• Diastolic Murmurs:
  1. Grade I - Barely Audible
  2. Grade II - Audible, but soft
  3. Grade III - Easily Audible
  4. Grade IV - Loud
  
  

  Posted 10/11/16 01:50:21 PM by Adam Faye

• Mentzer Index (Sensitivity 86%, Specificty 62% for diagnosing Beta Thal)
  • Used to differentiate Fe def. anemia vs. Beta Thalassemia
  • MCV/RBC count
    • If >13, Fe def. (microcytic but also low RBC count)
    • If <13, Beta Thal (microcytic, but NORMAL RBC count)
  
  

  Posted 10/11/16 02:10:51 PM by Adam Faye

• Takayasu Arteritis:
  • Incidence is higher in SE Asia
  • Female : Male - 3 : 1
  • Thought is that stimulus triggers heat shock protein-65 in aortic tissue --> induces MHC1 on vascular cells --> recognized by T lymps/Macrophages --> inflammation, necroses, neo-vascularization and Giant Cell formation
  Three Phases:
  1. Systemic - constitutional- fever, malaise, night sweats, arthralgia
  2. Vasculitic - Constitutional symptoms + vascular involvement (tenderness/pain over vessels)
  3. Late/Fibrotic - Arterial Stenosis/Occulusion --> pulseless disease
  ESR and CRP can be useful markers to monitor disease activity over time
  
  

  Posted 10/11/16 02:20:44 PM by Adam Faye

• Takayasu Arteritis typically occurs in individuals < 40 y/o
  Giant Cell Arteritis typically occurs in individuals > 50 y/o
  
  

  Posted 10/11/16 02:23:41 PM by Adam Faye

• Dr. Mayer usually finds if Ferritin >500, less likely to be solely from Fe def. anemia but suggests an underlying inflammatory state.
  
  

  Posted 10/11/16 02:25:39 PM by Adam Faye

• Treatment of Takayasu Arteritis:
  • Goal is to limit inflammation - Steroids, Methotrexate, Leflunomide. Some have used Tocilizumab (IL-6 antagonist)
  
  

  Posted 10/11/16 02:28:57 PM by Adam Faye

• For further reading...

  Takayasu Arteritis Review
  
  

  Posted 10/11/16 02:21:09 PM by Adam Faye

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