Vasculitis Flashcards Preview

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Flashcards in Vasculitis Deck (67):
1

What is stasis dermatitis?

Erythematous, pruritic, scaling patches on the lower extremities due to impaired *venous* circulation

2

What are the chronic skin changes that result from stasis dermatitis?

Edema
hyperpigmentation
Ulcers

3

What is vasculitis? How does it appear?

Inflammation of the blood vessels that appears as palpable purpuric papule /

4

What is atrophy?

Thinning or depression of skin d/t reduction of the underlying tissue

5

Is stasis dermatitis related to venous or arterial issues?

Venous

6

What are the two major systemic issues that cause stasis dermatitis?

DM Atherosclerosis

7

What are the three major, general causes of capillary disease?

-Dilation
-Disruption
-Defect

8

Which is a more common cause of leg ulcers: venous or arterial issues?

Venous

9

What are the two major risk factors for the development and persistence of ulcers?

Smoking
Obesity

10

What is the general appearance of arterial ulcers? Where on the body do they usually occur?

-Lower, lateral leg
-Punched out", with well demarcated edges and a pale base

11

What are the associated skin findings of arterial ulcers? (2)

Loss of hair
Shiny, atrophic skin

12

True or false: there is often an exudate with arterial ulcers

False--lack of blood supply means none

13

Which usually has stasis pigmentation: arterial or venous causes of stasis?

Venous

14

Which usually has lipodermatosclerosis: arterial or venous causes of stasis?

venous

15

What are the associated symptoms of arterial ulcers?

Claudication and pain

16

What is the normal value of the ABI?

More than 0.90

17

What position should the patient be in when testing the ABI?

Supine

18

True or false: once the ABI is down, it is too late for preventative measures

True

19

What may cause a false elevation of the AKI?

ASCVD

20

What causes the hyperpigmentation with venous insufficiency?

Hemosiderin deposits

21

What are the usual findings with venous insufficiency of the LEs

Erythematous, brown plaques with fine fissuring and scaling

22

True or false: venous stasis dermatitis is usually pruritic

True

23

Which has atrophy and which has swelling: venous vs arterial insufficiency

Swelling = venous
Atrophy = arterial

24

What, generally, causes venous stasis dermatitis?

Incompetent valves

25

Which gender is predisposed to venous insufficiency?

Females

26

True or false: prolonged standing is a risk factor for the development of venous stasis dermatitis

True

27

True or false: larger heights is a risk factor for the development of venous insufficiency

True

28

What are the early s/sx of venous insufficiency?

-TTP
-Edema
-Telangiectasias
-Hyperpigmentaiton

29

What are the late s/sx of venous insufficiency?

-Lipodermatosclerosis
-Venous ulcers
-White and atrophic scarring

30

Inverted champagne bottle appearance of the legs = ?

Lipodermatosclerosis from venous insufficiency

31

What are some of the serious complications from venous insufficiency?

-DVTs
-Cellulitis

32

What is the treatment for venous stasis dermatitis?

-High potency steroids
-Elevation
-Compression
-Keeping wound moist

33

What is the timeframe that is needed to treat venous stasis dermatitis with compression?

4-6 months

34

Under what value of ABI is a contraindication to compression wrapping?

0.8

35

What is the treatment for infected venous ulcers?

Debridement of necrotic tissue, and systemic abx

36

How often should dressings be changed with venous ulcers?

once weekly or maybe slightly more often, but not too much as to disturb the wound constantly

37

What is the role of topical abx in the treatment of venous ulcers?

Do not use--ineffective

38

Patients with venous ulcers that do not demonstrate response to treatment after what timeframe should be referred to dermatology?

6 weeks

39

What is the preulcerative lesion?

calluses

40

What is the skin temperature for arterial, venous, and diabetic ulcers?

Arterial = cold
Venous - warm
DM = warm and dry

41

Arterial, venous, or diabetic ulcer: irregular margin with punched out edges and little exudate

Arterial

42

Arterial, venous, or diabetic ulcer: irregular margin, sloping edges, pink base. Exudative

venous

43

Arterial, venous, or diabetic ulcer: overlying callus, undermined, red, often deep and infected

DM

44

Arterial, venous, or diabetic ulcer: skin changes that are shiny and taut, without edema

Arterial

45

Arterial, venous, or diabetic ulcer: skin changes with erythema, edema, hyperpigmentation, and lipodermatosclerosis

Venous

46

What are purpura?

Red-purple lesions that result from the extravasation of blood into the skin or mucous membranes

47

Are purpura palpable?

Can be

48

What is the size range of purpur?

3- 5 mm

49

What is the order of lesions that describe the extravasation of blood into the skin or mucous membranes?

Petechiae
Purpura
Ecchymoses

50

Which is usually inflammatory: macular or palpable purpura?

Macular is non-inflammatory
Papules = vascular inflammation

51

What is diascopy?

Use of a glass slide to apply pressure to a skin lesion in order to distinguish erythema (secondary to vasodilation) from erythrocyte extravasation)

52

What are some causes of petechiae?

-DIC
-TIP
-Thrombocytopenia

53

What causes the purpura with meningococcemia?

DIC

54

Do hyper or hypo coagulable states cause purpura?

Either

55

Does the rash from RMSF spare the hand?

No

56

How does vasculitis progress?

Expands outward, then intrude on the lumen

57

Small vessel vasculitis usually results in what skin finding?

Palpable purpura

58

Medium vessel vasculitis usually results in what skin finding?

Purpura and fixed livedo reticularis

59

Large vessel vasculitis usually results in what skin finding?

Ulceration and necrosis

60

What is the pathophysiology behind HSP?

complexes of immunoglobulin A (IgA) and complement component 3 (C3) are deposited on arterioles, capillaries, and venules. As with IgA nephropathy, serum levels of IgA are high in HSP and there are identical findings on renal biopsy; however, IgA nephropathy has a predilection for young adults while HSP is more predominant among children

61

What are the classic s/sx of HSP?

Purpura
Arthritis
abdominal pain

62

Are the purpura present in HSP palpable?

Yes

63

How do you diagnose vasculitis?

skin bx

64

What is Kawasaki disease?

an autoimmune disease[2] in which the medium-sized blood vessels throughout the body become inflamed. It is largely seen in children under five years of age. It affects many organ systems, mainly those including the blood vessels, skin, mucous membranes, and lymph nodes. Its rarest but most serious effect is on the heart, where it can cause fatal coronary artery aneurysms in untreated children

65

What are the s/sx of Kawasaki disease? (5)

-intractable fever
-bilateral conjunctival injection
-Strawberry tongue
-Purpura
-Exstremity edema

66

What is the treatment for Kawasaki disease?

ASA and IVIG

67

What is the major complication with Kawasaki disease?

Inflammation of the coronary vessels leads to an MI