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CARDIO EXAM 2 > 203: Red diamonds wright > Flashcards

203: Red diamonds wright Flashcards

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
Q

this type of hypertension often results in early death from congestive heart failure, cerebral vascular accident, kidney failure:

A

malignant hypertension

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26
Q

Multiple foci of tissue necrosis (fibrinoid)
(ex. Renal glomeruli)

							are associated with what?
A

Malignant Hypertension

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27
Q

Pathology consequences in HTN:

A

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)

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28
Q

An abnormal focal dilation of vessels and/or heart:

A

aneurysm

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29
Q

for an aneurysm, what layers of the vessels must be involved?

A

all 3

      (intima, media, adventitia)
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30
Q

what are the main complication of an aneurysm?

A

Erode adjacent structures or rupture

Predisposition to thrombosis

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31
Q

for an abdominal aneurysm, what is the most common cause?

A

atherosclerosis

32
Q

for an abdominal aneurysm, what is the most common location affected?

A

descending aorta

  Thinning and replacement of media by plaques
33
Q

Blood separates the laminar planes of the media to form blood-filled channel w/i the aortic wall:

A

aortic dissection

34
Q

for an aortic dissection what is the most common cause/risk factor?

A

HTN

35
Q

for an aortic dissection, what is the most common location affected

A

ascending aorta

Affects middle and outer thirds of media

36
Q

is aortic dissection a true aneurysm?

A

NO!

37
Q

Two types of aortic dissection:

A
  • Proximal lesion (Type A)-affect Aorta
  • Distal lesion (Type B)-affect subclavian artery
38
Q

AORTIC Aneurysm/DISSECTION predispostion factors:

A
  • 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
Q

clinical presentations of aortic aneurysm /dissection include:

A

Severe, tearing, stabbing chest pain often radiating through to the back

40
Q

what must be ruled out in the differential diagnosis for an aortic aneurysm /dissection

A

acute myocardial infarction

41
Q

AORTIC Aneurysm/DISSECTION
Often associated with:

A

cystic medial degeneration

42
Q

what are three possible outcomes of aortic aneurysm /dissection ?

A

-Massive fatal hemorrhage into thoracic cavity

  • retrograde spread (towards the heart): rupture into pericardial cavityfatal hemopericardium (cardiac tamponade)

-internal rupture: Blood back into lumen (double barrelled aorta)

43
Q

what is the most common cause for a non-infectious vasculitis?

A

hypersensitivity

44
Q

Name the disease:
Necrotizing immune complex inflammation of** small and medium sized** muscular arteries,
*
Affects renal & visceral vessels; pulmonary vessels not affected:*

A

polyarteritis nodosa

45
Q

Name the disease:
Necrotizing immune complex inflammation of** small and medium sized** muscular arteries,
*
Affects renal & visceral vessels; pulmonary vessels not affected:*

A

polyarteritis nodosa

46
Q

this pathology is marked by destruction of arterial media and internal elastic lamina,

A

Polyarteritis nodosa

47
Q

Classic presentation of this pathology includes:

Accelerating hypertension
-Abdominal pain & bloody stools
-Diffuse muscular aches & peripheral neuritis

A

Polyarteritis nodosa

48
Q

what organ will primarily be affected by polyarteritis nodosa?

A

kidneys

49
Q

polyarteritis nodosa is a type of:

A

vasculitis

50
Q

what are the two types of giant cell arteritis ( type of vasculitis):

A

Temporal arteritis
Takayasu arteritis (pulseless disease)-affects aortic arch

51
Q

Common form of vasculitis in adults over 50:

A

Temporal arteritis

52
Q

Temporal arteritis usually affects branches of the: ________

Takayasu arteritis usually affects branches of the: __________

A

**carotid artery ( temporal branch)

aortic arch**

53
Q

Sudden blindness due to ophthalmic artery involvement is associated with:

A

Temporal arteritis

54
Q

Acute and chronic inflammatory occlusion of small to medium sized arteries of the upper and lower limbs

A

Buerger Disease (THROMBOANGIITIS OBLITERANS)

55
Q

this pathology is related to heavy cigarette smoking:

A

Buerger Disease

56
Q

what can result from chronic, progressing ulcerations associated with Buerger Disease?

A

gangrene

57
Q

what blood vessels are most commonly associated with Buerger Disease?

A

radial and tibial arteries

58
Q

Abnormally dilated, tortuous veins:

A

varicose veins

59
Q

what is the cause of varicose veins?

A

-incompetence of the valves (allow engorgement with blood due to gravity)
- weakened vessel wall support
- Predisposed by increased venous pressure

60
Q

what is the most common site for varicose veins?

A

Upper & lower leg

61
Q
  • Dilated veins in the anal canal and anorectal junction
  • Associated w/ pregnancy or straining to defecate
  • Result from prolonged pelvic vascular congestion:
A

hemorrhoids

62
Q

Developmental malformation of blood vessels

Most common tumor of infancy and childhood:

A

hemangioma

63
Q

what are the two forms of hemangioma?

A
  • Capillary- most common
  • Cavernous-can be associated w/ von Hippel-Lindau disease
64
Q

Developmental malformation of lymphatic channels:

A

lymphangioma (Lymphatic malformation)

65
Q

what is the most common location for Lymphangioma?

A

oral cavity-tongue

66
Q

3 forms of Lymphangioma:

A
  • Capillary
  • Cavernous
  • Cystic hygroma
67
Q

pathology that presents as “tapioca pudding or frog’s eggs”

A

Lymohoangioma

68
Q

which type of Lymphangioma is associated with Turner’s Syndrome?

A

cavernous

69
Q

which type of Lymphangioma presents with enormous enlargement of neck & axilla?

A

cystic hygroma

70
Q

is Hemangioma malignant or benign?

is Lymphangioma malignant or benign?

is Kaposi sarcoma malignant or benign?

A

Hemangioma & Lymphangioma is benign

Kaposi sarcoma is malignant

71
Q

this type of vascular tumor is caused by HHV-8 (Human Herpes Virus 8):

A

Kaposi sarcoma

72
Q

which pattern of Kaposi sarcoma is associated w/HIV, can affect max. gingiva/palate?

A

epidemic

73
Q

4 patterns of Kaposi sarcoma :

A

Endemic

Classic

Transplant

Epidemic

74
Q

3 stages (found on skin and/or oral cavity) for Kaposi sarcoma

A
75
Q

functional vascular disorder:

-Exaggerated vasoconstriction of arteries & arterioles in extremities

-Most often in the fingers and toes, symmetric involvement

-Response to cold or emotion

A

Primary Raynaud phenomenon

76
Q

functional vascular disorder:

-Vascular insufficiency due to arterial disease from an underlying disorder, asymmetric involvement

(ex. Progressive systemic sclerosis (Scleroderma)

Lupus

Buerger disease)

A

Secondary Raynaud phenomenon

CARDIO EXAM 2 (3 decks)

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