Rheumatology/vasculitis

Front 1

two vasculitides affecting larger vessels?

Back 1

takayasu
GCA

Front 2

wegener's granulomatosis def

Back 2

primary granulomatous vasculitis of unknown aetiology which affects small vessels predominantly

Front 3

wegener's clinical features

Back 3

pattern: URTI, lungs, renal
URTI: necrotising vasculitis upper respiratory tract (epistaxis)
lungs: haemoptysis
renal

Front 4

wegener's diagnosis
(diagnostic test, helpful test, appearances on CXR)

Back 4

diagnostic: biopsy of affected organ (best renal or skin)
helpful: cANCA positive, CXR (migratory pattern nodules, cavities, infiltrates)

Front 5

wegener's treatment

Back 5

mainstay: IV methylprednisolon and cyclophosphamide

Front 6

Polymyalgia rheumatica def

Back 6

PMR is an inflammatory condition of the muscle causing sudden onset of pain or stiffness

Front 7

Polymyalgia rheumatica clinical features

Back 7

eldery (always >50) usually F 70yr
sudden onset severe pain and stiffness of shoulders, neck and hips and lumbar spine. ("limb girdle pattern")
systemic features: fever, tiredness, depression, nocturnal sweats

Front 8

PMR diagnosis
(diagnostic, helpful)

Back 8

diagnostic: no diagnostic test
clinical features + high ESR/CRP
temporal biopsy may show GCA but not necessary normally for diagnosis.

Front 9

PMR treatment and prognosis

Back 9

steroids over 1-2 years
NSAIDs not helpful

Front 10

Giant cell arteritis/temporal arteritis def

Back 10

Inflammatory granulomatous arteritis of large arteries which occurs in association with PMR

Front 11

GCA - clinical features
(epidemology, classical features and signs, associated disease)

Back 11

>50
severe headache
scalp tenderness ("pain when combing hair")
claudicatin of jaw
tender swelling of temporal or occipital arteries
VISUAL LOSS
systemic features: fever, tiredness
50% have PMR

Front 12

GCA - diagnosis
(diagnostic, helpful)

Back 12

diagnostic: 3 out of 5 (American college rheumatology)
1. age >50
2. new headache
3. temp. artery abnormality (tenderness, pulselessness)
4. very high ESR (>50)
5. positive temporal artery biopsy

Front 13

GCA histological features

Back 13

intimal hypertrophy
inflammation of intima, subintima, breaking up internal elastic lamina, giant cells, lymphocytes, plasma cells in internal elastic lamina

Front 14

GCA management

Back 14

if any visual loss or severe headache, presumptive clinical dx and immediate high dose steroids
biopsy within 1 week to confirm
high dose steroids: 60-100mg prednisolone/day (divided doses)
tapering dose according to ESR
Ca+VitD!!!
NSAIDs NOT USEFUL. AVOID

Front 15

Takayasu arteriits def

Back 15

Takayasu arteritis is a granulomatous inflammation of the aorta and its branches

Front 16

Takayasu clinical features

Back 16

female, japanese
"pulsless disease"
symptoms of vessel obstruction (heart, TIAs, peripheral arteries) with tenderness over affected arteries
systemic features: fever, malaise