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CARDIO EXAM 2 > 203: Red diamonds wright > Flashcards

203: Red diamonds wright Flashcards

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1
Q

General term describing thickening and hardening of arterial walls and loss of elasticity:

A

ARTERIOsclerosis

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2
Q

Arteriosclerosis usually affects:

A

small arteries and arterioles

Effects
- Internal diameter of arterial lumen reduced
- Loss of elasticity
- Thickened and rigid arterial wall
- Reduced ability to relax and contract

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3
Q

Which disease is responsible for the most frequent HTN or diabetess mellitus?

A

**arteriosclerosis **

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4
Q

Specific degenerative disease affecting large and medium arteries in systemic circulation:

A

ATHEROsclerosis

large & medium arteries such: Aorta, coronary, carotid, mesenteric, iliac, femoral and cerebral arteries most affected

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5
Q

what vessels does atherosclerosis NOT affect?

A

veins

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6
Q

in atherosclerosis, what part of the artery is affected FIRST?

A

tunica intima

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7
Q

results of atherosclerosis:

A
  • Lumen size reduced
  • Poor perfusion of tissues - hypoxia - cell death may occur

-Predisposes to thrombus formation-damage to endothelium/intima

-Predisposes to aneurysm-loss of elasticity

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8
Q

what are the 2 MAJOR risk factors for atherosclerosis?

A

Hypertension

Hypercholesterolemia

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9
Q

Current hypothesis for pathogenesis for atherosclerosis?

A

response to injury

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10
Q

Most frequent cause of significant morbidity caused by vascular disease

A

Atherosclerosis

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11
Q

what are the most common consequences of atherosclerosis?

A

ischemic heart disease

myocardial infarction

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12
Q

what is the most common cause of death within the U.S?

A

atherosclerosis

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13
Q

Fibrous, lipid-rich plaques in the intima of medium and large-sized arteries:

A

atheroma

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14
Q

where are atheromas NOT found?

A

pulmonary arteries or any veins

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15
Q

what is the first step for atheroma formation?

A

damage to endothelium

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16
Q

**what are the consequences of atheromas (plaques)?

A
  • Restriction of blood flow
  • Ulceration
  • Hemorrhage
  • Calcification
  • Thrombus formation - obstruction
  • Embolization of overlying thrombus or of the plaque material itself
  • Aneurysm formation
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17
Q

what are atheromas composed of?

A

central core

fibrous cap

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18
Q

Central core of atheroma:

A
  • Cholesterol and cholesterol esters
  • Lipid-laden macrophages (foam cells)
  • Calcium
  • Necrotic debris

“CL CN”

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19
Q

What does the fibrous cap (covers core) of atheroma composed of?

A
  • Smooth muscle cells
    - Foam cells
    - Fibrin and other coagulation proteins
    -Extracellular matrix
                                                   "SF FE"
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20
Q

what is hypertension?

A

Sustained diastolic pressure arbitrarily assigned **greater than 80 mmHg **or systolic pressure greater than 130 mmHg

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21
Q

HTN can predispose to

A

ischemic heart disease or stroke

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22
Q

Primary (essential) hypertension determinants:

A

-Genetic - more common in African lineage
- ** Insufficient renal sodium excretion**

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23
Q

What most commonly causes secondary HTN?

