Vasculitis

Question 1

Large :

Giant cell vasculitis (temporal)

Answer 1

Unilateral headache
Possible temporal artery tenderness
Jaw claudication
Irreversible blindness (ophthalmic artery occlusion) 
Associated with polymyalgia rheumatica

Tx: glucocorticoid
Focal granulomatous inflammation

Question 2

Large:

Takayasu arteritis

Answer 2

Pulseless disease

Weak upper extremity pulse
Fever, night sweat, arthritis, myalgia, skin nodules, ocular disturbance
Narrowing of aortic arch and proximal great vessels

Question 3

Medium
Buerger
(Thromboangitis obliterans)

Answer 3

Heavy smoker
Auto amputation of didgot
Raynauds phenomenon
Superficial nodular phlebitis
Intermittent claudication 
Segmental thrombosis vasculitis with vein and nerve involvement

Question 4

Medium
Kawasaki
Mucocutaneous lymph syndrome

Answer 4

Conjunctival injection
Polymorph rash
Cervical Adenopathy
Strawberry tongue (oral mycositis) 
Hand foot change (edema, erythema) 
Fever

Tx: IVIG + aspirin

Question 5

Medium

PAN

Answer 5

Hbv seropositivity
Fever
Weight loss 
Malaise
Headache
Abd pain and melena
HTN
Neurologic dysfunction 
Cutaneous erruption
Renal damage

Involve : renal and visceRal NOT pulmonary
Transmural inflammation of vessel+fibrinoid necrosis
Lots of renal microaneurysm
Tx : corticosteroids + cyclophosphamidd

Question 6

Small:

Behcet

Answer 6

Recurrent aphtous
Genital ulceration
Uveitis
Erythema nodusum
Immune complex vasculitis
HLA-B51⬆️

Question 7

Small

Cutaneous small vessel vasculity

Answer 7

7-10 days agter penicilin cephalosporin phenytoin allopurinol
Or after infection hcv or hiv

Palpable purpura

Question 8

Small
Churg strauss
Eosinophilic granulomatosis with polyangitis

Answer 8

Asthma
Sinusitis
Skin nodules/purpura
Peripheral neuropathy

Pauci immune glomerulonephritis
Eosinophilia
IgE⬆️
P-ANKA MPO-ANKA ⬆️

Question 9

Small
Wegner
Polyangitis granulomatosis

Answer 9

Upper respiratory tract: 
Perforation of nasal septum 
Chronic sinusitis
Otitis media
Mastoiditis

Lower resp tract :
Hemoptysis
Cough
Dyspnea

Renal :
Hematuria
Ted cell cast

Chest xray : large nodular densities
C-ANKA , PR3ANCA ⬆️

Tx: cyclophosphamide + corton

Question 10

Wegner triad

Answer 10

Focal necrotizing vasculitis
Necrotizing granulomas in lung and upper airway
Necrotizing glomerulonephritis

Question 11

Small
IgA vasculitis
Henoch schonlein purpura

Answer 11

After URI

Triad: palpable purpura on buttoks and legs, arthralgia, abd pain associated with intususception

Question 12

Microscopic poly angitis

Answer 12

Pauci immune Gn palpable purpura
Skin kidney lung
No granuloma
MPO ANCA ⬆️
P-ANCA ⬆️
Tx cyclphosphamide va corton