2-14-12 - Vasculitis - Dr. Humphrey

Front 1

What are the 2 large-vessel vasculitis?

Back 1

1. Temporal (Giant Cell) Arteritis

2. Takayasu Arteritis

Front 2

What are the 2 medium-vessel vasculitis?

Back 2

1. Polyarteritis Nodosa

2. Kawasaki Disease

Front 3

What are the 3 ANCA-associated, small/medium-vessel vasculitis?

Back 3

1. Wegener Granulomatosis

2. Microscopic Polyangiitis

3. Churg-Strauss Syndrome

Front 4

What are the 2 small-vessel vasculitis?

Back 4

1. Mixed Cryoglobulinemia

2. Henoch-Schonlein Purpura

Front 5

Which vasculitis affects vessels of all sizes?

Back 5

Behcet Disease

Front 6

Necrotizing medium-sized vessel vasculitis involving renal, coronary, and mesenteric arteries (spares pulmonary arteries) is associated with which vasculitis?

Back 6

Polyarteritis Nodosa (PAN)

Front 7

Polyarteritis Nodosa (PAN) affects what population?

Back 7

Middle-aged men

Front 8

Which vasculitis is associated with HBsAg?

Back 8

Polyarteritis Nodosa (PAN)

Front 9

Vessels at all stages of acute and chronic inflammation is associated with which vasculitis?

Back 9

Polyarteritis Nodosa (PAN)

Front 10

Focal vasculitis that produces aneurysms that are detectable with angiography is associated with which vasculitis?

Back 10

Polyarteritis Nodosa (PAN)

Front 11

Renal infarction but no glomerulonephritis is associated with which vasculitis?

Back 11

Polyarteritis Nodosa (PAN)

Front 12

Testicular pain is associated with which vasculitis?

Back 12

Polyarteritis Nodosa (PAN)

Front 13

Livedo reticularis is associated with which vasculitis?

Back 13

Polyarteritis Nodosa (PAN)

Front 14

Subcutaneous nodular vasculitis is associated with which vasculitis?

Back 14

Polyarteritis Nodosa (PAN)

Front 15

Digital infarction is associated with which vasculitis?

Back 15

Polyarteritis Nodosa (PAN)

Front 16

What is the diagnosis for Polyarteritis Nodosa (PAN)?

Back 16

Angiography and biopsy of lesions confirm the diagnosis

Front 17

What is the treatment for Polyarteritis Nodosa (PAN)?

Back 17

Corticosteroids

(Cyclophosphamide for life-threatening disease)

Front 18

Necrotizing medium and small-sized vessel vasculitis involving lung (infarctions) and renal vessels (glomerulonephritis) is associated with which vasculitis?

Back 18

Wegener Granulomatosis

Front 19

Wegener Granulomatosis is associated with which autoantibody?

Back 19

C-ANCA (Proteinase 3)

Front 20

C-ANCA (Proteinase 3) is associated with which vasculitis?

Back 20

Wegener Granulomatosis

Front 21

Perforation of nasal septum, saddle-nose deformity, chronic sinusitis, and collapse of trachea are associated with which vasculitis?

Back 21

Wegener Granulomatosis

(C-ANCA associated)

Front 22

Cavitary lung nodules and alveolar hemorrhage/hemoptysis is associated with which vasculitis?

Back 22

Wegener Granulomatosis

(C-ANCA associated)

Front 23

The triad of focal necrotizing vasculitis, necrotizing granulomas in the lung and upper airway, and necrotizing glomerulonephritis is associated with which vasculitis?

Back 23

Wegener Granulomatosis

(C-ANCA associated)

Front 24

Orbital pseudotumor is associated with which vasculitis?

Back 24

Wegener Granulomatosis

(C-ANCA associated)

Front 25

What is the treatment for Wegener Granulomatosis?

Back 25

Corticosteroids and Cyclophosphamide

Front 26

Pauci immune necrotizing glomerulonephritis and palpable purpura is associated with which vasculitis?

Back 26

Microscopic Polyangiitis

(P-ANCA associated)

Front 27

Diffuse alveolar hemorrhage is associated with which vasculitis?

Back 27

Microscopic Polyangiitis

(P-ANCA associated)

Front 28

Microscopic Polyangiitis is associated with which autoantibody?

Back 28

P-ANCA (myeloperoxidase)

Front 29

P-ANCA (myeloperoxidase) is associated with which vasculitis?

Back 29

Microscopic Polyangiitis

Churg-Strauss Syndrome

Front 30

What is the most common ANCA-associated vasculitis?

Back 30

Microscopic Polyangiitis

Front 31

Vessels at the same stage of inflammation is associated with which vasculitis?

Back 31

Microscopic Polyangiitis

(P-ANCA associated)

Front 32

Eosinophil-rich granulomatous inflammation of the respiratory tract with necrotizing vasculitis of small and medium vessels is associated with which vasculitis?

Back 32

Churg-Strauss Syndrome

(P-ANCA associated)

Front 33

Allergic rhinitis, asthma, and non-fixed pulmonary infiltrates are associated with which vasculitis?

Back 33

Churg-Strauss Syndrome

(P-ANCA associated)

Front 34

Churg-Strauss Syndrome is associated with which autoantibody?

Back 34

P-ANCA (myeloperoxidase)

Front 35

What is the most common vasculitis in children?

