2.Medium Sized arteries

graph TD
    X[Medium Vessel diseases] ==>|young Adults - Chronic Hepatitis B| X1["` Polyartristis Nodosa - ***String of Pearls appearance*** ]
    X1 ==> X1a[***Renal Artery***] & X1b[MEsentric Artery] & X1c[Branches of INternal Carotid Arteries] & X1d["` ***No Pulmonary Artery Involvment***];
    X1a ==> X1a1[Renal ischemia ➡️ Hypertension];
    X1b ==> X1b1[Abdominal Pain and Blood in stools];
    X1c ==> X1c1[Neurologicl Symptoms];

    X ==>|children <4years with Flu like symptoms| X2[Kawasaki Disease]
    X2 ==> X2a["` Damage medium arteries ***M/C Coronary Vessels 
    ➡️ Fibrinoid NEcrosis ➡️ ANeurysn ➡️ Risk Of THrombosis ➡️ 
    Myocardial Infartion at 4year old Child*** `"];
    X2a ==>|treatment| X2a1[MOstly Selflimiting 
    Risk MI -Aspirin or iv Ig];
    X2a ==>|Aspirin inhibit COX-1 COX-2 pathway| X2aa["`No TXA~2~`"] 
    X2aa ==> XXX[No platelet aggregation to form Thrombosis];


    X ==>|SMokers| X3[Beurgers Disease]
    X3 ==>|Chemaical of Cigarette injury| X3a[Necrotizing Vasculitis of Digtis and Toes]
    X3a ==> X3a1[Initial Raynourd Phenonmenon with pain on excercise]
    X3a1 ==> X3a1a[Ulceration and gangrene and the autoamputation]

Poly-artritis Nodosa

`` mermaid graph TD X[Other reason & HbsAg-HbsAb deposition on Vessesl] ==> X1[Fibrinoid Necrosis] X1 ==> X2["Aneurysm- Swelling "] X2 ==>|healing| X3[" Fibrosis- looks like a string `"] X3 ==>|occuring at different stages at continuous vessel | X3a[String of Pearls Appreance];

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Kwasaki Disease

Symptoms

1. Fever ,conjuctivitis
2. Desqaumation of Plams soles
3. Deems of Palms and Soles

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