A detailed, clean, handwritten-style MBBS medical revision notes poster on white paper background about Rheumatology - Vasculitis. The notes should look like premium topper handwritten study notes with: TITLE at top: "RHEUMATOLOGY: VASCULITIS" in large bold letters with a colored banner/underline Organized into clearly labeled sections with colored headings: SECTION 1 - DEFINITION (blue heading): • Vasculitis = inflammation + necrosis of blood vessel walls → organ ischemia/damage • Heterogeneous group of disorders linked by destructive inflammation within vessel walls • Primary (idiopathic) vs Secondary (infection, drugs, CTD) SECTION 2 - CHAPEL HILL 2012 CLASSIFICATION (red/orange heading) with a neat table: Large Vessel: Giant Cell Arteritis (GCA), Takayasu Arteritis Medium Vessel: Polyarteritis Nodosa (PAN), Kawasaki Disease Small Vessel (ANCA+): GPA (Wegener's), MPA, EGPA (Churg-Strauss) Small Vessel (Immune Complex): IgA Vasculitis (HSP), Cryoglobulinemic Vasculitis, Anti-GBM Variable Vessel: Behcet's Disease, Cogan Syndrome Single Organ: Cutaneous Leukocytoclastic Angiitis SECTION 3 - PATHOGENESIS (green heading) with arrows showing mechanism: • ANCA-associated: Infection/drug → cytokine release (TNF) → neutrophil priming → ANCA binds MPO/PR3 on neutrophil surface → Fc-γ receptor + target antigen activation → O2 radicals + proteolytic enzymes released → endothelial apoptosis + vessel wall necrosis • Immune Complex: Ag-Ab complex deposit in vessel wall → complement activation → neutrophil infiltration → vessel damage • Granulomatous: T-cell mediated → giant cell granuloma formation (GCA, Takayasu, GPA, EGPA) SECTION 4 - VESSEL SIZE & LOCATION TABLE (purple heading): A neat table with columns: Disease | Vessel Type | Main Locations Affected GCA | Large artery | Temporal artery, aorta, ophthalmic artery → BLINDNESS Takayasu | Large artery | Aorta + branches, subclavian, renal (young Asian females) PAN | Medium artery | Renal, mesenteric, hepatic, coronary (NOT glomeruli, NOT lung) Kawasaki | Medium artery | Coronary arteries (children <5 yrs) → aneurysm GPA (Wegener's) | Small (ANCA) | Upper airways + Lungs + Kidneys (Triad) MPA | Small (ANCA) | Lungs, Kidneys, skin (no granuloma) EGPA (Churg-Strauss) | Small (ANCA) | Lungs + Asthma + Eosinophilia IgA Vasculitis/HSP | Small (IC) | Skin, joints, kidneys, GI tract Cryoglobulinemia | Small (IC) | Skin purpura, peripheral nerves, kidneys Behcet's | Variable | Oral/genital ulcers, eyes, vessels SECTION 5 - DIAGNOSIS (yellow/amber heading): Key tests listed: • ANCA: c-ANCA (PR3) → GPA; p-ANCA (MPO) → MPA, EGPA • Biopsy: GOLD STANDARD - temporal artery biopsy (GCA), skin/kidney (small vessel) • Labs: ESR↑, CRP↑, WBC↑, eosinophilia (EGPA), IgA↑ (HSP) • Imaging: PET-CT/MRA (large vessel), angiography (PAN - beaded pattern), echo (Kawasaki) • Urine: RBC casts → renal involvement SECTION 6 - TREATMENT (teal heading): • Large vessel (GCA/Takayasu): High-dose Prednisolone 1mg/kg/day + Tocilizumab (IL-6 blocker) • ANCA vasculitis (GPA/MPA/EGPA): Induction → Rituximab OR Cyclophosphamide + high-dose steroids; Maintenance → Rituximab/Azathioprine/Methotrexate • PAN: Steroids ± Cyclophosphamide; if HBV-associated → Antivirals • Kawasaki: Aspirin + IVIG (within 10 days) • IgA Vasculitis/HSP: Usually self-limiting; steroids for severe GI/renal disease • Behcet: Colchicine, steroids, Azathioprine EXAM TIPS BOX (pink box): ★ PAN = NO lung, NO ANCA, NO glomerulonephritis ★ GPA = c-ANCA (PR3); MPA = p-ANCA (MPO) ★ GCA → Temporal artery biopsy → SKIP LESIONS ★ Kawasaki → coronary aneurysm → main complication ★ EGPA = Asthma + Eosinophilia + ANCA vasculitis ★ IgA vasculitis (HSP) = IgA deposits = palpable purpura on buttocks/legs QUICK REVISION BOX at bottom: Mnemonic "WEG-MPA-EGPA = 3 ANCA vasculitides" GCA age >50 | Takayasu age <40 | Kawasaki age <5 Use colored pens style: blue, red, green, purple. Include small simple diagrams of blood vessel sizes. Clean white background, neat borders, looks like premium handwritten notes ready for MBBS exam prep.