Vasculitis

Question 1

بسم الله توكلنا عليك وأنت خير الناصرين و انت سميع الدعاء مجيبه فلا تحرمنا من فضلك وأنزل علينا رحماتك تترا يارب العالمين

التهابات الشرايين تشترك جميعها في ؟

Answer 1

1-Thickening of the wall
2-Shedding of endothelium forming thrombosis
3-Weakness of wall and Aneurysm formation may rupture forming Hge

Question 2

قال معاذ الله إنه ربي أحسن مثواي إنه لا يفلح الظالمون

دور الأجسام المضادة في التهاب الشرايين اذكره

Answer 2

1-ممكن تهاجم الخلايا الطلائية علي طول وده في مرض اسمه Kawaski disease
2-ممكن تكون معقدات مناعية من انتيجينات وينشط المكملاتcomplemets وتعمل التهابات
في مرض الذئبة SLE
3-ANCA :Antinuclear cytoplasmic antibody
ودي تضرب في الاوعية الصغيرة وتعمل فيها مشاكل !
______________
Granuloma due to inflammation in wall of large blood vessels

Question 3

Large to small vessel vasculitis (Khalifs describe)

Answer 3

Aorta , branches, opthalmic , temporal — Migarane Old males
1-Temporal arteritis ! Giant cell arteritis granulomatous inflammation and giant cell
صداع temp وزغللة في العين opthalmic

2-Takayaso arteritis aorta and its branches to upper limb
radial arteritis pulsless disease granulomatous giant cells
Ischemia in upper limb and giant cell

complications
يطخن الجدار
يعمل جلطات
يعمل توسعات في الشريان

Question 4

Giant cell TEMORAL ARETRITID depends on …… immunity

Answer 4

T cell mediated immuinty

Question 5

Giant cell ARTERITIS affect which arterires ?

Answer 5

Temporal and opthalamic samll arteries

Question 6

Why it is called giant cell arteritis ?

Answer 6

Because it is mechnism is by granuloma formation and giant cells are present

Question 7

Takayso desvribe

Answer 7

In large to small arteries aortic arch and its branches to the upper limb middle age > granuloma

Question 8

Mention Medium vessel arteritis .

Answer 8

1-Polyarteritis nodosa

2-Kawaski

Question 9

strawberry tongue

appear in ?

Answer 9

Kawasaki arteritis

Question 10

Polyateritis nodosa mostly appear in and rescpect ?

Answer 10

Mostly in kidney cauisng renal arteristsis nodosa and renal failure \
Respect The pulmonary arteries

Question 11

The basis of Polayarteriris nodosa is ?

Answer 11

The formation of Immune complexes due to Hepatitis B virus

Question 12

The most common pathogen casuing the Polyarteritis nodosa?

Answer 12

Hepatitis B virus

Question 13

Describe the gross morph of the PAN .

Answer 13

multiple nodules - multiple aneurisms

Question 14

describe Microscopic appearance of the PAN .

Answer 14

Necrotizing inflammation+ Neutrophils and Fibrosis !

Question 15

Clinical picture of the PAN ?

Answer 15

Fever +HTN+ abdominal pain

Question 16

Poly Arteritis Nodosa PAN

Description !

Answer 16

Multiple arteries mostly renal (not affecting pulmonary
vessels)
Immune complex reaction , may be associated with HBV
infection
gross: multiple nodules - multiple aneurisms
micro: necrotizing inflammation + excess neutrophils →
chronic & fibrosis
Clinical: (Fever + hypertension + abdominal pain)

Question 17

Arteritis causing MucoCutanuous and LN syndrome involvement

Answer 17

Kawasaki

Question 18

Kawaski decribe

ركز في اسئلة هوار ولو سألك قله ربنا يعين الجميع ولو قالك يعني ايه قوله معلش مش عايز اقولك لحد بيني وبينه !

Answer 18

Medium arteitis

Multiple vessels children

Necrotizing inflammation with Mucocuatnous and LN syndrome
cassuing Strawberry tongue

Question 19

ALL OF small arteritis is characterized by ?>

Answer 19

ANCA

Question 20

cANCA appear in ?

Answer 20

Wegner granulomatosis .

Question 21

Wegner granulomatosis is chararterizd by

?

