Vasculitis

Question 1

what conditions are covered in ANCA vasculitis

Answer 1

GPA, EPGA, MPA

Question 2

common features of ANCA vasculitis (5)

Answer 2

renal, resp (haemoptysis), fatigue + fever, rash, sinusutus

Question 3

renal symptoms ANCA

Answer 3

immune glomerulonephritis –> creatine, haematuria + proteinuria

Question 4

first line invx ANCA

Answer 4

urinalysis // bloods, U+E, CRP, ANCA // CXR

Question 4

which vasculitis + target is GPA

Answer 4

cANCA + anti-PR3

Question 5

which vasculitis + target is EGPA

Answer 5

pANCA + MPO

Question 6

what other condition is pANCA usually positive in

Answer 6

UC

Question 7

distinguishing features GPA

Answer 7

nosebleeds, sinusitis, saddle nose!! glomerulonephtitis, vasculitis rash

Question 8

invx GPAA (3)

Answer 8

cANCA // CXR // renal biopsy (epithelial crescents)

Question 9

distinguishing features EGPA

Answer 9

asthma!!! blood eosinophilia!! paranasal sinusitis // polyneuropathy

Question 10

distinguishing features MPA

Answer 10

no nasopharynx symptoms // renal impairment, rash

Question 11

which ANCA vasculitis is no granulomatous

Answer 11

MPA

Question 12

mx ANCA vasculitis (4)

Answer 12

1) steroids 2) cyclophosphamide 3) rituximab 4) plasma exchange + IV Ig

Question 13

what type of vasculitis is polyarteritis nodusa

Answer 13

medium vessel vasculitis –> necrotizing inflamm –> aneurysm formation

Question 14

who gets polyarteritis nodusa

Answer 14

middle aged men + hep B

Question 15

symptoms polyarteritis nodusa

Answer 15

fever, weight loss, arthalgia, hypertension, testocular pain, livedo reticularis, haematuria

Question 16

what mediates Henoch-Schonlein pupura (HSP) vasculitis

Answer 16

IgA

Question 17

what disease does HSP overlap with

Answer 17

IgA nephropathy

Question 18

features HSP

Answer 18

palpable pupuric rash over buttocks and extensors // abdo pain // polyarthritis // haematuria + renal failure

Question 19

who usually gets HSP

Answer 19

children

Question 20

what usually precedes HSP

Answer 20

URTI or GI infection

Question 21

mx HSP

Answer 21

supportive

Question 22

how is HSP monitored

Answer 22

BP + urinalysis

Question 23

what are common large vessel vasculitis’

Answer 23

temporal and takayasu’s

Question 24

what are common medium vessel vasculitis’

Answer 24

polyarteritis nodusa + kawasaki

Question 25

what are common small vessel vasculitis’

Answer 25

ANCA (GPA, MPA, EGPA) and immune (HSP, goodpastures)

Question 26

what are common small vessel vasculitis’

Answer 26

ANCA (GPA, MPA, EGPA) and immune (HSP, goodpastures)

Question 27

what vessel is usually affected in takayus vasculitis

Answer 27

aorta

Question 28

symptoms takayus vasculitis

Answer 28

absent limb pulse // asian female // headache and malaise // unequal BP // claudication // carotid bruit

Question 29

what is takayus vasculitis assoc with

Answer 29

renal artery stenosis

Question 30

invx takayus vasculitis

Answer 30

MR angi or CT angio

Question 31

mx takayus vasculitis

Answer 31

steroids

Question 32

who usually gets GCA

Answer 32

elderly

Question 33

what is GCA assoc with

Answer 33

polymyalgia rheumatica (PMR)

Question 34

symptoms GCA

Answer 34

go+ // headache // jaw claudication // vision changes // PMR

Question 35

vision issues in GCA

Answer 35

anterior ischaemic optic neuropathy // swollen + pale disc with blurred margins

Question 36

invx GCA

Answer 36

inflamm (ESR + CRP) // biopsy

Question 37

when should mx be started in GCA

Answer 37

as soon as suspected - prior to biopsy

Question 38

mx GCA with no visual symptoms

Answer 38

high dose pred (40-60mg)

Question 39

mx GCA with visual loss

Answer 39

IV methylpred –> high dose pred