A

renal disease

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24
Q

HTN histopathology of arteriole change

A
  • Hyaline wall thickening(hyaline arteriosclerosis)
  • Increased rigidity (limited ability to expand and constrict)
    - Reduction in lumen size
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25
this type of hypertension often results in early death from congestive heart failure, cerebral vascular accident, kidney failure:
malignant hypertension
26
Multiple foci of tissue necrosis (**fibrinoid**) (ex. Renal glomeruli) are associated with what?
Malignant Hypertension
27
Pathology consequences in HTN:
**Heart** -Left ventricular myocardium hypertrophy -Coronary blood flow may be insufficient -- Ischemic heart disease-left ventricular failure **Aorta** -Severe atherosclerosis - Abdominal aortic aneurysm -Dissection ** Brain** -Rupture of intracerebral blood vessels -Massive hemorrhage and microinfarcts of the cerebral hemispheres filled with fluid (hypertensive lacunae)
28
An abnormal focal dilation of vessels and/or heart:
aneurysm
29
for an aneurysm, what layers of the vessels must be involved?
all 3 (intima, media, adventitia)
30
what are the main complication of an aneurysm?
**Erode adjacent** structures or **rupture** Predisposition to **thrombosis**
31
for an **abdominal aneurysm**, what is the most common cause?
atherosclerosis
32
for an abdominal aneurysm, what is the **most common location affected?**
descending aorta Thinning and replacement of media by plaques
33
Blood separates the laminar planes of the media to form blood-filled channel w/i the aortic wall:
aortic dissection
34
for an **aortic dissection** what is the **most common cause/risk factor?**
HTN
35
for an aortic dissection, what is the most common location affected
**ascending aorta** Affects middle and outer thirds of media
36
is aortic dissection a true aneurysm?
NO!
37
Two types of aortic dissection:
* Proximal lesion (Type A)-**affect Aorta** * Distal lesion (Type B)-affect **subclavian artery**
38
AORTIC Aneurysm/DISSECTION predispostion factors:
- **Hypertension** – major risk - **Degenerative** changes in the aortic media - Often associated with **disorder** of **connective tissue ** *ex. Marfan syndrome, Ehlers-Danlos syndromes*    - **Atherosclerosis** -** Instrumentation of an artery **
39
clinical presentations of aortic aneurysm /dissection include:
Severe, tearing, stabbing chest pain often radiating through to the back
40
what must be ruled out in the differential diagnosis for an aortic aneurysm /dissection
acute myocardial infarction
41
AORTIC Aneurysm/DISSECTION Often associated with:
cystic medial degeneration
42
what are three possible outcomes of aortic aneurysm /dissection ?
-**Massive fatal hemorrhage** into thoracic cavity - retrograde spread (towards the heart): rupture into pericardial cavity**fatal hemopericardium** (cardiac tamponade) -internal rupture: Blood back into lumen **(double barrelled aorta)**
43
what is the most common cause for a non-infectious vasculitis?
hypersensitivity
44
Name the disease: **Necrotizing** immune complex inflammation of** small and medium sized** muscular arteries, * Affects renal & visceral vessels; pulmonary vessels not affected:*
polyarteritis nodosa
45
Name the disease: **Necrotizing** immune complex inflammation of** small and medium sized** muscular arteries, * Affects renal & visceral vessels; pulmonary vessels not affected:*
polyarteritis nodosa
46
this pathology is marked by destruction of arterial media and internal elastic lamina,
Polyarteritis nodosa
47
Classic presentation of this pathology includes: *Accelerating hypertension* -*Abdominal pain & bloody stools*               -*Diffuse muscular aches & peripheral neuritis*
Polyarteritis nodosa
48
what organ will primarily be affected by polyarteritis nodosa?
kidneys
49
polyarteritis nodosa is a type of:
vasculitis
50
what are the two types of **giant cell arteritis** ( type of vasculitis):
Temporal arteritis Takayasu arteritis (pulseless disease)-affects aortic arch
51
Common form of vasculitis in adults over 50:
Temporal arteritis
52
Temporal arteritis usually affects branches of the: ________ Takayasu arteritis usually affects branches of the: __________
**carotid artery ( temporal branch) aortic arch**
53
Sudden blindness due to ophthalmic artery involvement is associated with:
Temporal arteritis
54
Acute and chronic inflammatory o**cclusion of small to medium sized arteries of the upper and lower limbs**
Buerger Disease (THROMBOANGIITIS OBLITERANS)
55
this pathology is related to heavy cigarette smoking:
Buerger Disease
56
what can result from chronic, progressing ulcerations associated with Buerger Disease?
gangrene
57
what blood vessels are most commonly associated with Buerger Disease?
radial and tibial arteries
58
Abnormally dilated, tortuous veins:
varicose veins
59
what is the cause of varicose veins?
-incompetence of the valves (allow engorgement with blood due to gravity) - weakened vessel wall support - Predisposed by increased venous pressure
60
what is the **most common site for varicose veins?**
Upper & lower leg
61
- Dilated veins in the anal canal and anorectal junction - Associated w/ pregnancy or straining to defecate - Result from prolonged pelvic vascular congestion:
hemorrhoids
62
Developmental malformation of blood vessels **Most common tumor of infancy and childhood:**
hemangioma
63
what are the two forms of hemangioma?
- **Capillary- most common** - Cavernous-can be associated w/ von Hippel-Lindau disease
64
Developmental malformation of lymphatic channels:
lymphangioma (Lymphatic malformation)
65
what is the most common location for Lymphangioma?
oral cavity-tongue
66
3 forms of Lymphangioma:
- Capillary - Cavernous - Cystic hygroma
67
pathology that presents as "tapioca pudding or frog's eggs"
Lymohoangioma
68
which type of Lymphangioma is associated with Turner's Syndrome?
cavernous
69
which type of Lymphangioma presents with enormous enlargement of neck & axilla?
cystic hygroma
70
is Hemangioma malignant or benign? is Lymphangioma malignant or benign? is Kaposi sarcoma malignant or benign?
Hemangioma & Lymphangioma is benign Kaposi sarcoma is malignant
71
this type of vascular tumor is caused by HHV-8 (Human Herpes Virus 8):
Kaposi sarcoma
72
which pattern of Kaposi sarcoma is associated w/HIV, can affect max. gingiva/palate?
epidemic
73
4 patterns of Kaposi sarcoma :
Endemic Classic Transplant Epidemic
74
3 stages (found on skin and/or oral cavity) for Kaposi sarcoma
75
*functional vascular disorder:* -Exaggerated vasoconstriction of arteries & arterioles in extremities -Most often in the fingers and toes, symmetric involvement -Response to **cold or emotion**
Primary Raynaud phenomenon
76
functional vascular disorder: **-Vascular insufficiency due to arterial disease from an underlying disorder, asymmetric involvement** (ex. Progressive systemic sclerosis (Scleroderma) Lupus Buerger disease)
Secondary Raynaud phenomenon

CARDIO EXAM 2 (3 decks)

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