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41 Cards in this Set

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  • Back
Generally, what are characteristics of vasculitis?
inflammation and necrosis of blood vessels with resulting ischemia
What are examples of large vessel vasculitis?
• Giant cell arteritis/polymyalgia rheumatica
• Takayasu arteritis
List examples of medium vessel vasculitis
• Churg-Strauss syndrome
• Kawaski disease
• polyarteritis nodosa
List examples of small vessel vasculitis
• microscopic polyarthritis
• Henoch-Schönleöin purpura
• Leukocytoclastic vasculitis
• Wegener's granulomatosis
What is the most common type of systemic vasculitis?
Giant cell arteritis (aka temporal arteritis)
What are clinical findings of giant cell arteritis?
• arthralgias
• headaches
• jaw claudication
• malaise
• scalp tenderness
• visual disturbance
What are characteristics of polymyalgia rheumatic?
a complex of symptoms that includes pain and stiffness of the shoulder and hip girdles and proximal extremities
What is the treatment for giant cell arteritis/polymyaglia rheumatic?
glucocorticoids (high dose for GCA; low dose for PMR)
Takayasu arteritis is a large vessel vasculitis that predominantly affects young women (but can be seen in either men or women up to age 50). What vessels are affected in Takayasu arteritis?
aorta and its main branches
• brachiocephalic
• cerebral
• coronary arteries
• femoral
• mesenteric
• renal
What vessels are most commonly stenosed in Takayasu arteritis?
proximal aorta and its branches
What are treatment options for Takayasu arteritis?
• glucocorticoids
• immunosuppressive agents (ex. methotrexate, cyclophosphamide)
What are characteristics of classic polyarteritis nodosa?
• involves only medium-sized vessels
• associated with a renin-mediated HTN but spares the lungs
Polyarteritis nodosa is associated with which viral infections?
Hepatitis B and C
What are typical skin findings for polyarteritis nodosa?
• livedo reticularis
• subcutaneous nodules
• skin ulcers

* reflects the involvement of deeper, medium-sized blood vessels
What is the most common cutaneous presentation of polyarteritis nodosa?
lower extremity ulcerations (usually near the malleoli)
What organ systems are most commonly affected by polyarteritis nodosa?
• renal
• gastrointestinal
• peripheral nervous system
What are lab findings of polyarteritis nodosa?
• anemia
• leukocytosis
• elevated ESR

* usualy ANCA-negative
What is the treatment for polyarteritis nodosa?
• glucocorticoids
• immunosuppressives (used in severe cases)
What is another name for Churg-Strauss Syndrome?
• allergic granulomatosis
• angiitis
What is the classic presentation of Churg-Strauss syndrome?
middle aged women with chronic asthma who develops pulmonary infiltrates, vasculitis, and eosinophilia
What are significant lab findings in patients with Churg-Strauss Syndrome?
• eosinophilia
• antineutrophil cytoplasmic autoantibodies (ANCA): usually P-ANCA
Wegener's granulomatosis is a small to medium vessel vasculitis with many extravascular maniffestations. What are the most common sites of involvement?
• sinus and upper airway
• lung
• kidney
What are upper respiratory tract symptoms seen in Wegener's granulmatosis?
• inflammation of the gums
• mastoiditis
• nasal congestion
• otitis media
• sinusitis
• stridor
What are examples of ocular manifestations of Wegener's granulomatosis?
• anterior uveitis
• episcleritis
• keratitis
• proptosis
• scleritis
Henoch-Schonlein purpura is small vessel vasculitis most common affecting what patients?
children and young adults
What is the classic clinical triad of Henoch-Schonlein purpura?
• abdominal pain
• arthritis
• palpable purpura
IgA deposition in glomerular lesions is characteristics of what vasculitis condition?
Henoch-Schonlein Purpura
What is Leukocytoclastic vasculitis?
• refers to inflammation and fibrinoid necrosis of vessel walls
• deposition of cellular debris in the surrounding tissue of the skin
• more of a sign of disaese rather than a unique vasculitis
What is the clinical sign of Leukocytoclastic vasculitis?
palpable purpura
When LCV is an isolated finding, what is a common cause?
drug reaction
What is the "gold standard" test for diagnosing vasculitis?
tissue biopsy
Angiography can be used to diagnose vasculitis. What are some abnormalities that can be seen on angiography?
• microaneurysms
• stenosis
• tapering
What vasculitis disorders are associated with positive ANCA?
• Churg-Strauss syndrome
• microscopic polyangitis
• Wegener's granulomatosis
What are characteristics of antiphospholipid syndrome?
• destructive thrombocytopenia
• recurrent thrombosis
• fetal loss
How is antiphospholipid syndrome diagnosed?
by demonstration of a lupus anticoagulant and/or anticardiolipin antibody
What is Livido reticularis?
• a mottled purplish discoloration of the skin
• "fish-net" appears
• a cutaneous manifestation of vasculitis
What are extrapulmonary manifestations of sarcoidosis?
• joint-related pain
• sialoadentitis
• skin lesions
What is a cytotoxic response?
• aka serum sickness
• fever, lymphadenopathy, myalgias (B symptoms)
What infectious disease can produce a vasculitis?
tertiary syphilis (meningovasular etiology that can present like a stroke)
What are clincial manifestations of Kawaski disease?
• fever
• cervical lymphadenopathy
• conjunctivitis
• mucous membrane changes (ex. injected pharynx, erythema, swelling & fissuring of lips, strawberry tongue)
• peripheral extremity changes (ex. edema, desquamation, erythema of palms or soles, induration of hands & feet)
• rash
What is a major complication of Kawaski disease?
arteritis of the coronary vessels