper airway
necrotizing glomerulonephritis
105
granulomatosis with polyangiitis: which ANCA?
C-ANCA/PR3-ANCA
106
granulomatosis with polyangiitis: CXR?
large nodular densities
107
in which vascilitis large nodular densities on CXR?
granulomatosis with polyangiitis
108
granulomatosis with polyangiitis: treatment?
glucocorticosteroids in combination with rituximab or cyclophosphamide
109
glucocorticosteroids in combination with rituximab or cyclophosphamide
treatment for what?
granulomatosis with polyangiitis
110
what does rituximab do?
kills b-cells
111
Immunoglobulin A vasculitis: other name?
henoch schonlein purpura
112
henoch schonlein purpura: other name?
immunoglobulin A vasculitis
113
Immunoglobulin A vasculitis: often follows what?
URI (upper resp infection)
114
most common childhood systemic vasculitis?
Immunoglobulin A vasculitis
henoch schonlein purpura (HSP)
115
Immunoglobulin A vasculitis: classic triad?
HSP
Hinge pain (arthralgia)
Stomach pain
Palpable purpura
116
Immunoglobulin A vasculitis: stomach pain associated with what?
intussusception
(invaginatie)
117
Immunoglobulin A vasculitis: where are the palpable purpura?
buttocks and legs
118
child with arthalgia, purpura on buttocks and legs, stomach pain
suggestive of?
immunoglobulin A vasculitis
119
henoch schonlein purpura: which immunoglobins are involved?
IgA immune complexes
120
Hinge pain (arthralgia)
Stomach pain
Palpable purpura
what is this?
immunoglobin A vasculitis
or henoch schonlein purpura
121
immunoglobin A vasculitis: treatment?
supportive care
possibly glucocorticoids
122
henoch schonlein purpura: treatment?
supportive care
possibly glucocorticoids
123
microscopic polyangiitis: presentation?
lung: couch, hemoptysis, dyspnea
kidney: hematuria, red clasts
skin: palpable purpura
similar to granulomatosis with poylangiitis without nasopharyngeal involvement
124
microscopic polyangiitis: which 3 systems are involved?
lung
kidney
skin
125
microscopic polyangiitis: skin symptoms?
palpable purpura
126
microscopic polyangiitis: lung symptoms?
coughing, hemoptysis, dyspnea
127
microscopic polyangiitis: renal symptoms?
hematuria and red cell clasts
128
how do call kidney involvement in microscopic polyangiitis?
pauci-immune glomerulonephritis
129
microscopic polyangiitis: granulomas?
no
130
microscopic polyangitis: which ANCA?
P-ANCA (MPO-ANCA)
131
what is P-ANCA?
anti-myeloperoxidase
(also anti-MPO)
132
microscopic polyangiitis: treatment?
cyclophosphamide, glucocorticoids
133
which vasculitides have ANCA?
- eosinophilic granulomatosis with polyangiitis
- granulomatosis with polyangiitis
- microscopic polyangiitis
134
which vasculitis have P-ANCA
- eosinophilic granulomatosis with polyangiitis
- microscopic polyangiitis
135
which vasculitide has C-ANCA?
granulomatosis with polyangiitis
136
which vasculitide is similar to granulomatosis with polyangiitis, but without nasopharyngeal involvement?
microscopic polyangiitis
137
Mixed cryoglobulinemia: often due to what?
infections
especially HCV (Hep C)
138
Mixed cryoglobulinemia: triad?
palpable purpura, weakness, arthralgias
139
Mixed cryoglobulinemia: other involvement (outside triad)?
peripheral neuropathy, renal disease (glomerulonephritis)
140
what are cryoglobulins?
immunoglobulins that precipitate in the cold
141
Mixed cryoglobulinemia: what kind of vasculitis?
immune complex
mix of IgG and IgM
142
Mixed cryoglobulinemia: mix of which immunoglobulins?
IgG and IgM
143
mix of IgG and IgM immuno complex deposition
which vasculitis?
Mixed cryoglobulinemia
144
palpable purpura, weakness, arthralgias
HCV seropositive
suggestive of?
Mixed cryoglobulinemia
