Vasculitides Quiz: Henoch-Schönlein Purpura
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Questions and Answers

Which demographic group is primarily affected by giant cell (temporal) arteritis?

  • Older adults aged 50 years and above (correct)
  • Young adults aged 20 to 30 years
  • Children under 10 years
  • Adults aged 40 to 49 years

    • What type of immune response is primarily involved in giant cell arteritis?

  • Humoral immune injury
  • Cell-mediated immune injury (correct)
  • Viral immune response
  • Innate immune response

    • What is the likely antigen involved in the pathogenesis of giant cell arteritis?

  • Elastin (correct)
  • Keratins
  • Fibrinogen
  • Collagen

    • Which of the following arteries is NOT commonly affected by giant cell (temporal) arteritis?

    <p>Pulmonary arteries</p> Signup and view all the answers

    In terms of vessel size, giant cell arteritis affects which type of vessels?

    <p>Large and medium-sized arteries</p> Signup and view all the answers

    Giant cell arteritis is generally classified under which type of vasculitis?

    <p>Large vessel vasculitis</p> Signup and view all the answers

    What is one of the major clinical manifestations of Henoch-Shönlein purpura?

    <p>Arthralgia</p> Signup and view all the answers

    Which small vessel vasculitis primarily affects adults and is associated with ANCA-mediated injury?

    <p>Microscopic polyangiitis</p> Signup and view all the answers

    Which of the following organs is typically involved in Henoch-Shönlein purpura?

    <p>Kidneys</p> Signup and view all the answers

    What type of smooth muscle structure is characterized in arterioles?

    <p>1-3 layers of smooth muscle cells</p> Signup and view all the answers

    What is the primary source of potential triggers for microscopic polyangiitis?

    <p>Drugs and toxins</p> Signup and view all the answers

    Which symptom is associated with lung involvement in small-vessel vasculitides?

    <p>Hemoptysis</p> Signup and view all the answers

    What is a characteristic clinical feature of Microscopic Polyangiitis (MPA)?

    <p>Palpable purpura</p> Signup and view all the answers

    What treatment is primarily used for Churg-Strauss Syndrome (CSS)?

    <p>Steroids</p> Signup and view all the answers

    Which immunological marker is typically associated with Microscopic Polyangiitis?

    <p>MPO-ANCA</p> Signup and view all the answers

    Which demographic is most commonly affected by Granulomatosis with Polyangiitis (GPA)?

    <p>Adult males</p> Signup and view all the answers

    What type of vasculitis is characterized by neutrophils and fibrinoid necrosis?

    <p>Microscopic Polyangiitis</p> Signup and view all the answers

    What is a common gastrointestinal manifestation of Churg-Strauss Syndrome?

    <p>GI bleeding</p> Signup and view all the answers

    What is the prognosis for patients with Microscopic Polyangiitis when treated appropriately?

    <p>Good, with effective treatment</p> Signup and view all the answers

    What pathology is associated with Churg-Strauss Syndrome (CSS) regarding eosinophils?

    <p>Extravascular necrotizing granulomas</p> Signup and view all the answers

    What is the primary mechanism behind the symptoms of Primary Raynaud Phenomenon?

    <p>Cold-induced vasospasm of small arteries</p> Signup and view all the answers

    Which color change sequence occurs in Primary Raynaud Phenomenon?

    <p>White → Blue → Red</p> Signup and view all the answers

    What distinguishes Secondary Raynaud Phenomenon from Primary Raynaud Phenomenon?

    <p>More severe manifestations and potential for necrosis</p> Signup and view all the answers

    Which of the following conditions is NOT commonly associated with Secondary Raynaud Phenomenon?

    <p>Primary hypertension</p> Signup and view all the answers

    What age group is primarily affected by Primary Raynaud Phenomenon?

    <p>Young adults</p> Signup and view all the answers

    In Secondary Raynaud Phenomenon, what does the prognosis primarily depend on?

    <p>The primary disease associated with it</p> Signup and view all the answers

    What is a characteristic feature of Giant Cell Arteritis?

    <p>Destruction of internal elastic membrane</p> Signup and view all the answers

    Which of the following treatments is commonly used for Takayasu Arteritis?

    <p>Corticosteroids</p> Signup and view all the answers

    Which demographic is most commonly affected by Takayasu Arteritis?

    <p>Young adults, particularly Asian females</p> Signup and view all the answers

    What is the prognosis for Giant Cell Arteritis?

    <p>Benign and self-limited except for potential vision impairment</p> Signup and view all the answers

    Which is a clinical manifestation of Takayasu Arteritis?

