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BLOOD VESSEL PATHOLOGY Flashcards

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1
Q

most imp risk factor for DVT

A

prolonged immobilization

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2
Q

Primary or secondary Raynaud?

  • exaggerated central and local vasomotor responses to cold or emotion
  • Young women
  • symmetrically affect the extremities
  • Static extent & severity
A

Primary Raynaud phneomenon

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3
Q

1. Identify the lesion described:

a. calcification of the walls of muscular arteries, typically involving the internal elastic membrane
b. do not encroach on the vessel lumen
c. not clinically significant.

2. Radiographic pattern?

A
  1. Mönckeberg medial calcific sclerosis
  2. Pipestem appearance
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4
Q

homogeneous, pink hyaline thickening with associated luminal narrowing

A

Hyaline arteriolosclerosis

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5
Q

•Necrotizing granulomas of URT/LRT & Kidneys +Necrotizing granulomatous vasculitis of small/medium vessels esp lungs & upper airways

  • PR3-ANCAs -up to 95% of cases
  • •sinusitis / mucosal ulcerations of the nasopharynx
  • bilateral nodular and cavitary infiltrates
A

Wegner granulomatosis (Granulomatosis with Polyangiitis)

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6
Q

Identify the vasculitis:

  1. •Main arteries affected- temporal, vertebral, ophthalmic
  2. Age >50
  3. Microscopy: medial granulomatous inflammation centered on the internal elastic lamina
  4. •Increased ESR , sometimes exceeding 100mm/1st hour
  5. Assoc with polymyalgia rheumatica
A

Giant Cell (Temporal) Arteritis

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7
Q

Most common cause of thoracic aortic aneurysms

A

Hypertension

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8
Q

Identify the lesion described:

•malignant endothelial neoplasm

  • Develops in the ipsilateral upper extremity several years after radical mastectomy
A

Lymphangiosarcoma

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9
Q

Identify the lesion described:

frequency increases with age, does not regress.

Microscopy shows thin-walled capillaries with scant

stroma

A

Cherry hemangioma

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10
Q

3 conditions assoc with hyaline arteriolosclerosis

A
  1. hypertension
  2. diabetic microangiopathy
  3. Nephrosclerosis
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11
Q

Identify the lesion described:

assoc with Turner Syndrome

Indistinct margins, unencapsulated

massively dilated lymphatic spaces lined by endothelial cells and separated by intervening connective tissue stroma containing lymphoid aggregates.

A

Cystic Hygroma (Cavernous Lymphangioma)

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12
Q

•conjunctival and oral erythema

  • •desquamative rash of palms and soles
  • Coronary artery aneurysm
  • Strawberry Tongue
  • Hand and feet edema
  • less than 4 years old
A

Kawasaki Disease (MUCO CUTANEOUS LYMPH NODE SYNDROME)

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13
Q

Is this a Vulnerable/ Stable plaque?

  • Thin fibrous cap
  • Large lipid core
  • Intense inflammation
A

Vulnerable

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14
Q

Identify this condition:

Assoc with hyperestrogenic states

radial,pulsatile arrays of dilated subcutaneous arteries/arterioles bout a central core

blanch with pressure

A

Spider telangiectasia

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15
Q

Why do we get onion skinning in malignant hypertension- what do those laminations represent?

A

Laminations consist of smooth muscle cells with thickened, reduplicated basement membrane

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16
Q

What is the downstream effect of fibromuscular dysplasia?

A

Can cause renal artery stenosis which in turn leads to secondary hypertension

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17
Q

In a hypertensive with activation of the RAA axis, where will the levels of Angiotensin II be highest?

Pulmonary artery or pulmonary veins?

A

Pulmonary veins - as ACE is produced primarily within the endothelial cells of small pulmonary vessels

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18
Q

Identify the lesion described:

  • malignant endothelial neoplasm
  • older adults

Assoc with exposure to Thorotrast/arsenic/polyvinyl chloride

plump, atypical endothelial cells forming vascular channels

A

Hepatic angiosarcoma

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19
Q

Identify this lesion:

assoc with von Hippel Lindau disease

large, cavernous blood-filled vascular spaces separated by connective tissue stroma

A

Cavernous hemangioma

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20
Q

small-vessel

MPO-ANCAs

Classically associated with asthma, allergic rhinitis, lung infiltrates, peripheral hypereosinophilia

Multisystem involvement

extravascular necrotizing granulomas

A

Churg - Strauss Syndrome aka allergic granulomatosis and angiitis

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21
Q
  1. What is the gross appearance called?
  2. Secondary to which infection?
  3. Which layer of the vessel is affected?
A
  1. Tree barking
  2. Syphilis
  3. Vasa Vasorum
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22
Q
  1. Identify the lesion described below:

Young woman of child bearing age

Histopathologic examination of the renal arteries exhibit collagenized tunica media alternating with regions of thinned media

Angiogram image attached

  1. What’s the classic pattern seen on angiogram called?
A
  1. Fibromuscular dysplasia
  2. Beading
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23
Q

Primary or secondary Raynaud?

  • vascular insufficiency due to arterial disease caused by other entities
  • Eg: SLE, scleroderma, Buerger disease, atherosclerosis.
  • asymmetric involvement of the extremities
  • Worsens in extent & severity over time
Study These Flashcards
A

Secondary Raynaud phenomenon

24
Q

Secondary hypertension that occurs secondary to renovascular disease such as atherosclerosis or fibromuscular dysplasia is an example of high renin or low renin hypertension?

