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Specialty Medicine > Vasculitis > Flashcards

Vasculitis Flashcards

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1
Q

What is stasis dermatitis?

A

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

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2
Q

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

A

Edema
hyperpigmentation
Ulcers

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3
Q

What is vasculitis? How does it appear?

A

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

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4
Q

What is atrophy?

A

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

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5
Q

Is stasis dermatitis related to venous or arterial issues?

A

Venous

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6
Q

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

A

DM Atherosclerosis

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7
Q

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

A
  • Dilation
  • Disruption
  • Defect
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8
Q

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

A

Venous

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9
Q

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

A

Smoking

Obesity

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10
Q

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

A
  • Lower, lateral leg

- Punched out”, with well demarcated edges and a pale base

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11
Q

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

A

Loss of hair

Shiny, atrophic skin

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12
Q

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

A

False–lack of blood supply means none

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13
Q

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

A

Venous

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14
Q

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

A

venous

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15
Q

What are the associated symptoms of arterial ulcers?

A

Claudication and pain

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16
Q

What is the normal value of the ABI?

A

More than 0.90

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17
Q

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

A

Supine

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18
Q

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

A

True

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19
Q

What may cause a false elevation of the AKI?

A

ASCVD

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20
Q

What causes the hyperpigmentation with venous insufficiency?

A

Hemosiderin deposits

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21
Q

What are the usual findings with venous insufficiency of the LEs

A

Erythematous, brown plaques with fine fissuring and scaling

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22
Q

True or false: venous stasis dermatitis is usually pruritic

A

True

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23
Q

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

A 
Swelling = venous
Atrophy = arterial
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24
Q

What, generally, causes venous stasis dermatitis?

A

Incompetent valves

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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

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