Vasculitis Flashcards Preview

Cardiovascular > Vasculitis > Flashcards

Flashcards in Vasculitis Deck (45):
1

What are the clinical features of vasculitis?

  • Nonspecific symptoms of inflammation
  • Symptoms of organ ischemia
    • Due to luminal narrowing or thrombosis of the inflamed vessels
    • Damaged endothelial cells expose subendothelial collagen causing coagulation

2

What are the three classes of vasculitis?

  • Large vessel vasculitis
    • involves aorta and its major branches
  • Medium vessel vasculitis
    • involves muscular arteries that supply organs
  • Small vessel vasculitis
    • involves arterioles, capillaries and venules

3

What are the large vessel vasculitis?

  • Temporal (giant cell) arteritis
  • Takayasu's arteritis

4

What is temporal arteritis?

Granulomatous vasculitis that classically involves branches of the carotid artery

5

What population is most affected by temporal vasculitis?

Older females (> 50 yo)

6

What are the clinical presentations of temporal arteritis?

  • Unilateral headache
    • temporal artery
  • Jaw claudication
  • Visual disturbances
    • ophthalmic artery
  • Associated with polymyalgia rheumatica 
  • Elevated ESR
     

7

What is seen in a temporal arteritis biopsy?

  • Giant cells
  • Intimal fibrosis
  • Lesions are segmental
    • Dx requires biopst of a long segment og vessel
    • Negative biopsy does not exclude disease

8

What is the Tx of temporal arteritis?

corticosteroids

9

What is takayasu arteritis?

GRanulomatous vasculitis that classically involves the aortic arch at branch points

10

What population is Takayasu arteritis often seen in?

  • Adults < 50 yo
  • Classically young Asian female 

11

What are the clinical presentations of Takayasu arteritis?

  • Visual and neurologic symptoms
  • Weak or absent pulse in the upper extremity 
  • ESR is elevated 

12

What is the Tx for Takayasu arteritis?

Corticosteroids

13

What are the medium vessel arteritis?

  • Polyarteritis nodosa
  • Kawasaki disease
  • Buerger's disease (thromboangitis obliterans)

14

What is polyarteritis nodosa?

Necrotizing vasculitis involving multiple organs but lungs are spared

15

What is the classical clinical presentation of polyarteritis nodosa?

  • Presents in young adults as:
    • HTN (renal artery involvement)
    • Abdominal pain with melena (mesenteric artery involvement)
    • Neurologic disturbances
    • Skin lesons
  • Associated with serum HBsAg

16

What is the histologic presentation of polyarteritis nodosa?

  • String of pearls
    • Lesions of varying stages are present
    • Early lesion consists of transmural inflammation with fibrinoid necrosis
    • After lesion, heal with fibrosis

17

What arteries are commonly involved in polyarteritis nodosa?

  • renal vessels
  • visceral arteries
  • NOT pulmonary arteries

18

What is the Tx of polarteritis nodosa?

  • Corticosteroids
  • Cyclophosphamide 

19

What population is often affected by Kawasaki disease?

Medium vessel vasculitis often affecting asian children < 4 yo

20

What are the clinical presentations of Kawasaki disease?

  • Fever
  • Conjunctivitis
  • Erythematous rash of palms and soles
  • Enlarged cervical lymph nodes 
  • Strawberry tongue

21

What artery is commonly involved in Kawasaki disease?

Coronary artery

22

Kawasaki disease increases risks for what complications?

  • Thrombosis with MI
  • Aneurysm 

23

What is the Tx for Kawasaki disease?

  • Aspirin
  • IVIG

24

What is buerger's disease? 

Necrotizing vasculitis involving digits

25

What are the clinical presentations of Buerger disease?

  • Ulceration
  • Gangrene
  • Autoamputation of fingers and toes 
  • Raynaud phenomenon is often present
  •  

26

What behavior is Buergers disease highly associated with?

SMOKING

27

What are the small vessel vasculitis conditions?

  • Wegener granulomatosis
  • Microscopic polyangitis 
  • Churg-Strauss syndrome 
  • Henoch-Schonlein purpura 

28

What is Wegener granulomatosis?

Necrotizing granulomatous vasculitis involving nasopharynx, lungs and kidneys

29

What is the classical presentation of Wegener's granulomatosis?

  • Middle aged male with:
    • sinusitis
    • nasopharyngeal ulceration
    • hemoptysis with bilaterla nodular lung infiltration 
    • hematuria due to to rapidly progressive glomerulonephritis 

30

What serum protein correlated with disease activity?

c-ANCA

31

What is seen in a biopsy from Wegener's granulomatosis?

Large necrotizing granulomas with adjacent necrotizing vasculitis

32

Tx for Wegener's granulomatosis?

  • Corticosteroids
  • Cyclophosphamide 

33

What is microscopic polyangiitis?

Necrotizing vasculitis involving multiple organs

34

What organs are especially involved in microscopic polyangiitis?

Lung and kidney

35

What are the presentations of microscopic polyangiitis?

  • Middle ages male
  • Hemoptysis with bilateral nodular lung infiltration
  • Hematuria 
  • NO granulomas are nasopharyngeal involvement

36

What serum protein correlates with microscopic polyangiits?

p-ANCA

37

Tx for microscopic polyangiitis?

  • Corticosteroids
  • Cyclophophamide

38

What is Churg-Strauss syndrome?

Necrotizing granulomatous inflammation with esoinophils involving multiple organs, especially heart and lungs. 

39

What are the clinical presentations of Churg-Strauss syndrome?

  • Asthma
  • Peripheral eosinophilia
  • Sinusitis
  • Palpable purpura
  • Peripherla neuropathy

40

What serum protein is correlated with Churg-Strauss disease activitity?

p-ANCA

41

What is Henoch-Schonlein purpura?

Vasculitis due to IgA immune complexe deposition. Most common vasculitis in children

42

What are the clinical presentations of Henoch-Schonlein purpura?

  • Palpable purpura on buttocks and legs
  • GI pain and bleeding
  • Hematuria 
  • Arthralgia 

43

Henoch-Schonlein purpura usually follows what condition?

  • Upper respiratory tract infection
    • due to increased IgA from respiratory infection

44

What is Sturge-Weber disease?

Congenital vascular disorder that affected capillary sized blood vessels.

45

What is the manifestation of Sturge-Weber disease?

  • Port-wine stain on face
  • Ipsilateral leptomeningeal angiomatosis
  • Seizures
  • early onset glaucoma