Answer 21

العجب فقد جمع بين التهابات الشرايين الكبيرة في تكوين الجرانيولوما والتهابات الشرايين المتوسطة في انها
necrotizing

كمان تجرأ علي مالم تتجرأ عليه الالتهابات المتوسطة وهي الرئة والجهاز التنفسي بالإضافة إلي الكلية

Question 22

Wegner granulomatosis وصف

Answer 22

respiratory tract & Kidney
– cANCA -
granuloma & necrotizing vasculitis

Question 23

pANCA appar in

Answer 23

Charug -straus

Question 24

Charug-Straus disease is characterized by :-

Answer 24

Asthma +Eosinophils

Question 25

Chrug straus describe .

Answer 25

Affect respiratory aretries forming granuloma and is necrotizing and there is Asthma and eosinopilhs +pANCA

Question 26

ايه الفرق بين Microscopic polyanigitis وغيرها ؟

Answer 26

انه بعض الحالات مفيش فيها ترسيبات مناعية من ANCA

Question 27

Microscopic polyangitis briefly

Answer 27

It is Respiratory and renal disease and is not granulomatous and necrotizing with ANCA and There may be no immune deposits in some cases

Question 28

disease appear in male somkers due to genetic immune and tobacco effect on the endothelium in small and medium vvessels of limbs

Answer 28

it is burger disease thromboangitis obliterans segemtnal inflammation and necrosis thrombosis gangrerne

Question 29

Complications of Burger's disease

Answer 29

Caludications تشنجات في عضلات الساق لنقص التروية trophic ulcer gangrene

Question 30

Complications of Renayd disease mention

Answer 30

Cyanosis of finger nose ear

Question 31

Renayd disease appear mostly in ?

Answer 31

Females due to cold and stress and emotions Mostly in small arteries

Question 32

Causes of Renayd disease ?

Answer 32

1ry due to Vasospasm due to cold and emotions | 2ry to DISEASE SLE Burger's disease

Question 33

Mechanism of burger's diease ?

Answer 33

``` It is due to granulomatus inflammation in the veins and arteris and nervers causing thrombosis Microabscesses Fibrosis and aneurysm . ```

Question 34

SVC syndrome mean ?

Answer 34

This occure due to obstruction of the SVC due to ? Lung carcinoma or Mediastinal lymphoma this lead to congestion and cyanosis of head and upper limbs

Question 35

IVC Syndrome mean

Answer 35

this obstruction of the IVC due to TUMORS OR enlarged LN and this leads to LL and Renal congestion + proteinuria and dilated abdominal veins

Question 36

Lymphangitis mean ?

Answer 36

It is inflammed lymph vessesl due to infection filaria or radiation appearing as Red streaks and causing obstruction leading to lymphedema suppurative or tb

Question 37

Chylus effusion defintion .

Answer 37

it is effusiion of milky lymph from the lymphatic vessels due to its obsetcuton or rupture into the serous sacs

Question 38

Congenital Vascular disease :

Answer 38

AV SHUNT Berry aneurysm Fibromusclar dysplasia وهو استبدال الجزء العضلي في جدار الشريان بنسيج ليفي thick wall of large and medium sized arteries

Question 39

Monckberge disease >

Answer 39

it is senile idiopathic disease hyalinosis and thickening and dystrophic calcification and ossification of ( M)edia of (M)usclar (M)deium sized artery like feomral discoverd by (M)onckeberge مزودتش نسيج جديد بس عملية استبدال

Question 40

Monckeberge is asymptomatic due to ?

Answer 40

No Narrowing of the Wall of the blood vessel

Question 41

الحــمــدلله الذي أنزل علي عبده الكتاب لم يجعل له عوجا ! | تبارك الذي نزل الفرقان علي عبده ليكون للعالمين نذيرا !

Question 42

pathogensis of vasculitis

Answer 42

• Immunological o Immune complex type III hypersenset.(e.g. SLE, PAN, drug) o Anti-neutrophil cytoplasmic Ab ANCAs (e.g. Wegener) o Anti endothelial Ab (e.g. Kawasaki) • Infections o Direct by organism o Indirect → immune mediated reaction • Other causes (e.g. radiation, Trauma, Chemicals)

Question 43

Complications: of vasculitis

Answer 43

Ischemia – Thrombosis - Ruptured vessels → hemorrhage