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Flashcards in Vasculitis Deck (28):
1

How can vasculitis be classified?

Into the vessel size affected- small, medium and large

2

What are the small vasculitis?

Granulomatous with polyangitis
Microscopic polyangitis
Churg strauss
Henloch Scholein Purpura

3

What are the medium cell vasculits?

Kawaski disease
Polyarteritis nodosa
Beurgers disease

4

What are the large vessel vasculitis?

GCA and Takayasu

5

How can small vessel vasculitis be further split?

ANCA associated - microscopic polyangitis, Wergeners and Churg strauss
Immunological associated - Goodpastures disease, IgA vasculitis

6

What is the general management for vascultiis?

Large - steriods
Medium and small - immunosuppression

7

What is polyarteritis nodosa?

Necrotsing vasculitis that causes aneurysms and thrombosis in medium size vessels leading to infarct of organs affected and severe systemic symptoms
Appears like beads on a string
Can be secondary to HBV

8

What are the symptoms of polyarteritis nodosa?

Skin - punched out ulcers, nodules
Renal - main cause of death - renal artery narrowing, glomerular ischaemia and HTN
Cardiac, GI and GU invovlement
Usually spares the lungs

9

How does Wergeners disease present?

cANCA positive
Affects the nasopharynx, lung and kidney
> rapidly progressing cresenteric glomerulonephritis
Biopsy shows inflammation and granulamas in vessel wall

10

How is Wergeners treated?

Corticosteriods and cyclophosphamide

11

How does Churg Strauss present?

pANCA - sinusitis, lung, kidney, GI, skin, nerve and heart damage
Increased eosinophils
Granulomas

12

What is the pathophysiology behind HSP?

IgA deposition against endothelial cells
Buttock and thigh purpura

13

Where does microscopic polyangitis affect?

Lungs and Kidney
pANCA positive
No granulomas

14

What is Kawaski disease?

Vasculitis of the coronary arteries which can lead to aneurysms and ischaemia of the coronary tissue

15

What should be done in a patient with suspected Kawaski disease?

MI ECHO
Aspirin and Ig IV

16

What are the features for diagnosis of Kawaski disease?

Conjunctivitis
Rash
Adenopathy
Strawberry tongue
Swollen hands and feet
Plus fever for more than five days

17

What is Beurgers disease?

Clots in fingers and toes --> ulcer --> auto amputation

18

What is GCA?

Inflammation of the branches of the carotid arteries. Usually the temporal artery

19

How does GCA present?

Headaches, scalp tenderness, jaw claudication, systemic symptoms
May have vision changes including Amaurosis fugax

20

What are the investigations done in GCA?

ESR will be greatly raised and urgent referral for biopsy

21

What is the treatment for GCA?

Prednisolone 40mg per day
60mg if visual changes
*will be on long term steriods so think about bone and GI protection*

22

What is affected in Takayasu arteritis?

Aortic arch branches - can lead to pulselessness and neuro/visual symptoms
Long term complications include limb ischaemia and renal failure

23

what is the management of Takayasu disease?

Corticosteriods

24

What are the three main features of polyarteritis nodosa?

Aneursym, thrombosis and infarct

25

In all vasculitis what should be done?

Urine dip to look for signs of haematuria and proteinuria

26

What may be found on examination in a patient with Takyasu?

vascular bruits may be audible over the carotids, abdominal aorta, or subclavian vessels. Unequal blood pressures may be recorded between sides, and a murmur of aortic regurgitation may be heard if there is aortic root dilation.

27

How is remission maintained in a patient with granulomatosis with polyangitis ?

Remission can be maintained using low-dose corticosteroids and either azathioprine or methotrexate.

28

6. Which is the most common type of vasculitis?

Kawasaki’s