Vasculitides

Question 1

Complication of giant cell (temporal) arteritis?

• Elderly female > 50
• Unilateral HA, jaw claudication, flu-like sx

Answer 1

BLINDNESS (ophthalmic artery occlusion)

Question 2

What condition is giant cell (temporal) arteritis associated with?

Answer 2

Polymyalgia rheumatica

Question 3

What artery is giant cell (temporal) arteritis associated with?

Answer 3

Branches of carotid –> temporal

Question 4

giant cell (temporal) arteritis bx shows?

Answer 4

Focal granulomatous inflammation (segmental)

Question 5

giant cell (temporal) arteritis labs?

Answer 5

Elevated ESR

Question 6

giant cell (temporal) arteritis Rx?

Answer 6

Corticosteroids to prevent blindness

Question 7

What do people call Takayasu arteritis?

- Asian females

Answer 7

“Pulseless DZ” - weak UE pulses

Question 8

Takayasu arteritis bx?

Answer 8

Granulomatous thickening

Question 9

What artery is involved with Takayasu arteritis?

Answer 9

Aortic arch and proximal great vessels

Question 10

Takayasu arteritis labs?

Answer 10

Elevated ESR

Question 11

Takayasu arteritis Rx?

Answer 11

Corticosteroids

Question 12

What infection is polyarteritis nodosa associated with?

• Young adult male
• Fever, weight loss malaise, HA
• Abdominal pain, melena
• HTN, neuro dysfunction, cutaneous eruptions, renal damage

Answer 12

Hepatitis B

Question 13

What vessels does polyarteritis nodosa involve?

Answer 13

Renal and visceral vessels

NOT pulmonary arteries (lungs are spared)

Question 14

Pathogenesis of polyarteritis nodosa?

Answer 14

Immune complex mediated

Question 15

polyarteritis nodosa bx?

Answer 15

Transmural inflammation of arterial wall with fibrinoid necrosis
- Different stages of inflammation in different vessels

Question 16

polyarteritis nodosa arteriogram?

Answer 16

Innumerable renal microaneurysms and spasms

Question 17

polyarteritis nodosa rx?

Answer 17

Corticosteroids, cyclophosphamide

Question 18

Kawasaki Disease presentation?

Answer 18

Asian children

Question 19

Complication of Kawasaki?

Answer 19

Coronary artery aneurysms

Question 20

Kawasaki rx?

Answer 20

IV Ig and aspirin

Question 21

Presentation of Buerger DZ?

Answer 21

Male

Question 22

Complications of Buerger DZ?

Answer 22

• Gangrene, autoamputation of digits, superficial nodular phlebitis

Question 23

Buerger DZ bx?

Answer 23

Segmental thrombosing vasculitis

Question 24

Buerger DZ treatment?

Answer 24

Smoking cessation

Question 25

Wegener's Granulomatosis with polyangiitis presentation

Answer 25

Middle aged male - URT: perforation of nasal septum, chronic sinusitis, otitis media, mastoiditis - LRT: hemoptysis, cough, dyspnea - Renal: hematuria, RBC casts

Question 26

Wegener's Granulomatosis with polyangiitis triad?

Answer 26

- Focal necrotizing vasculitis - Necrotizing granulomas in the lung and upper airway (giant cells) - Necrotizing GN

Question 27

Wegener's Granulomatosis with polyangiitis marker?

Answer 27

c-ANCA (PR3-ANCA) - antiproteinase 3 (neutrophil)

Question 28

Wegener's Granulomatosis with polyangiitis CXR?

Answer 28

Large nodular densities

Question 29

Wegener's Granulomatosis with polyangiitis Rx?

Answer 29

Cyclophosphamide, corticosteroids

Question 30

Microscopic polyangiitis presentation?

Answer 30

Like Wegener's but no URT involvement

Question 31

Microscopic polyangiitis bx?

Answer 31

- Necrotizing vasculitis in lungs, kidneys, skin - Pauci-immune GN - Palpable purpura - NO GRANULOMAS

Question 32

Microscopic polyangiitis marker?

Answer 32

p-ANCA (MPO-ANCA) - anti-myeloperoxidase

Question 33

Microscopic polyangiitis rx?

Answer 33

Cyclophosphamide, corticosteroids

Question 34

Churg-Strauss (eosinophilic granulomatosis with polyangiitis) presentation?

Answer 34

Asthma, sinusitis, skin nodules/purpura, peripheral neuropathy (wrist/foot drop)

Question 35

Churg-Strauss (eosinophilic granulomatosis with polyangiitis) bx?

Answer 35

Granulomatous, necrotizing vasculitis with eosinophilia

Question 36

Churg-Strauss (eosinophilic granulomatosis with polyangiitis) marker?

Answer 36

p-ANCA, increased IgE

Question 37

Henoch-Schonlein purpura presentation?

Answer 37

KIDS, follows URI - Skin: palpable purpura on buttocks/legs - Arthralgias - GI: abdominal pain and bleeding

Question 38

Henoch-Schonlein purpura pathogenesis?

Answer 38

IgA immune complex deposition | Type III HSN

Question 39

What renal thingamajig is Henoch-Schonlein purpura associated with?

Answer 39

IgA Nephropathy (Berger DZ)