Vasculitis

Question 0

Takayasu’s arteritis

Answer 0

Granulomatous thickening of aortic arch, proximal great vessels
Asian females < 40
Pulseless disease, weak UE pulses

Question 1

Temporal arteritis

Answer 1

Carotid artery usually
Focal Granulomatous inflammation with increased ESR
-can lead to blindness, unilateral headache, jaw claudiaction

Question 2

Polyarthritis nodosa

Answer 2

30% Hep B, fever, wt loss, malaise, headache, dark stools
Renal and visceral vessels, NOT pulmonary arteries
Immune complex mediated
Transmural inflammation of arterial wall with fibrinoud necrosis
Many aneurysms,
RX: corticosteroids and cyclophosphamide

Question 3

Kawasaki disease

Answer 3

Fever, cervical lymphadenopathy, conjunctival injection, strawberry tongue, hand foot erythema, desquamating rash
***may develop coronary aneurysm
RX aspirin and IV immunoglobulin

Question 4

Buergers disease

Answer 4

Heavy smokers, younger males
Intermittent claudiaction may lead to gangrene, raynauds
Segmental thrombosing vasculitis
RX. Smoking cessation

Question 5

Microscopic polyangitis

Answer 5

Involves lung, kidneys, skin with pauci immune glomerulonephritis and palpable purpura

• p-ANCA
• no granulomas
• RX: cyclophosphamide and corticosteroids

Question 6

Wegeners

Answer 6

Think C= respiratory, lung, kidney
-upper respiratory (perforation nasal septum, sinusitis)
-lower respiratory (HEMOPTYSIS)
Renal (HEMATURIA), red cell casts

Triad:
Focal necrotizing vasculitis 
Necrotizing granuloma in lung and airway
Necrotizing glomerulonephritis 
c-ANCA
CXR shows large nodular densities
RX cyclophosphamide and cortico.

Question 7

Churg-Strauss syndrome

Answer 7

Asthma, sinusitis, wrist and foot drop, heart, GI, kidneys, pauci immune glomerulonephritis
-Granulomatous, necrotizing vasculitis with EOSINoPHILIA
p-ANCA and high IgE

Question 8

Henoch Schonlein purpura

Answer 8

Most common childhood vasculitis
Follows URI
Triad:
Skin palpable purpura
Arthralgia
GI-abdominal pain, melena, 

Vasculitis secondary to IgA complex deposition (Type III hypersensitivity)

Associated with IgA nephropathy