vasculitis

Question 1

define vasculitis

Answer 1

inflammation of blood vessels

Question 2

general presentation of vasculitis

Answer 2

Joint/muscle pain
Peripheral neuropathy
Renal impairment
Purpura
Necrotic skin ulcers
GI symptoms

Question 3

associated systemic symptoms with general vasculitis

Answer 3

• Fatigue
• fever/night sweats
• weight loss
• anorexia
• anaemia

Question 4

investigations for general vasculitis

Answer 4

Inflammatory markers high (CRP + ESR)

ANCA is associated with some types - ones that have polyangitis in the name

Question 5

general treatment for vasculitis

Answer 5

corticosteroids

Question 6

what are large vessel vasculitis

Answer 6

• giant cell ateritis
• Takayasu’s Arteritis

Question 7

what are medium level vasculitis

Answer 7

• Polyarteritis Nodosa
• Kawasaki Disease
• buergers disease

Question 8

what are small level vasculitis

Answer 8

• Eosinophilic Granulomatosis with Polyangiitis
• Granulomatosis with Polyangiitis
• Microscopic Polyangiitis
• Henoch-Schonlein Purpura

Question 9

what is Henoch-Schonlein Purpura

Answer 9

• an IgA vasculitis
• common in children
• occurs due to IgA deposits in small blood vessels causing inflammation.

Question 10

what does HSP affect

Answer 10

affects the skin, kidneys, and GI tract.

Question 11

what triggers HSP

Answer 11

upper airway infection or gastroenteritis

Question 12

features of HSP

Answer 12

• Purpura
• Joint pain
• Abdominal pain
• Renal involvement (IgA nephritis)

Question 13

how to manage HSP

Answer 13

• Supportive with analgesia
• Monitor urine dipstick and BP

Question 14

can HSP cause renal failure

Answer 14

Patients without renal involvement recover in 4-6 weeks, however, the disease can result in renal failure.

Question 15

what is microscopic polyangitis

Answer 15

a small-vessel vasculitis that mainly affects the kidneys and lungs.

Question 16

features of MP

Answer 16

1. renal failure due to the vasculitis causing glomerulonephritis.
2. lso affects the lungs by causing diffuse alveolar haemorrhage, leading to haemoptysis (coughing up blood).

Question 17

treatment for MP

Answer 17

Usually involves administering corticosteroids (prednisone) to manage the inflammation.

Question 18

what is Granulomatosis with Polyangiitis

Answer 18

GPA is a small-vessel vasculitis that primarily affects the respiratory tract and kidneys.

Question 19

what does GPA affect

Answer 19

1. Ears –hearing loss
2. Sinuses –sinusitis
3. Kidneys –glomerulonephritis
4. Nose –nose bleeds, crusting in the nose and nasal secretions, saddle-shaped nose, due to nasal bridge collapse.
5. lower respiratory tract, it can cause cough, wheeze, and haemoptysis.

Question 20

treatment for GPA

Answer 20

Corticosteroids
Immunosuppression

Question 21

what is Eosinophilic Granulomatosis with Polyangiitis

Answer 21

a small-vessel vasculitis that primarily affects the lungs and skin but can affect other organs such as the kidneys.

Question 22

features of EGPA

Answer 22

presents with severe asthma, sinusitis, and allergic rhinitis.

Raised eosinophils on blood counts is a characteristic finding

Question 23

treatment of EGPA

Answer 23

Corticosteroids
Immunosuppression (severe cases)

Question 24

what is Polyarteritis Nodosa

Answer 24

a medium-vessel vasculitis that is caused idiopathically or secondary to an infection (esp. hep B)

Question 25

features of PAN

Answer 25

Renal impairment Hypertension Tender, erythematous skin nodules Myocardial infarction Stroke Mesenteric arteritis (causing intestinal symptoms)

Question 26

treatment of PAN

Answer 26

Corticosteroids Immunosuppression (severe cases)

Question 27

what is KAWASAKI disese

Answer 27

a medium-vessel vasculitis that typically affects children under the age of 5. There is no clear cause.

Question 28

features of kawasaki disease

Answer 28

- Persistent high fever (>5 days) - Widespread erythematous maculopapular rash - Desquamation (skin peeling) of palms and soles - Bilateral conjunctivitis - Strawberry tongue

Question 29

treatment of kawasaki disease

Answer 29

High-dose IV aspirin IVIG (IV immunoglobulins

Question 30

what is Takayasu’s Arteritis

Answer 30

a large-vessel vasculitis that mainly affects the aorta and its branches but can also affect the pulmonary arteries.

Question 31

pathophysiology of takayasus arteritis

Answer 31

The vessels swell and form aneurysms or become narrowed and blocked. Stenosis or occlusion reduces pulses and BP in the limbs, leading to the name or “pulseless disease”.

Question 32

presentation of takayasus arteritis

Answer 32

usually present before the age of 40 with non-specific systemic symptoms: Fever Malaise Muscle aches Claudication symptoms (pain and fatigue that worsen using the limb).

Question 33

treatment of takayasus arteritis

Answer 33

Corticosteroids

Question 34

what is giant cell artirits

Answer 34

GCA (also known as temporal arteritis) is a medium- and large-vessel vasculitis that has a strong link with polymyalgia rheumatica.

Question 35

features of GCA

Answer 35

Unilateral headache Scalp tenderness Jaw claudication (pain/fatigue/discomfort while chewing) Blurred/double vision or loss of vision (if untreated) Tender and inflamed temporal artery Systemic symptoms (weight loss, fatigue, fever) Carpel tunnel syndrome Peripheral oedema

Question 36

how to diagnose GCA

Answer 36

- Clinical presentation - Raised inflammation markers (esp. ESR) - Temporal artery biopsy and ultrasound

Question 37

treatment of GCA

Answer 37

- Corticosteroids (started immediately, before diagnosis - Other (if needed) – aspirin, PPI - Bisphosphonates, calcium/vit