    <p>Coldness or numbness of the fingers</p> Signup and view all the answers

    What systemic sign of inflammation is commonly used to assess Giant Cell Arteritis?

    <p>ESR</p> Signup and view all the answers

    What type of immune response is primarily involved in the pathology of Takayasu Arteritis?

    <p>Cell-mediated immune injury</p> Signup and view all the answers

    What term is used to describe the low blood pressure and weak pulse experienced in the upper extremities with Takayasu Arteritis?

    <p>Pulseless disease</p> Signup and view all the answers

    Which characteristic is typical of Granulomatosis with Polyangiitis?

    <p>Commonly affects the lungs and kidneys</p> Signup and view all the answers

    What is a common complication of Deep Venous Thrombosis (DVT)?

    <p>Pulmonary embolism</p> Signup and view all the answers

    What is a primary contributor to the development of Varicose Veins?

    <p>Venous valve incompetence</p> Signup and view all the answers

    Granulomatous Vasculitis is primarily characterized by which histopathological feature?

    <p>Non-caseating granulomas</p> Signup and view all the answers

    What is the most common presenting symptom of varicose veins?

    <p>Swelling in the lower limbs</p> Signup and view all the answers

    Which condition is a key risk factor for developing deep venous thrombosis?

    <p>Prolonged immobility</p> Signup and view all the answers

    Which of the following conditions is classified as a small-vessel vasculitis?

    <p>Granulomatosis with polyangiitis</p> Signup and view all the answers

    What type of inflammation is primarily associated with granulomatous vasculitis?

    <p>Necrotizing inflammation</p> Signup and view all the answers

    Which systemic manifestation is commonly associated with vasculitides?

    <p>Fever and fatigue</p> Signup and view all the answers

    What is a potential complication of deep venous thrombosis?

    <p>Pulmonary embolism</p> Signup and view all the answers

    Which of the following is a characteristic finding in varicose veins?

    <p>Valve incompetence</p> Signup and view all the answers

    What immune mechanism is involved in the pathology of small-vessel vasculitides?

    <p>Deposition of immune complexes</p> Signup and view all the answers

    Which of the following is NOT a clinical manifestation of Churg-Strauss syndrome?

    <p>Chronic migraines</p> Signup and view all the answers

    In chronic ischemia following healing from vasculitis, what is likely to occur?

    <p>Vascular wall thickening</p> Signup and view all the answers

    Which of the following conditions is NOT a common complication of varicose veins?

    <p>Pulmonary embolism</p> Signup and view all the answers

    Which risk factor is most associated with the development of varicose veins?

    <p>Having a family history of venous issues</p> Signup and view all the answers

    What primary symptom is typically associated with deep venous thrombosis (DVT)?

    <p>Edema distal to the occluded vein</p> Signup and view all the answers

    What is a significant provocative factor for the development of hemorrhoids?

    <p>Pregnancy</p> Signup and view all the answers

    Which of the following best describes a common complication that can arise from DVT?

    <p>Pulmonary thromboembolism</p> Signup and view all the answers

    What condition is characterized by persistent pain, swelling, and the dilation of superficial veins?

    <p>Varicose veins</p> Signup and view all the answers

    Which factor could contribute to the activation of coagulation leading to DVT?

    <p>Adenocarcinomas</p> Signup and view all the answers

    Which age group is most prone to developing varicose veins?

    <p>Individuals over 50 years</p> Signup and view all the answers

    Study Notes

    Henoch-Schönlein Purpura (HSP)

    • Affects small vessels: arterioles, capillaries, venules.
    • Manifestations include purpura on the skin and hematuria related to glomerulonephritis.
    • Pulmonary symptoms: hemoptysis due to pneumonitis, gastrointestinal bleeding, and signs of systemic involvement such as arthralgia and myocarditis.

    Microscopic Polyangiitis (MPA)

    • Primarily affects adults with immune ANCA-mediated injury as a key factor.
    • Associated triggers: drugs, toxins.
    • Characterized by necrotizing vasculitis with neutrophils, fibrinoid necrosis, and thrombosis.
    • Clinical features: palpable purpura, pneumonitis with hemoptysis, gastrointestinal bleeding.
    • Immunology: presence of MPO-ANCAs; treatment includes corticosteroids and immunosuppressants.
    • Prognosis is favorable with treatment.

    Churg-Strauss Syndrome (CSS)

    • Primarily impacts adults; linked to allergic rhinitis, asthma, and hypereosinophilia.
    • Characterized by necrotizing vasculitis involving eosinophils and extravascular necrotizing granulomas.
    • Common symptoms: pulmonary infiltrates, GI bleeding, palpable purpura, myocarditis.
    • Treatment typically includes corticosteroids; outlook is good with treatment.

