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J MSK > Vasculitis > Flashcards

Vasculitis Flashcards

(49 cards)

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1
Q

definition of vasculitis

A

inflammation of blood vessels (usually arteries)

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2
Q

aetiology of vasculitis

A

secondary inflammation from near by inflammatory site

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3
Q

histology (3)

A

lymphocytes = chronic inflammation
neutrophils = acute inflammation
plasma cells/B cells = chronic inflammation

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4
Q

large vessel vasculitis (2)

A

takayasu arteritis

giant cell arteritis

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5
Q

medium vessel vasculitis (2)

A

polyarteritis nodosa

Kawasaki disease

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6
Q

small vessel vasculitis (4)

A

churg strauss syndrome (eosinophilic granulomatosis with polyangitis (EGPA))
wegners granulomatosis (granulomatosis with polyangitis (GPA))
microscopic polyangitis (MPA)
henoch schnleein purpura (HAP aka IgA vasculitis)
others…

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7
Q

what investigation do you always do if you suspect vasculitis

why

A

urinalysis

for renal involvement

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8
Q

prognosis of vasculitis

A

good if treated, fatal if untreated

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9
Q

who does takayasu arteritis occur in

A

<40 y/o
females
Asians

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10
Q

who does giant cell arteritis present in

A

> 50 y/o

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11
Q

which other MSK condition is giant cell arteritis associated with

A

polymyalgia rheumatica (morning stiffness in shoulders/hips)

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12
Q 
unilateral temporal headache
tender, enlarged, non pulsatile arteries 
fever 
jaw claudication (osteoarthritis in TMJ)
unilateral hypertension
A

giant cell arteritis

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13
Q

patient >50 y/o with sudden onset headache

A

giant cell arteritis

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14
Q

investigations for giant cell arteritis

A

inflammatory markers - ESR, plasma viscosity, CRP raised
temporal artery biopsy
fundoscopy (dont forget!)

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15
Q

what are you looking for on temporal artery biopsy in giant cell arteritis (4)

A

thickening of media
infiltration
multinucleated giant cells
inflammation

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16
Q

who does Kawasaki disease affect

A

<5 y/o

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17
Q

where does Kawasaki disease occur

A

coronary arteries

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18
Q

polyarteritis nodosa occurs at…

A

vessel bifurcations (aneurysms develop)

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19
Q

rosary bead sign

A

polyarteritis nodosa

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20
Q

treatment of giant cell arteritis

Study These Flashcards
A

steroids, reduce over 2 years;
prednisolone 40mg if no visual symptoms
prednisolone 60-80mg if visual symptoms

aspirin long term
PPI long term

21
Q

do you treat giant cell arteritis before or after you get the temporal artery biopsy back

Study These Flashcards
A

before! could be fatal (vision loss)

22
Q

what happens if giant cell arteritis isnt treated

23
Q

why do you take aspirin long term in giant cell arteritis

Study These Flashcards
A

reduce ischaemia = reduce optic neuropathy risk

24
Q

why do you take a PPI long term in giant cell arteritis

Study These Flashcards
A

you need GI protection bc youre taking aspirin

25
what type of vasculitis is eosinophilic granulomatosis with polyangitis (EGPA)
small vessel
26
what is eosinophilic granulomatosis with polyangitis (EGPA) also known as
churg strauss syndrome
27
``` late onset asthma/rhinitis mononeuritis multiplex (neuroproblem) oral ulcers nose bleeds cough deafness skin involvement ```
eosinophilic granulomatosis with polyarteritis (EGPA)
28
which type of vasculitis is associated with asthma
eosinophilic granulomatosis with polyanteritis (EGPA)
29
investigations for eosinophilic granulomatosis with polyarteritis (EGPA)
high eosinophil pANCA anti-MPO (same as MPA)
30
histology of eosinophilic granulomatosis with polyarteritis (EGPA)
eosinophils
31
what other name is granulomatosis with polyarteritis (GPA) known as
wegners granulomatosis
32
granulomatosis with polyarteritis (GPA) usually occurs in...
35-55 y/o males
33
histology of granulomatosis with polyarteritis (GPA) (2)
necrotising granulomatous glomerulonephritis | nucleate giant cells
34
presentation of granulomatosis with polyarteritis (GPA)
ENT symptoms - oral ulcers, nose bleeds, nasal cartilage collapse (saddle nose), cough, deafness haemoptysis
35
investigations in granulomatosis with polyarteritis (GPA)
cANCA positive | anti-PR3 antibody positive
36
cANCA positive | anti-PR3 positive
granulomatosis with polyarteritis (GPA)
37
pANCA positive | anti-MPO positive
eosinophilic granulomatosis with polyarteritis (EGPA) OR microscopic polyangitis (MPA)
38
which vasculitis presents with ENT symptoms (not asthma)
granulomatosis with polyangitis (GPA)
39
which vasculitis present with ENT and asthma
eosinophilic granulomatosis with polyangitis (EGPA)
40
histology of microscopic polyangitis (MPA)
necrotising glomerulonephritis
41
investigations for microscopic polyangitis (MPA)
pANCA positive anti-MPO positive (same as EGPA)
42
what is henoch schnlein purpura (HSP) also known as
IgA vasculitis
43
which vasculitis is IgA mediated
henoch schnlein purpura
44
which group of people get henoch schnlein purpura
children aged 2-11 (not infants)
45
which vasculitis presents in kids and follows a URTI (1-3 weeks before)
henoch schnlein purpura
46
presentation of henoch schnlein purpura (5)
purpuric rash over buttocks and lower limbs colicky abdo pain bloody diarrhoea joint pain proteinuria/haematuria after recent infection
47
treatment of ALL small vessel vasculitis (EGPA, GPA, MPA, HSP) (3) if kidney involvement
IV steroids IV cyclophosphamide long term immunosuppression - methotrexate if kidney involvement - dialysis
48
what is used to detect ANCAs
immunofluorescence
49
often the first sign of small vessel vasculitis why
renal involvement kidneys v susceptible to damage

J MSK (30 decks)

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