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34 Cards in this Set

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What is the most classic presentation of leukocytoclastic vasculitis?
Palpable purpura.
What are 3 scenarios that yu see leukocytoclastic vasculitis?
Serum Sickness (drug rxn)

Henoch Schonlein Purpurs

Essential mixed cryoglobulinemia
Palpable purpura with no other associated signs or symptoms is indicative of _
a drug rxn (serum sickness)

(this is small vessel vasculitis aka leukocytoclastic vasculitis)
Henoch-Schonlein Purpura typically occurs in who during _ time of the year
children during spring time (indicating involvement of an environmental microorganism)
What is the presumptive mechanism f Henoch-Schonlein Purpura
(this is a small vessel vasculitis, aka leukocytoclastic vasculitis) - it is IgA immune complex mediated
What are typical findings in Henoch-Schonlein purpura?
Purpura, GI bleeding,

arthritis, nephropathy
Essential Mixed Cryoglobulinemia is a _ vessel vasculitis, and is _ mediated.

This is highly associated with what underlying disorder?
small vessel vasculitis (leukocytoclastic vasculitis)

Cold temperature mediated -IgG /IgM complex mediation

Hepatitis C
Pt presents with lower extremity "bruises that won't go away" and joint pain. Upon physical exam, you note that the brown papules on her legs are slightly palpable. When you place an ice cube on her arm, she breaks out in a rash. What is the dx?
Essential Mixed Cryoglobulinemia, this is a leukocytoclastic vasculitis
Pt presents with lower extremity "bruises that won't go away" and joint pain. Upon physical exam, you note that the brown papules on her legs are slightly palpable. When you place an ice cube on her arm, she breaks out in a rash. What underlying disorder is this associated with?
(the patient has Essential Mixed Cryoglobulinemia)

Ass with HEPATITIS C
Take home points of Essential Mixed Cryoglobulinemia?
Small Vessel vasculitis,

Cold temp precipitation of IgG/IgM complexes

Associated with Hep C
Take home points of Henoch-Schonlein Purpura?
Small Vessel vasculitis

typically in children, IgA complex deposition resulting in purpura, GI bleeding (arthritis and nephropathy less common)
What vasculitis disorder is characterized by Segmental necrotizing inflammation of arteries involving bifurcations and branch points (It does not involve veins
Polyarteritis Nodosa

It is associated with Hepatitis B
Pt is diagnosed with Polyarteritis Nodosa. Where would you expect to NOT find any lesions?
Lung

(compare to Churg - Strauss, another medium vasculitis that does involve the lung)
The diagnosis of polyarteritis nodosa is based on _ and _
clinical suspicion and radiographical images
Churg-Strauss is AKA _

There is a strong association is _
allergic granulomatosus

(this is where the tissues are filled with eosinophils)

asthma/allergy history
A granulomatous reaction where the tissues are filled with eosinophils
Churg - Strauss ( a medium vasculitis)
Eosinophilia, neuropathy, transitory pulmonary infiltrates, paranasal sinus abnormalities and asthma are all criteria for the diagnosis of what vasculitis?
Churg Strauss (allergic granulomatosus)
Wegener's Granulomatosis affects what size vessel?

It is highly associated with _
small and medium arteries

C ANCA antibody (specifically PR3)
The ELK classification is diagnostic for what vasculitis?
Wegener's Granulomatosis

stands for ENT, Lungs, Kidney

Typically these patients have a history of chronic nasal infections
Takayasu's Arteritis is classically seen in _.

This has a strong preference to what vessels?
young asian women

aortic arch and it's branches
An abormal arteriogram - showing occlusion or narrowing of proximal aorta or it's main branches is diagnostic of what vasculitis?
Takayasu's Arteritis
Temporal arteritis is classically seen in _.
older women

(with jaw claudication, visual changes, or new headache)
A 70 yo women presents with a new onset headache, visual changes and jaw claudication. ESR level is 85. What is the vasculitis disorder that you should consider in this patient?
Temporal Arteritis
With regards to vasculitis, it is important to look at your patients from what standpoint?
An organ system....

this helps you diagnose the problem
Most vasculitites are assumed to be mediated by _ mechanisms that occur in response to _.
immunopathogenetic mech

response to certain antigenic stimuli
What are the 3 proposed mechanism of vascular damage that cause vasculitis?
1. Pathogenic immune complex form/deposition 2. Production of ANCA or 3. Pathogenic T lymph responses and granuloma form.
The distribution and therefore clinical symptoms of vasculitis depend on _
the vessel size
What are the main symptoms of large vessel vasculitis?
limb claudication, asymmetric BP, absence of pulses, bruits, aortic dilation
limb claudication is a symptom of what group of vasculitities?
Large Vessel
What are the symptoms for medium vessel vasculitis?
cutaneous nodules, ulcers, digital gangrene
What are the symptoms of small vessel vasculitis?
purpura, vesiculobullous lesions, urticarial, glomerulonephritis
How are vasculitities typically treated?
glucocorticoids (anti- inflammatories) and immunosuppressives.

Start strong and step down once the pt starts responding
_ vasculitis is associated with hepatitis C
essential mixed cryoglobulinemia
_ (vasculitis) is associated with hepatitis B
Polyarteritis Nodosa