Back 35

Henoch Schonlein Purpura

Front 36

IgA immune complexes are associated with which vasculitis?

Back 36

Henoch Schonlein Purpura

Front 37

Palpable purpura of buttocks and lower extremities, arthralgia, GI bleeding, and nephropathy are associated with which vasculitis?

Back 37

Henoch Schonlein Purpura

Front 38

Which vasculitis commonly follows an upper respiratory infection such as a Group A streptococcal pharyngeal infection?

Back 38

Henoch Schonlein Purpura

Front 39

What is the treatment for Henoch-Schonlein Purpura?

Back 39

Most have spontaneous recovery in 4 months without therapy

Corticosteroids used if severe GI or renal disease

Front 40

What is the most common vessel involved in hypersensitivity vasculitis?

Back 40

Venules (producing a venulitis)

Front 41

What is the most commonly involved organ in hypersensitivity vasculitis?

Back 41

Skin (palpable purpura)

Front 42

What is the term for an immune system reaction to certain medications/injected proteins used to treat immune conditions that develops 7-21 days after the first exposure to the medication?

Back 42

Serum Sickness

Front 43

Monoclonal RF and Polyclonal IgG is associated with which vasculitis?

Back 43

Type 2 Mixed Cryoglobulinemia

Front 44

Hepatitis C is associated with which vasculitis?

Back 44

Type 2 Mixed Cryoglobulinemia

Front 45

How should you transport a blood sample in a patient with Cryoglobulinemia?

Back 45

Keep blood at 37C until the clot is separated; otherwise antibodies will end up in the clot

Front 46

What is the term for antibodies that precipitate at cold temperatures?

Back 46

Cryoglobulins

Front 47

Palpable purpura, acral cyanosis of nose and ears, and Raynaud's Phenomenon are associated with which vasculitis?

Back 47

Type 2 Mixed Cryoglobulinemia

Front 48

Granulomatous large vessel vasculitis involving superficial temporal and ophthalmic arteries is associated with which vasculitis?

Back 48

Giant Cell (Temporal) Arteritis

Front 49

Women > 50yo is associated with which vasculitis?

Back 49

Giant Cell (Temporal) Arteritis

Front 50

New-onset unilateral headache, jaw claudication, blindness on ipsilateral side, and polymyalgia rheumatica (muscle and joint pain with normal CK) are associated with which vasculitis?

Back 50

Giant Cell (Temporal) Arteritis

Front 51

Elevated ESR is associated with which vasculitis?

Back 51

Giant Cell (Temporal) Arteritis

Takayasu Arteritis

Front 52

Involvement of the carotid artery is associated with which vasculitis?

Back 52

Giant Cell (Temporal) Arteritis

Front 53

What are the diagnostic criteria for Giant Cell (Temporal) Arteritis?

Back 53

3 of the 5:

1. Age > 50

2. New-onset headache

3. Temporal artery tenderness or decreased pulsation

4. Elevated ESR

5. Abnormal temporal artery biopsy

Front 54

What is the preferred diagnosis of Giant Cell (Temporal) Arteritis?

Back 54

Bilateral temporal artery biopsy of at least 2cm (due to skip lesions)

Do not withhold steroids for biopsy result

Front 55

What is the treatment for Giant Cell (Temporal) Arteritis?

Back 55

Immediate administration of high dose corticosteroids

Front 56

Muscle pain of the shoulders and pelvic girdle lasting at least one month, a normal serum CK, and an elevated ESR in a Caucasian woman > 55 is associated with which diagnosis?

Back 56

Polymyalgia Rheumatica

(associated with Giant Cell Temporal Arteritis)

Front 57

Granulomatous large vessel vasculitis involving the aortic arch is associated with which vasculitis?

Back 57

Takayasu Arteritis (Pulseless Disease)

Front 58

Asian females < 40 yo is associated with which vasculitis?

Back 58

Takayasu Arteritis (Pulseless Disease)

Front 59

Presentation of arm or leg claudication with decreased or absent pulses on exam is associated with which vasculitis?

Back 59

Takayasu Arteritis (Pulseless Disease)

Front 60

Recurrent aphthous ulcers, uveitis, and genital ulcers is associated with which vasculitis?

Back 60

Behcet Syndrome

Front 61

Necrotizing medium-sized vessel vasculitis involving coronary arteries is associated with which vasculitis?

Back 61

Kawasaki Disease

Front 62

Asian children < 4yo is associated with which vasculitis?

Back 62

Kawasaki Disease

Front 63

Fever, erythema and edema of hands and feet convalescing with desquamated rash are associated with which vasculitis?

Back 63

Kawasaki Disease

Front 64

Cervical adenopathy, "strawberry tongue," oral erythema, and cracking of the lips are associated with which vasculitis?

Back 64

Kawasaki Disease

Front 65

Coronary artery aneurysms and thromboses are associated with which vasculitis?

Back 65

Kawasaki Disease

Front 66

What is the most common acquired heart disease in children?

Back 66

Kawasaki Disease

Front 67

What is the treatment of Kawasaki Disease?

Back 67

IV immunoglobulin and aspirin

(corticosteroids are contraindicated due to danger of vessel rupture)

Front 68

In which vasculitis are corticosteroids contraindicated due to danger of vessel rupture?

Back 68

Kawasaki Disease