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Pathology > Blood Vessels > Flashcards

Blood Vessels Flashcards

1
Q

Definition of malignant hypertension

A

> 200/>120 mmHg

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2
Q

Key initiating event in essential hypertension

A

Reduced renal Na secretion

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3
Q

Gain of function mutation of ENaC channel

A

Liddle syndrome

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4
Q

Seen in malignant HTN

A

Laminated thickening or onion-skin lesions (hyperplastic arteriolosclerosis)

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5
Q

Seen in essential HTN

A

Hyaline material (hyaline arteriolosclerosis)

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6
Q

Diagnostic lesion of atherosclerosis

A

Atheroma or atheromatous plaque

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7
Q

Components of atherogenesis

A

Endothelial injury, accumulation of lipoproteins in vessel wall, migration of smooth muscle cells into into intima (neo-intima), intra and extracellular lipid accumulation

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8
Q

Initial lesion of atherosclerosis

A

Fatty streak with foam cells

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9
Q

Structural parts of a plaque

A

Fibrous cap and lipid core

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10
Q

Most common sites of involvement

A

Lower abd aorta > coronary > popliteal > ICA > Circle of Willis

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11
Q

Critical stenosis (level at which tissue ischemia starts)

A

70% at coronaries

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12
Q

True aneurysm vs false aneurysm

A

True if intact vascular wall, false if there is compromise with extravascular hematoma

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13
Q

Blood tunnels between layers of wall, most commonly due to intimal tear

A

Dissection

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14
Q

Both ascending and descending dissection

A

DeBakey I

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15
Q

Ascending dissection

A

DeBakey II

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16
Q

Descending dissection

A

DeBakey III

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17
Q

Stanford A

A

DeBakey I and II (both and ascending only)

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18
Q

Stanford B

A

DeBakey III (descending only)

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19
Q

Basis of classification of vasculitides

A

By size of vessels affected (large, medium, small)

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20
Q

Morphology of large vessel vasculitis

A

Granulomatous

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21
Q

Morphology of medium and small vessel vasculitis

A

Necrotizing

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22
Q

Giant cell arteritis and Takayasu arteritis

A

Large vessel

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23
Q

Polyarteritis nodosa and Kawasaki

A

Medium vessel

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24
Q

MPO-ANCA (p-ANCA): Microscopic polyangiitis and Churg-Strauss syndrome

A

Small vessel

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25
Q

PR3-ANCA (c-ANCA): Granulomatosis with polyangiitis (formerly Wegener’s granulomatosis)

A

Small vessel

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26
Q

Mechanism of large vessel vasculitis

A

Cell-mediated (T-cells)

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27
Q

Mechanism of Kawasaki

A

Anti-endothelial cell antibody

28
Q

Mechanism of polyarteritis nodasa

A

Immune complex (associated with chronic hep B)

29
Q

Mechanism of small vessel vasculitis

A

Anti-neutrophil cytoplasmic autoantibodies

30
Q

Vessel involved in giant cell arteritis

A

Temporal, can be ophthalmic

31
Q

Vessel involved in Takayasu

A

Branches of the aortic arch

32
Q

Characterized by marked weakening of UE pulses (pulseless disease)

A

Takayasu

33
Q

Vasculitis morphology characterized by medial granulomatous inflammation with fragmentation of internal elastic lamina

A

Large vessel vasculitides (giant cell arteritis and Takayasu)

34
Q

Vasculitis associated with chronic hep B infection

A

Polyarteritis nodosa

35
Q

Important cause of MI in children due to coronary aneurysm

A

Kawasaki

36
Q

Vessels involved in polyarteritis nodosa

A

Renal and visceral (NEVER PULMONARY)

37
Q

Vasculitis morphology characterized by segmental, transmural necrotizing inflammation with fibrinoid necrosis with temporal heterogeneity

