Vasculitis

Question 1

What is the mortality rate of untreated small vessel vasculitis ?

Answer 1

90% after two years

Question 2

What is primary vasculitis?

Answer 2

Autoimmune vasculitis

Question 3

What is secondary vasculitis?

Answer 3

Vasculitis triggered by an infection, drug, toxin or cancer.

Question 4

What are the different classes of Vasculitis?

Answer 4

Large-vesselVasculitis

Medium vessle vasculitis

Small-vessel vasculitis:-

ANCA associated small vessel vasculitis

Immune complex small vessel vasculitis

Question 5

What symptoms are common to all vasculitides?

Answer 5

Fever

malaise

Weight loss

fatigue

Question 6

What are the two main causes of Large vessle vasculitis?

Answer 6

Takayasu arteritis (TA)

Giant Cell Arteritis (GCA)

Question 7

Who gets Takayasu arteritis?

Answer 7

Asian woman under 40yrs

Question 8

Who gets Giant Cel arteritis?

Answer 8

people older than 50.

Increased risk in polymyalgia rheumatica

Question 9

What is characterisitc of both Takayasu Arteritis and Giant cell arteritis?

Answer 9

Granulomatous infiltration of the walls of large vessels.

Question 10

What percentage of patients with Giant cell arteritis also have Temporal arteritis?

Answer 10

50%

Question 11

What are the classic symptoms of this disease?

Answer 11

Temporal Arteritis

Unilateral temporal headache

Scalp tenderness

Jaw claudiaction

Question 12

Why is there a risk of blindness in people with temporal arteritis?

Answer 12

Due to iscaemia of the optic nerve

Question 13

What autoimmune disease greatly increase the risk of giant cell arteritis?

Answer 13

Polymyalgia Rheumatica

Question 14

Whats the problem with a Temporal Artery biopsy

Answer 14

Temporal arteritis has skip lesions. You could miss it

Question 15

What is the mangement plan for Temporal Arteritis ?

Answer 15

40-60mg of prednisolone

or

methotrexate/azathioprine

Question 16

What causes Medium vessel vasculitis?

Answer 16

Kawasaki Disease

Polyarteritis nodosa

Question 17

Who gets Kawaski disease?

Answer 17

Kids under 5yrs

Question 18

Which vessle is it imporant to pay particular attention to in Kawasaki disease?

Answer 18

Cornary arteries as aneuyrisims can develop

Question 19

What is Polyarteritis nodosa?

Answer 19

Necrotizing inflammatory lesions that affect arteries at vessel bifurcations resulting in microaneurysms.

Question 20

Where in the body does Polyarteritis nodosa usually have an effect?

Answer 20

Skin

gut

kidneys

Question 21

What are the two classes of Small vessel Vasculitis?

Answer 21

ANCA associated Vasculitis

ANCA negative Vasulitis

Question 22

study this

Question 23

Who gets Granulomatosis with Polyangiitis?

Answer 23

Northern Europeans

male - female 1.5 - 1

any age but typically 35-55

Question 24

How does Eosinophilic granulomatos with Polyangitis compare to Granulomatosis with polyangiitis

Answer 24

In eosinophilic granulomatosis with polyangitis you will find the presence of late onset asthma and a high eosinophil count

Question 25

What tests can you do to diagnose Temporal Arteritis?

Answer 25

Biospy - beware of skip lesions

Question 26

What is a buzzword for granulmoatosis with polyangiitis?

Answer 26

Weight loss with ENT problems

Question 27

What must you always check for in suspected vasculitis ?

Answer 27

**Renal Function tests**

Question 28

What would you look for/find in the blood tests in a patient with Giant cell arteritis?

Answer 28

Raised ESR Raised plasma viscosity Raised CRP

Question 29

What would you do if a patient came in and you suspected Temporal Arteritis?

Answer 29

Start Prednisolone 40-60mg Reffer for a biopsy Check renal function

Question 30

Who gets this and Why?

Answer 30

People with Granulomatosis with Polyangiitis (GPA) Ischeamia of the cartilage resulting in saddle nose.

Question 31

What 4 things are classic of granulomatosis with polyangiitis?

Answer 31

1. Nasal or oral inflammation- ulcers 2. Nodules, fixed infiltrates or cavities on CXR 3. Microhematuria 4. Gramulatomous inflammation of artery walls