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56 Cards in this Set
- Front
- Back
Large Vessel Vasculitis
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Temporal Giant Cell Arteritis
Takayasu Arteritis |
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Medium Vessel Vasculitis
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Polyarteritis Nodosa
Kawasaki Disease Buerger Disease |
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Small Vessel Vasculitis
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Wegener Granulomatosis(Granulomatosis with Polyangiitis)
Microscopic Polyangiitis Churg-Strauss Syndrome Henoch-Schonlein Purpura |
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MOST COMMON vasculitis in older adults
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Temporal(Giant Cell) Arteritis
vasculitis in older adults(>50) usually affects females |
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Temporal Arteritis clinical symptoms?
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Affects branches of carotid artery leading to headache, and visual disturbances(if it hits ophthalmic artery) and jaw claudication.
Vascular lesions are SEGMENTAL so a negative biopsy does NOT exclude disease. |
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What is at risk to be damaged if Giant Cell Arteritis is not treated?
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Ophthalmic Nerve ischemic damage causing blindness
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Takayasu Arteritis demographic
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Young Asian females less than 50 years old
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Takayasu Arteritis clinical symptoms
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involves the aortic arch at branch points, leading to upper extremity absent pulses(opposite to coarctation of aorta). Presents with visual and neurological symptoms similar to giant cell arteritis
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Polyarteritis Nodosa demographic
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young adults
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Polyarteritis Nodosa clinical symptoms? Classic finding? a/w?
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Hypertension(renal artery involvement), abdominal pain with melena(mesenteric artery involvement), neurologic symptoms and skin lesions.
'String of Pearls' appearance on imaging a/w HBsAg |
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Diseases associated with 'String of pearls'
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Polyarteritis Nodosa
Fibromuscular Dysplasia |
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Polyarteritis Nodosa treatment
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cyclophosphamide and corticosteroids
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Kawasaki Disease demographic
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Asian children less than 4 years old
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Kawasaki Disease presentation
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non-specific similar to infection in beginning but coronary artery involvement common leading to infarction and/or aneurysm.
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Kawasaki Disease clinical signs
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Rash on the palms of their hands and soles of their feet.
(think of a kid on a motorcycle) Coronary artery involvement is common! YOUNG CHILD with a thrombosis and MI or ruptured aneurysm. |
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Kawasaki Disease treatment
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Aspirin -- prevents platelet aggregation via COX inhibitors which block TXA2.
DESPITE possibility of Reye syndrome which could cause encephalopathy |
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Buerger Disease HY associations
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SMOKING disease. Treatment is to STOP smoking.
presents with necrotizing vasculitis involving digits. Associated with Raynauds(white-blue-red). autoamputation of digits without treatment. |
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Wegener's Granulomatosis
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Involves nasopharynx, lungs and kidneys.
c-ANCA positive Treatment is Cyclophosphamide Rapidly Progressive Glomerulonephritis |
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middle aged male with nasopharyngeal ulceration, lung infiltrates and hematuria
What likely renal problem arises? |
Wegener's Granulomatosis
Renal problem is Rapidly Progressive Glomerulonephritis |
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Compare Wegener's to Microscopic Polyangiitis
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Microscopic Polyangiitis involves lung and kidney but NOT oropharynx. Also expresses p-ANCA NOT c-ANCA. Will also NOT have granulomas.
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Compare Microscopic Polyangiitis to Churg-Strauss Syndrome
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Churg-Strauss presents with Asthma, Granulomas and peripheral eosinophilia.
They BOTH have lung involvement, both express p-ANCA. |
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What drug treats vasculitis?
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Cyclophosphamide
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Nephropathy following Upper Respiratory infection?
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IgA nephropathy associated with Henoch-Schonlein Purpura
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Henoch-Schonlein Purpura demographic
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most common vasculitis in children
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Henoch-Schonlein Purpura clinical signs
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palpable purpura on buttocks and legs, GI pain and bleeding, IgA nephropathy.
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Important cause of stenosis in young females?
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fibromuscular dysplasia(frequently involves renal artery)
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Atherosclerotic Clefts characterized by cholesterol clefts
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Etiology of aneurysm
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Arteriolosclerosis types...
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Hyaline and hyperplastic type
Hyaline arteriolosclerosis caused by proteins leaking into vessel wall causing vascular thickening. Hyperplastic arteriosclerosis caused by malignant hypertension |
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Hyaline Arteriolosclerosis caused by...
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Benign Hypertension and diabetes.
Hypertension forces protein into membrane. Diabetes -- non-enzymatic glycosylation of basement mebrane making them more leaky to proteins. |
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Hyaline Arteriolosclerosis classically causes...?
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Glomerular Scarring(arteriolonephrosclerosis) This is what causes chronic renal failure in chronic hypertension/diabetes.
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Hyperplastic arteriosclerosis caused by
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malignant hypertension
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Hyperplastic arteriosclerosis leads to...
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end organ ischemia due to reduced vessel caliber. FIBRINOID necrosis with possible hemorrhage. "onion skin" appearance
Classically causes acute renal failure with 'flea bitten' appearance |
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'flea bitten' appearance of kidney
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acute renal failure due to hyperplastic arteriolosclerosis in response to malignant hypertension
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Etiology of Aortic Dissection due to HTN
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Describe clinical syndromes that could predispose to aortic dissection
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Marfan's Syndrome(fibrillin defect) or Ehlers-Danlos Syndrome(collagen defect)
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Complications of aortic dissection
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Most common cause of death due to aortic dissection
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pericardial tamponade
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Classically causes thoracic aneurysm
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tertiary syphilis which causes endartertis of the vaso vasorum resulting in 'tree barkin' of the aorta.
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Major complication of thoracic aneurysm
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dilation of the aortic valve root, resulting in regurgitation
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Abdominal Aortic Aneurysm demographic
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male smokers >60 with history of hypertension
etiology: Atherosclerosis increases the diffusion barrier to the media, resulting in atrophy and weakness of vessel wall |
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Reddish growth that blanches on pressure
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Hemangioma -- will go away with growth of child
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Reddish rash that does not blanch on pressure
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Kaposi's Sarcoma
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Kaposi's Sarcoma demographic
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Older Eastern European males -- tumor remains localized to skin
AIDS and Transplant patients -- tumor spreads early. |
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Associated with exposure to PVC?
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Liver angiosarcoma
also a/w arsenic and Thorotrast |
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Liver angiosarcoma association?
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Poly-vinyl Chloride
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high risk of blindness without treatment in this disorder. What treatment?
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Giant Cell Temporal Arteritis
Prednisone, or other corticosteroid |
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Weak or absent pulse in upper extremities
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Takayasu's Arteritis
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Takayasu involves which branches of vasculature?
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Branch points of Aortic Arch
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Organ spared in PAN
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lungs
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associated with HBsAg
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PAN
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transmural inflammation with fibrinoid necrosis
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PAN
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intimal fibrosis with _______ is what?
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with giant cells is
Giant Cell Temporal Arteritis |
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Which vasculitis is fatal if not treated
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PAN - treat with cyclophosphamide and corticosteroids
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myocardial infarction in young asian child
treat with? |
Kawasaki Disease - can also result in aortic aneurysms with rupture
aspirin and IVIG |
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large necrotizing granulomas with adjacent necrotizing vasculitis
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Wegeners
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