Study These Flashcards
A

High renin hypertension

25
Mechanism of varicose veins development
prolonged, increased intraluminal pressure leads to vessel dilation and incompetence of the venous valves which in turn leads to stasis, congestion, edema, pain, and thrombosis
26
**One term that describes the following:** systolic pressure more than 200 mm Hg, diastolic pressure more than 120 mm Hg), renal failure, and retinal hemorrhages and exudates, with or without papilledema
Malignant hypertension
27
**_SVC/IVC compression syndrome?_** * Marked dilation of the veins of the head, neck, and arms with cyanosis * Respiratory distress
SVC syndrome Typically occurs secondary to a bronchogenic carcinoma
28
Substance whose production drives intimal smooth muscle cell proliferation
PDGF
29
**1. Identify the lesion described:** a. Initiates with an intimal tear b. CXR shows mediastinal widening c. See attached CT/MRI **2. List 2 radiographic features seen in the attached image**
1. Aortic dissection 2. a. intimal flap, b. double barrel lumen
30
Heavy cigarette smokers luminal thrombosis with microabscesses intermittent claudication gangrene
Thromboangiitis Obliterans (Buerger Disease)
31
Identify this vascular tumor from the features described: grow during childhood do not fade/regress with time assoc with Sturge Weber Syndrome
Port wine stain
32
**Identify the vasculitis described below:** • Known association in 30% with chronic hepatitis B * medium vessel involvement •Vessels at various stages of acute & chronic inflammation; segmental transmural necrotizing inflammation Acute stages may show fibrinoid necrosis
Polyarteritis nodosa (PAN)
33
most common site for traumatic aortic rupture
aortic isthmus
34
2 important risk factors for aortic dissection
* Hypertension * inherited or acquired connective tissue disorders with defective vascular extracellular matrix
35
Major cause of abdominal aortic aneurysms
atherosclerosis
36
Complications of the lesion seen in the image
The lesion is Varicose veins. The complications are: * Stasis dermatitis * Ulcerations * Poor wound healing * Superimposed infections
37
1. What does this gross image represent? 2. What is this composed of?
1. Fatty streak 2. lipid-filled foamy macrophages.
38
1. What finding does this gross lesion represent? 2. What is this lesion composed of?
1. Atherosclerotic plaque 2. intimal thickening + lipid accumulation
39
**Identify the lesion described** ## Footnote * follows viral upper respiratory infection, group A streptococcal pharyngeal infection * **IgA–anti-IgA immunocomplex (type III** hypersensitivity disease) * Kidneys- hematuria, glomerulonephritis * GIT- colicky abdominal pain and vomiting, melena
Immunoglobulin A vasculitis (Henoch Schoenlein Purpura)
40
What finding does this image represent?
Hyperplastic arteriolosclerosis (onion-skinning)
41
What is an additional finding seen in malignant hypertension apart from onion-skinning?
Fibrinoid necrosis
42
1. What lesion does this image represent? 2. What causes this lesion?
1. cystic medial degeneration 2. Medial wall ischemia
43
•Leukocytoclastic vasculitis . All lesions tend to be of same age
Microscopic Polyangiitis
44
Identify the vasculitis described below: * Microscopic features-granulomatous vasculitis of medium and larger arteries * Predilection: aortic arch & great vessls * Less than 50 years * Young females, Asia * marked weakening to absence of the pulses in the upper extremities
Takayasu Arteritis(pulseless disease)
45
Enumerate the possible Pathologic changes in an atheromatous plaque
1. Rupture, ulceration or erosion of the plaque surface 2. Thrombosis 3. Hemorrhage into a plaque 4. Atheroembolism 5Aneurysm formation
46
most frequent pre-existing histologically detectable lesion in aortic dissection
cystic medial degeneration
47
most common serious clinical complication of DVT
Pulmonary embolism
48
What finding does this image represent?
Atherosclerotic plaque with a thrombus occluding the lumen
49
Morphology: red purple macules- nodules- plaques assoc with HHV -8 sheets of plump proliferating spindle cells commonly seen in immunocompromised
Kaposi Sarcoma
50
1. Clinical presentation of aortic dissection 2. Which valvular heart lesion can develop secondary to aortic dissection?
1. Sudden onset of excruciating pain, usually beginning in the anterior chest, radiating to the back between the scapulae 2. Aortic regurgitation
51
Initial trigger event in the pathogenesis of atherosclerosis
Chronic endothelial injury and dysfunction
52
**Name a condition where the following microscopic vessel finding is encountered:** •concentric, laminated (“onion-skin”) thickening of the walls with luminal narrowing
Severe hypertension
53
See attached image. What is the function of the cells that this tumor originates from?
The image shows a glomus tumor. It originates from glomus bodies. Function: Temperature regulation
54
Levels of this cytokine correlate with severity of giant cell arteritis
IL-6
55
Drug used for treatment of Giant cell arteritis
Tocilizumab (anti IL-6)
56
Newborn infant, reddish lesion on the buttocks, benign, requires watchful waiting and reassurance to parents
Juvenile hemangioma also known as strawberry hemangioma
57
cause for reddish brown discoloration in stasis dermatitis
Deposition of hemosiderin

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