Qbank - Vasculitis

Front 1

strawberry vs cherry hemangioma?

Back 1

strawberry occur during 1st few weeks of life, grow rapidly then regress by 5-8 yo
cherry hemangiomas appear in 30-40's, do not regress & increase w/age (aka senile hemangiomas) - ALWAYS cutaneous, histologically are sharply circumscribed areas of congested capillaries & post-capillary venules in the papillary dermis

Front 2

vasculitis in child showing IgA & C3 deposition?

Back 2

Henoch-Schonlein purpura
-recent infection, -palpable skin lesions, -with/or without abdominal pain & arthralgias
self-limiting but glomerulonephritis & even ESRD are possible complications

Front 3

vasculitis w/nasal mucosal ulcerations, "saddle nose" & oliguria?

Back 3

Wegeners, c-ANCA (serum anti-neutrophil)

Front 4

vasculitis w/weak upper extremity pulses?

Back 4

Takayasu arteritis
-large vessels (aorta & prox branches)

Front 5

vasculitis w/headache & blurred vision?

Back 5

Giant Cell Arteritis

Front 6

sx of vasculitis w/hypersensitivity to intradermally injected tobacco extract?

Back 6

Buerger's dz - thromboangiitis obliterans
exhibits segmental vasculitis extending into contiguous veins & nerves
heavy smokers before age 35
most common in Israel, Japan, & India
typical of tibial & radial arteries

Front 7

vasculitis w/granulomatous inflammation of the media?

Back 7

temporal (giant cell) arteritis
medium to small branches of the carotid, especially temporal arteries

Front 8

vasculitis w/transmural inflammation of arterial wall w/fibrinoid necrosis?

Back 8

polyarteritis nodosa

Front 9

segmental vasculitis extending into contiguous veins and nerves?

Back 9

Buerger's

Front 10

what medication is used in diagnosing prinzmetal's angina?

Back 10

ergonovine is most sensitive provocative dx test
ergot alkaloid that constricts vascular smooth mm by stimulating both alpha adrenergic & serotnergic receptors
this causes sx in patients w/hypercontractile coronary artery segments

Front 11

granulomatous inflammation of the media?

Back 11

temporal (giant cell) arteritis
MC form systemic vasculitis in adults
typically > 50, headache, facial pain, jaw claudication, visual loss

Front 12

homogenous acellular thickening of arterolar walls?

Back 12

hyaline arteriolosclerosis

homogenous deposition hyaline material in intima & media of small arteries & arterioles

diabetic microangiopathy

Front 13

medial band-like calcification?

Back 13

Monckeberg's medial calcific sclerosis, or medial calcinosis

calcified depositis in muscular arteries

> 50 yo, visible radiologically, often PALPABLE on physical exam

clinically asymptomatic b/c do not narrow vessel lumen

Front 14

transmural inflammation of arterial wall w/fibrinoid necrosis?

Back 14

polyarteritis nodosa

Front 15

granulomatous inflammation of the media?

Back 15

temporal (giant cell) arteritis (ESR up, resolves w/steroids)
takayasu arteritis (aortic arch)

Front 16

in Giant Cell arteritis what changes are seen to vessels?

Back 16

granulomatous inflammation of media & fragmentation of internal elastic lamina

perhaps due to autoimmunity of elastin

Front 17

what is Polyarteritis nodosa? Histologic features & vessels involved? Organs involved? Characteristic findings?

Back 17

segmental, transmural, necrotizing inflammation
medium to small sized arteries in any organ (except lung)

Kidneys most often involved
Heart, liver, & GI also most often involved

SPARES pulmonary arteries & bronchial art

inflammation can cause ischemia, infarction, or hemorrhage

bead-like aneurysm formation, especially in mesenteric circulation
1/3 of patients get cutaneous manifestations - Livedo reticularis (purplish network patterend) & palpable purpura

Front 18

transmural inflammation of arterial wall w/fibrinoid necrosis?

Back 18

polyarteritis nodosa (PAN), associated w/hepatitis B in 10-30% cases

this vasculitis can resemble Churg Strauss by histology (the one w/eosinophilia & asthma), but Churg Strauss characteristically has granulomas & eosinophilic necrosis