vasculitis

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Author:
jaz_walker
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272367
Filename:
vasculitis
Updated:
2014-04-29 07:31:15
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Pathology
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pathology
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pathology
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  1. 0. True or false regarding Microscopic polyangiitis. Vessels involved are small to medium sized.
    T - (capillaries, venules, arterioles and arteries)
  2. 1. True or false regarding Kawasaki disease. Most patients are aged 4-8 years old.
    F - 80% of patients are aged 4 and under.
  3. 2. True or False concerning temporal arteritis. A neutrophil mediated reaction is involved.
    F - A t cell mediated response is involved.
  4. 3. A 19 year old male develops purpura. He is on a multitude of medications for his sickle cell anaemia. What is the most common cause of drug hypersensitivity vasculitis?
    Penicillin - acts as a hapten by binding to host proteins
  5. 4. True or false regarding Buerger disease. established vascular lesions can be ameliorated by smoking cessation.
    F - Although in the early stages, cessation can ameliorate further attacks.
  6. 5. A 35 year old woman with known asthma presents with palpable purpura. What are you concerned about and what is the most common cause of death?
    Churg-Strauss syndrome - Cardiomyopathy
  7. 6. a 36 year old man with known asthma presents with blood in his stool. urea and creatinine are raised. Renal biopsy shows a focal segmental glomerulosclerosis. Eosinophilia. What are you concerned about and what is the most common cause of death?
    Churg-Strauss syndrome - Cardiomyopathy
  8. 7. True or false regarding Churg-Strauss syndrome. It is commonly associated with pneumonia.
    F - Commonly associated with asthma, allergic rhinitis and lung infiltrates.
  9. 8. True or false regarding Kawasaki disease. there are regularly sequelae outside of the cardiovascular system which need attention.
    F - Coronary arteritis is the most serious complication and occurs in about 20% of untreated patients.
  10. 9. A 4 year old female presents with conjunctival and oral erythema. You note edema of the hands and feet, and cervical lymphadenopathy. Which arteries are you worried about and why?
    Kawasaki disease - Coronary arteritis often involves rupture or thrombosis, causing MI.
  11. 10. Presentation. Investigations. Question
    Disease - Further information
  12. 11. True or false regarding Wegener granulomatosis. In limited forms of disease, usually only the kidneys are affected.
    F - In limited forms, only the respiratory tract is affected.
  13. 12. True or False concerning temporal arteritis. It involves inflammation of large arteries only.
    T - It involves inflammation of small to large arteries.
  14. 13. Ture or false regarding Takayasu arteritis. distinction between this and temporal arteritis lies mainly in the affected arteries.
    F - lies mainly in age - over 50 years is temporal arteritis
  15. 14. A 43 year old male presents with ocular disturbances. MRI thorax shows transmural scarring and thickening of the aorta, particularly the aortic arch and great vessels. What are you suspicious of and which other vessels may be involved?
    Takayasu arteritis - Luminal narrowing of the major branch vessels
  16. 15. True or false regarding Microscopic polyangiitis. Often fragmented neutrophils are visible in the thickened vessel wall.
    t - Microscopic polyangiitis is also known as leukocytoclastic vasculitis
  17. 16. True or False concerning temporal arteritis. It can occur with equal probability at any age.
    F - most common in elderly people
  18. 17. True or false concerning polyarteritis nodosa. Necrosis is rarely involved.
    F - Often a segmental transmural necrotizing inflammation, involving fibrinoid necrosis.
  19. 18. True or false concerning polyarteritis nodosa. Often associated with hepatitis C.
    F - Often associated with hepatitis B
  20. 19. True or false regarding Microscopic polyangiitis. Often associated with P-ANCA.
    F - Often associated with MPO-ANCA
  21. 20. True or false concerning polyarteritis nodosa. Often involves the pulmonary circulation and spares the renal and visceral vessels.
    F - Often involves the renal and visceral vessels and spares the pulmonary circulation
  22. 21. True or false regarding Churg-Strauss syndrome. Granulomas are rarely found.
    F - particularly in the lungs and upper respiratory system
  23. 22. Ture or false regarding Takayasu arteritis. Intestinal arteries are affected in 50% of patients.
    F - Pulmonary arteries are involved in 50% of patients, coronary and renal arteries can also be affected.
  24. 23. a 16 year old female presents with haemoptysis. She also has muscle pain and cutaneous purpura. Biopsy shows a necrotising vasculitis which affects capillaries, as well as small arterioles and venules. MPO-ANCA is positive. What are you worried about and which 2 forms are most commonly involved
    Microscopic polyangiitis - pulmonary capillaritis and necrotizing glomerulonephritis
  25. 24. A 28 year old woman is known to have hepatitis B. She presents with rapidly accelerating hypertension, abdominal pain and bloody stools. She also complains of diffuse muscular aches and pains. kidney arteries are involved on MRI. What are you concerned about and what is the most common cause of death?
    Polyarteritis nodosa - Renal involvement
  26. 25. A 40 year old man presents with bilateral pneumonitis with nodules and cavitary lesions, chronic sinusitis and mucosal ulcerations of the nasopharynx. PR3-ANCA is raised. What are you concerned about and what is the most common cause of death?
    Wegener granulomatosis - Renal involvement
  27. 26. True or False concerning temporal arteritis. Vertebral and opthalmic arteries can also be involved.
