Vasculitis

Front 1

How does infectious vasculitis occur and what results?

Back 1

Directly enters the vessel and result in series of Ag-Ab rxns that can cause injury

Front 2

What are the causes of infectious vasculitis?

Back 2

Embolic endocarditis, pseudomnoas, Neisseria meningitides, Rocky mountain spotted fever

Front 3

What is the cause of Good Pastures Disease?

Back 3

Due to anti basement membrane antibody

Front 4

What are the systemic affects of Good Pasture Disease?

Back 4

Systemic affects involve kidney and lung
Can result in Hemoptysis (coughing up blood) and hematuria (blood in urine)

Front 5

What are pts with Buergers disease sensitive to and what demographic is it usually seen in?

Back 5

Tobacco sensitivity
Usually seen in middle age and older men

Front 6

What vasculitis is involved in Large Vessel and what are some sympotoms?

Back 6

Giant Cell and Takayasu Arteritis
Bruits, Claudication (pain or tired feeling in the legs), Absent pulse either in legs or arms, Asymetrical blood pressure reading (particulary in Takayasu)

Front 7

What type of vasculitis is involved in medium vessel and what are some symptoms?

Back 7

PAN and Kawasaki
Necrosis of and gangrene of digits, abdominal pain associated with visceral involvement (black/tarry feces or red feces), MI, hypertension with microaneurysms (vessel weakening)

Front 8

What is involved in small vessel vasculitis and what are the sympotoms?

Back 8

Goodpasture, microscopic polyangitis, Wegeners, Henoch-Schonlein, Cryoglobulinemia and Curg-Strauss
Palpable purpura (purpura is a discrete area of dislocation on skin; typically purple), glomerulonephritis alveolar hemorrage, uvelitis, episcleritis

Front 9

What is typically involved in Hypersensitivity Vasculitis how does it present, what is the mean age and how is it treated?

Back 9

Typically due to a drug induced hypersensitivity, like penicillin
Present with palpable purpura, maculopapular rash and leukocytoclastic
Mean age in the 40's, typically teenages or older
Often affects lower extremities and are treated similar to burn victoms

Front 10

What is Leukocyoclastic Vasculitis, what is it associated with and how does it occur?

Back 10

It is a histogical presentation with WBC's being destroyed and broken apart; look likes tiny dots,
Typically associated with Hypersensitivity and Henoch-Schonlein & microscopic polyangitis
Involves infiltration of dermis, apoptosis with fragmented nuclei termed "nuclear dust"

Front 11

What are the criteria for Vasculitis?

Back 11

Age at onset >16, Medication at disease onset, Palpable purpura, Maculopapular rash, biopsy including arteriole and venule

Front 12

What does Henoch-Schonlein affect, what is involved and what are symptoms?

Back 12

Vasculitis with IgA-dominant immune complex deposits affected capillaries, venules and arterioles
Typically involves skin, gut and glomeruli, and associated with Arthritis
Age is <20 yrs old, abdominal pain/GI bleed, hematuria, NO MED history palpable purpura (extremeties then trunk),leukocytoclastic vasculitis

Front 13

What is the presentation of Buergers Disease

Back 13

MALE SMOKERS, 25-50 yrs old, vascular insufficiency of lower extremities, hypersensitivity to tobacco, typically seen in meedium size arteries (tibial/radial), thrombus formation

Front 14

What is involved in PAN?

Back 14

Medium to small arteries
Transmural necrotizing inflammation (goes through entire thickness of vessel wall), focal and random, inflammation can turn to fibrosis, ALL STAGES MAY COEXIST IN SAME ARTERY

Front 15

What is the major cause of death in PAN, what virus is it associated with and what is not associated with?

Back 15

Renal involvement is major cause of death, Associated with hepatitis B, NO ASSOCIATION with ANCA

Front 16

What are diagnostic guidelines for PAN?

Back 16

Unxplained weight loss (>4 kg), Livedo reticularis (color change on the body), teticular pain, myalgia or leg tenderness, elevated levels of urea nitrogen or creatinine, Hep B, Neutrophls in biopsy specimen

Front 17

What is the five factor score for PAN and what is the survival rate?

Back 17

Proteinuria >1 g/24hrs, Creatinine > 2 mg/dl, Cardiomyopathy, GI involvement
Add the # together to get survival rate 0=88%, 1=74%, 2+=54%

Front 18

What is the presentation of Kawasak's?

Back 18

Involves smaller vessels (coronary artery can lead to aneurysma), Infants and young children, fever, conjunctivitis, rash, lymphadenopathy

Front 19

What types of Vasculitis are associated with ANCA?

Back 19

Microscopic Polyangitis, Wegners and Churg-Strauss

Front 20

What is the presentation of Microscopic Polyangitis?

Back 20

Smaller vessels (typically smaller then those of PAN), LESIONS ARE ALL OF THE SAME STAGE (Will not see both chronic and acute like in PAN), segmental fibrinoid necrosis, ASSOCIATED W/ P-ANCA (PAN will be ANCA negative), glomerulonephritis (very commone), pulmonary involvement

Front 21

What is associated with Wegeners?

Back 21

Associated with C-ANCA, granulomas of upper respiratory tract, small arteris and viens especially in the lungs, MALES, very often affects the NOSE/NASOPHARYNX (saddle nose)

Front 22

What is the criteria for Churg-Strauss?

Back 22

History of Asthma, Eosinphillia >10% of WBC, paranasal sinusitis, mononeuropathy, extravascular eosinophils, non-fixed pulmonary infiltrates, P-ANCA

Front 23

What is a big manifestation of Churg-Strauss?

Back 23

Cardiac manifestation

Front 24

What is the criteria for Rheumatoid Vasculitis?

Back 24

>10 years of RA, high Ig titers, leukocytoclastic , leg ulcers and digital infarcts, P-ANCA, anti-MPO, low serum complement

Front 25

What syndrome is assiciated with Rheumatoid Vasculitis?

Back 25

Felty's syndrome, which is when you have a RA with splenomegaly and low WBC count

Front 26

What is involved with Temporal Arteritis?

Back 26

Larger arteries (often the temporal), usually women, Age 50+, Headache is the most symptom presented by pts, temporal pain, infarction of the scalp due to occlusion of the temporal artery

Front 27

What is the criteria for Temporal Arteritis?

Back 27

Age 50+, Temporal artery tenderness/decreased pulse, new onset localized headache, High ESR 50 mm/HR +, positive biopsy

Front 28

What is the pulseless disease and why is it called this?

Back 28

Takayasu's Arteritis
Because it typically involves Aorta and other great vessels

Front 29

What is Takayasu disease characterized by?

Back 29

Distinctive demographics of JAPANESE WOMEN less then 40 yrs old, DECREASED pulse in extermities and asymetry in BP, histologically can resemble temporal arteritis b/c of giant cell infiltration