A

Polyarteritis nodosa > Kawasaki

38
Q

Small vessel vasculitis associated with connective tissue disorders

A

Microscopic polyangiitis

39
Q

Small vessel vasculitis associated with asthma, AR, eosinophilia

A

Churg-Strauss (chARN - AR, asthma)

40
Q

Aka MPO-ANCA or p-ANCA vasculitis

A

Microscopic polyangiitis and Churg-Strauss

41
Q

Vessels involved in microscopic polyangiitis

A

Viscera, kidneys and lungs

42
Q

Vessels involved in Churg-Strauss

A

Cutaneous, GI, renal, cardiac (may cause cardiomyopathy)

43
Q

Vasculitis morphology characterized by segmental, transmural necrotizing inflammation with fibrinoid necrosis with temporal HOMOGENEITY

A

Microscopic polyangiitis (vs polyarteritis nodosa, na temporally heterogenous)

44
Q

Aka PR3-ANCA or c-ANCA vasculitis

A

Formerly Wegener’s granulomatosis

45
Q

Prominent clinical feature of Wegener’s

A

Persistent pneumonitis with bilateral nodular and cavitary infiltrates

46
Q

Vasculitis morphology characterized by necrotizing granulomas of the respiratory tract and focal segmental necrotizing GN (early) and crescentic GN (late)

A

Wegener’s granulomatosis

47
Q

Vasculitis with recurrent oral / aphthous ulcers

A

Behcet’s syndrome (say BEH, open your mouth)

48
Q

Vasculitis associate with Raynaud’s and PAOD like symptoms

A

Buerger’s disease (thromboangiitis obliterans), associated with smoking

49
Q

Exaggerated vasoconstriction of arteries and arterioles in the extremities

A

Raynaud’s phenomenon (red white and blue, because of proximal vasodilation, middle vasoconstriction, then distal cyanosis)

50
Q

Diseases associated with secondary Raynaud’s

A

SLE, scleroderma, buerger’s, atherosclerosis

51
Q

“Cardiac raynaud’s” seen in Prinzmetal angina

A

Coronary vasospasm

52
Q

Migratory thrombophlebitis indicative of possible malignancy

A

Trousseau’s sign or syndrome

53
Q

Most common causative agent of lymphangitis

A

GABHS

54
Q

Harmless vascular ectasia known as birthmark

A

Nevus flammeus

55
Q

Nevus flammeus over trigeminal nerve distribution that does not regress

A

Port-wine stain, seen in Sturge-Weber syndrome (Facial port wine nevus, ipsilateral leptomeningeal cortical venous angioma, mental retardation, seizures, hemiplegia, skull radio-opacities_

56
Q

Facial port wine nevus, ipsilateral leptomeningeal cortical venous angioma, mental retardation, seizures, hemiplegia, skull radio-opacities

A

Sturge-Weber syndrome

57
Q

Vascular ectasia associated with hyperestrinism (pregnancy and liver cirrhosis)

A

Spider telangiectasia

58
Q

Autosomal dominant defect in TGF-B

A

Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease)

59
Q

Two types of hemangioma

A

Capillary and cavernous

60
Q

Hemangioma that grows rapidly in neonates and mostly completely regresses by age 7

A

Juvenile type (strawberry) capillary hemangioma

61
Q

Cavernous hemangioma with cerebellar, brain stem, retinal, pancreatic, or liver involvement)

A

Von Hippel-Lindau disease

62
Q

Cavernous lymphangioma found in the neck

A

Turner syndrome

63
Q

Vascular neoplasm caused by HHV-8 found in AIDS patients

A

Kaposi’s sarcoma

64
Q

Type of Kaposi’s found in HIV-negative Africans below 40 years

A

Endemic KS

65
Q

Type of Kaposi’s found in HIV-positive peeps

A

Epidemic KS

66
Q

Immunostains used in angiosarcoma

A

CD31, CD34, vWF (endothelial origin)

67
Q

Associated with arsenic, PVC, and thorotrast

A

Hepatic angiosarcoma

Pathology (13 decks)

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