Vasculitis

Question 1

define vasculitis

Answer 1

this is inflammation of the blood vessels

Question 2

what is vasculitis associated with

Answer 2

ischaemia
necrosis
organ inflammation

Question 3

define primary vasculitis

Answer 3

results from inflammatory response that targets the vessel walls

Question 4

define secondary vasculitis

Answer 4

triggered by infection, drug, toxin or predisposing condition

Question 5

presentation of vasculitis

Answer 5

systemic= fever, malaise, weight loss
bruit, claudication and high BP
organ involvement, especially kidneys as asymptomatic

Question 6

diagnosis of vasculitis

Answer 6

• urinalysis for kidneys/glomerular nephritis
• ESR/plasma viscosity/ CRP/ complement reduced (C3/4 immune complex forming)
• temporal artery biopsy or any affected area to detect granulomas
• immunofluorescence for ANCA
• antibodies (anti-PR3- GPA and anto-mpo- EGPA)
• CXR (granulomas with a caveatting centre)
  CT of abdomen

Question 7

management of vasculitis

Answer 7

prednisolone (high dose steroids)

immunosuppressants e.g. cyclophosphamide (FIRST LINE) methotrexate, azathioprine, rituximab

Question 8

two types of large vessels vasculitis

Answer 8

takayasu arteritis (TA)
giant cell arteritis (GCA)

Question 9

define takayasu arteritis

Answer 9

inflammation of all the large vessels, seen in developing parts of the world

Question 10

presentation of giant cell arteritis

Answer 10

loss of sight/vision change
tenderness of scalp
prominent temporal arteries and loss of pulse due to thickened wall

Question 11

diagnosis of giant cell arteritis

Answer 11

biopsy

Question 12

management of giant cell arteritis

Answer 12

steroids

Question 13

what is small vessels vasculitis divided into?

Answer 13

ANCA positive and negative

Question 14

four examples of small vessel vasculitis

Answer 14

• granulomatosis with polyangiitis (GPA)
• eosinophilic granulomatosis with polyangiitis (EGPA)
• microscopic polyangiitis
• HSP

Question 15

define granulomatosis with polyangiitis

Answer 15

inflammation of the respiratory tract

Question 16

presentation of granulomatosis with polyangiitis

Answer 16

mouth ulcers
hearing loss
systemically unwell- purpuric non-blanching rash and palsy symptoms

Question 17

define eosinophilic granulomatosis with polyangiitis (EGPA)

Answer 17

eosinophilic granulomatous inflammation of respiratory tract with late onset asthma and high eosinophils. they patients are systemically well

Question 18

define microscopic polyangiitis

Answer 18

necrotising vasculitis with few deposits

Question 19

define Henoch-Schoenlein Purpura (HSP)

Answer 19

acute IgA mediated disorder

Question 20

what ages does HSP present in?

Answer 20

2- 11 years

Question 21

what is common in HSP

Answer 21

preceding infection

Question 22

presentation of HSP

Answer 22

purpuric rash over lower limbs
abdominal pain
diarrhoea
joint swellings

Question 23

management of HSP

Answer 23

usually resolves within 8 weeks

Question 24

what test should be done in HSP

Answer 24

urinalysis for renal involvement

Question 25

which vasculitis is associated with p-ANCA and anti-MPO

Answer 25

MPA

Question 26

which vasculitis is associated with c-ANCA and anti-PR3

Answer 26

GPA