Ch 10: Blood Vessels Q & A Flashcards
Inflammatory disease of medium & small arteries of the distal arms & legs. Cessation of smoking can be followed by remission. PMN infiltrates extending into neighboring veins thrombosis & obliteration of the affected vessels can occur.
Buerger Disease
Obliteration causes focal necrosis & scarring of the media , with disruption & disorganization of the elastic lamellae. Inner surface of the ascending aorta shows a typical “tree bark” appearance, encircled by lymphocytes, plasma cells & macrophages. (+) trepmonema ab test
Endarteritis of the Vasa Vasorum due to Syphilitic Aneurysm
Rapidly progressive vascular disease affecting the brain, heart & kidney. This disease injures endothelial cells, causing increased vascular permeability, which leads to insudation of plasma proteins into the vessel wall & morphologic evidence of fibrinoid necrosis. Risk factors are smoking and hyperlipidemia
Malignant Hypertension
Acute necrotizing vasculitis that affects medium-sized & smaller muscular arteries. Can extend to larger arteries on occasion. Most common morphologic feature of affected arteries is fibrinoid necrosis. Frequently associated with p-ANCA. Some patients also demonstrate HBsAg or anti-HCV
Polyarteritis Nodosa (PAN)
Broad spectrum of inflammatory lesions that respresent a reaction to foreign materials (bacterial products or drugs*)
Hypersensitivity Angitis
Most common vasculitis. Local, chronic granulomatous inflammation of the temporal arteries. Age of onset >50 yrs. Headaches in the form of throbbing temporal pain & visual problems. Palpable, tortuous temporal artery may be the only finding on PE.
Temporal (Giant-cell) Arteritis
Inflammatory disorder of the large arteries (aortic arch & its major branches). Aorta is thickened, intima exhibits focal, raised plaques. Branches of aorta display stenosis or occlusion leading to “Pulseless Disease”. Differential b/w BP in the left and right arms. Age of onset
Takayasu Arteritis
Idiopathic , systemic, granulomatous disease of small & medium size arteries characterized by vasculitis of many organs, fluctuating eosinophilia & late onset asthma. p-ANCA present in many patients. Lung biopsy shows granulomatous lesions in vascular and extravascular sites, accompanied by intense eosinophilia. Histologically resembles lesions of PAN.
Churg-Strauss Disease
Eosinophilic Granulomatosis w/ Polyangitis
Systemic vasculitis characterized by oral aphthous ulcers, genital ulceration & ocular inflammation w/ occasional involvement of CNS, GI, CV systems. Mucocutaneous lesions show a non-specific vasculitis of arterioles, capillaries & venules. There may be an immune basis due to association with certain HLA types
Becet Disease
Purpura or skin rash in a patient w/ known autoimmune disease, such as Sjrogren Syndrome or SLE is usually attributed to this disorder. The vasculitis is caused by the deposition of immune complexes in dermal venules.
Hypersensitivity Vasculitis
Vasculitis of unknown etiology that presents w/ fever, skin rash on palms & soles, mucosal inflammation & lymph node enlargement. Age of onset
Kawasaki Disease (Mucocutaneous lymph node syndrome)
Most common type of childhood vasculitis. Caused by vascular localization of immune complexes, containing predominantly IgA. Pupuric skin lesions that are palpable on buttocks & legs and glomerulonephritis are seen.
Henoch-Schonlen Purpura
IgA Vasculitis
Necrotizing granulomatous vasculitis involving the nasopharynx, lungs and kidneys. (+) c-ANCA. Parenchymal necrosis, vasculitis & granulomatous inflammation composed of neutrophils, lymphocytes, plasma cells,macrophages & eosinophils. Most prominent pulmonary features is persistent bilateral pneumonitis w/ nodular infiltrates undergoing caviation. Hematuria, proteinuria
Wegener Granulomatosis
Granulomatosis w/ Polyangitis
