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Pathology · USMLE Step 1

USMLE Pathology: Vasculitis and Vascular Pathology

Vasculitis classification by vessel size and vascular tumor morphology, distinct from the atherosclerosis focus of the cardiovascular pathology deck.

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Which vasculitis is the most common in adults over age 50?
Giant cell (temporal) arteritis
Giant cell arteritis most commonly affects branches of which artery?
The carotid artery, especially the temporal artery
What symptom of giant cell arteritis results from ischemia of the muscles of chewing?
Jaw claudication
Untreated giant cell arteritis can cause irreversible vision loss due to occlusion of which artery?
The ophthalmic artery
What lab finding is classically markedly elevated in giant cell arteritis?
Erythrocyte sedimentation rate (ESR)
What histologic finding characterizes giant cell arteritis?
Granulomatous inflammation with multinucleated giant cells in the vessel wall
When should corticosteroid treatment begin in suspected giant cell arteritis?
Immediately, before biopsy confirmation, to prevent blindness
Giant cell arteritis is associated with which other rheumatologic condition in about 40 percent of cases?
Polymyalgia rheumatica
Takayasu arteritis primarily involves which vessels?
The aortic arch and its major branches
Takayasu arteritis typically affects which demographic?
Young women, often of Asian descent, usually under age 40
Polyarteritis nodosa is a necrotizing vasculitis of which size vessels?
Medium-sized muscular arteries
Polyarteritis nodosa is associated with which chronic viral infection in a significant subset of cases?
Hepatitis B
What histologic feature of polyarteritis nodosa reflects its episodic course?
Lesions of different ages, acute and healing, within the same vessel, with fibrinoid necrosis
Polyarteritis nodosa produces a '____' appearance on angiography due to multiple small aneurysms.
string of pearls
Which organ is classically spared in polyarteritis nodosa?
The lungs

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