    T - the aorta can also be involved (giant cell aortitis)
  28. 27. True or False concerning temporal arteritis. The majority of the inflammation involves the intima.
    F - The inflammation invovles the inner media.
  29. 28. True or False concerning temporal arteritis. The internal elastic lamina is usually left intact.
    F - The internal elastic lamina is often fragmented.
  30. 29. True or false regarding Kawasaki disease. the vasculitis looks similar to polyarteritis nodosa.
    t - there is a dense transmural inflammatory infiltrate, with fibrinoid necrosis.
  31. 30. True or False concerning temporal arteritis. Ocular symptoms (e.g. diplopia, vision loss) are present in around 5% of patients.
    F - They are present in around 50% of patients.
  32. 31. True or false regarding Churg-Strauss syndrome. Granulomas are commonly present.
    T - This helps distinguish from polyarteritis nodosa or microscopic polyangiitis
  33. 32. True or false regarding Microscopic polyangiitis. It mainly involves small to medium sized arteries.
    F - this is polyarteritis nodosa. In fact, inflammation is similar, but spare medium sized and larger arteries.
  34. 33. True or false regarding Buerger disease. It usually affects the ulnar and femoral arteries.
    F - Usually affects the radial and ulnar arteries
  35. 34. True or false regarding Buerger disease. It usually occurs after the age of 35.
    F - usually before age 35
  36. 35. What are the 2 most common mechanisms of vasculitis?
    Immmune-mediated inflammation and direct vascular invasion by infectious pathogens.
  37. 36. A 27 year old woman with SLE presents with purpura. What category of vasculitis is she likely to have?
    immune complex associated vasculitis
  38. 37. A 8 year old female develops vasculitis. On closer questioning you discover she has taken an unknown medication of her grandfather's. What is the most common drug to act as a foreign protein to cause vasculitis?
    streptokinase
  39. 38. What does ANCA stand for?
    Anti-neutrophil cytoplasmic antibodies
  40. 39. A 37 year old man develops purpura. PR3-ANCA is raised. What kind of vasculitis would you be suspicious of?
    Wegener granulomatosis
  41. 40. A 37 year old man develops purpura. MPO-ANCA is raised. What reaction is MPO involved in?
    Myeloperoxidase is a lysosomal granule constituent involved in oxygen free radical generation.
  42. 41. A 37 year old man develops purpura. MPO-ANCA is raised. What drug most commonly induces this?
    Propylthiouracil.
  43. 42. A 37 year old man develops purpura. MPO-ANCA is raised. What 2 types of vasculitis are associated with this?
    Microscopic polyangiitis, Churg-Strauss syndrome
  44. 43. What is the most common vasculitis?
    Temporal arteritis
  45. 44. True or False concerning temporal arteritis. It involves chronic inflammation and therefore granulomas are often found.
    T
  46. 45. True or False concerning temporal arteritis. There is in infiltrate of lymphocytes and macrophages, with multinucleate giant cells.
    T
  47. 46. True or False concerning temporal arteritis. granulomas and giant cells are sometimes absent.
    T
  48. 47. True or False concerning temporal arteritis. There are often lesions at different stages of development in the same artery.
    T
  49. 48. A 43 year old male presents with ocular disturbances. examination shows marked weakness of pulses in upper extremeties. What are you suspicious of?
    Takayasu arteritis
  50. 49. Ture or false regarding Takayasu arteritis. Typically affects the aortic arch and arch vessels.
    t
  51. 50. Ture or false regarding Takayasu arteritis. Advential fibrosis and intimal hyperplasia are often involved.
    T
  52. 51. A 41 year old male is noted to have systemic hypertension on a GP visit. On further questioning, he has weight loss, fever, fatigue. Upper pulses are weak. What vasculitis are you suspicious of?
    Takayasu arteritis
  53. 52. True or false concerning polyarteritis nodosa. This is a vasculitis of small or medium sized arteries.
    T
  54. 53. True or false concerning polyarteritis nodosa. Granulomas are often present.
    F
  55. 54. True or false regarding Microscopic polyangiitis. It is characterised by segmental fibrinoid necrosis of the media with focal transmural necrotizing lesions.
    T
  56. 55. True or false regarding Microscopic polyangiitis. Granulomas are often present.
    F
  57. 56. what triad of findings are pathognomic for Wegner granulomatosis?
    Granulomas of the lung/URI, vasculitis of small to medium vessels, glomerulonephritis
  58. 57. True or false regarding Wegener granulomatosis. PR3-ANCA is raised.
    T
  59. 58. True or false regarding Wegener granulomatosis. It is a common cause for focal segmental necrotizing glomerulonephritis, and can also cause crescentic glomerulonephritis.
    T
  60. 59. True or false regarding Churg-Strauss syndrome. Eosinophilia is common.
    T
  61. 60. A 33 year old male is a known heavy smoker. He presents with instep foot pain induced by exercise, and cold-induced raynaud phenomenon. Biopsy of the tibial artery shows thrombosis and a sharply segmental acute and chronic transmural vasculitis. What are you concerned about?
    Buerger disease
  62. 61. True or false regarding Buerger disease. It is associated with heavy smoking.
    t
  63. 62. Which 2 fungi are most associated with infectious arteritis?
    Aspergillus, mucos spp.

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