    Granulomatosis with Polyangiitis (GPA)

    • Predominantly affects adult males; involves ANCA-mediated immune injury.
    • Potential triggers include drugs and toxins.
    • Notable for granulomatous inflammation and systemic vasculitis, causing damage to various organs.

    Giant Cell Arteritis (GCA)

    • Most common in older adults (≥ 50 years); involves cell-mediated immune injury, particularly affecting large and medium-sized arteries.
    • Affects vessels: aorta, vertebral, and extracranial arteries (e.g., temporal, ophthalmic).
    • Characterized by granulomatous vasculitis, intimal thickening, and destruction of the internal elastic membrane.
    • Symptoms include headache, blurred vision (potentially leading to blindness), and polymyalgia rheumatica.
    • Treatment: corticosteroids and anti-TNF agents; generally a benign condition but can cause vision impairment.

    Takayasu Arteritis

    • Typically affects young adults, particularly Asians (more females).
    • Involves cell-mediated immune injury resulting in large vessel vasculitis affecting the aorta and its branches.
    • Manifestations include transmural thickening of the vessel wall, lumen narrowing, and symptoms like weak pulses and cold extremities.
    • Treatment: corticosteroids with a generally favorable prognosis.

    Raynaud Phenomenon

    • Primary Raynaud (Raynaud Disease):

      • Characterized by cold-induced vasospasm causing paroxysmal pallor or cyanosis in fingers and toes.
      • Common in young adult females; no structural vessel wall changes; prognosis is good.

    • Secondary Raynaud Phenomenon:

      • Similar symptoms but more severe; can lead to necrosis and ulceration.
      • Associated with conditions such as systemic sclerosis, SLE, and others; prognosis varies based on the underlying disease.

    Venous Disorders

    • Include varicose veins; study notes on age, gender predisposition, pathogenesis, affected vessels, and major clinical manifestations are needed to differentiate primary and secondary conditions.

    Varicose Veins

    • Abnormally dilated and tortuous veins result from increased intraluminal pressure and/or venous valve incompetence.
    • Most commonly occur in superficial leg veins, but can also appear in esophageal veins (esophageal varices due to portal hypertension) and recto-anal junction (hemorrhoids).

    Causes of Varicosity

    • Increased intraluminal pressure is caused by prolonged standing or long-duration traveling (automobile, airplane).
    • More prevalent in females, especially during pregnancy.
    • Associated with advanced age (over 50 years), obesity, and genetic predisposition to defective venous wall development.

    Clinical Aspects of Varicose Veins

    • Symptoms include venous congestion, persistent edema, and pain.
    • Complications can involve thrombosis (rarely thromboembolism), subcutaneous fibrosis, petechiae, hemosiderosis, and ulcerations leading to poor wound healing (varicose ulcers).

    Hemorrhoids

    • Characterized by dilation and protrusion of veins at the recto-anal junction.
    • Provoked by constipation or straining during defecation and can also occur during pregnancy.
    • Complications include thrombosis, inflammation (resulting in pain), and potential bleeding which may mimic colon cancer.

    Deep Venous Thrombosis (DVT)

    • Typically occurs in deep leg veins, including periprostatic venous plexus (males), pelvic veins (females), and dural sinuses.

    Predisposing Factors for DVT

    • Impacts individuals with prolonged bed rest, immobilization, or those in a postoperative state.
    • Increased risk during pregnancy and in patients with cardiac failure or adenocarcinomas (which can activate coagulation).
    • FV Leiden mutation is associated with recurrent DVT.

    Clinical Manifestations of DVT

    • Often subtle symptoms include edema distal to the occluded vein, dusky cyanosis, and dilation of superficial veins.
    • Homan sign indicates pain upon pressure over affected veins or calf muscle squeezing.
    • Serious complication includes pulmonary thromboembolism.

    Pathology of Vasculitides and Venous Disorders

    • Vasculitides classified into small, medium, and large-vessel categories, affecting various vessels and organs with distinctive clinical manifestations.
    • Common features include necrotizing or granulomatous inflammation in vascular walls, bleeding, thrombosis, and chronic ischemia in survivors.
    • Immune mechanisms involve immune complexes deposition, cell-mediated responses, and circulating antibodies (e.g., ANCAs and IgA in small-vessel vasculitides).
    • Systemic symptoms include fever, fatigue, weight loss, arthralgia, and myalgia.

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    Description

    Test your knowledge on small vessel vasculitides, including Henoch-Schönlein purpura and associated conditions. This quiz covers important structural features and diseases affecting arterioles and venules. Dive into the complexities of microscopic polyangiitis and Churg-Strauss syndrome.

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