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CV II Exam 2 > Blood Vessels IV > Flashcards

Blood Vessels IV Flashcards

(51 cards)

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1
Q

abdominal aortic aneurysm

A

below renal aa
male smokers >50yo
severe atherosclerosis with attenuated media

also - higher incidence of ischemic heart disease

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2
Q

inflammatory AAA

A

5-10%

-rich in lymphocytes, plasma cells, macrophages, giant cells

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3
Q

mycotic AAA

A

infected with salmonella gastroenteritis***

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4
Q

when to surgically repair AAA

A

5cm or greater in size

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5
Q

clinical consequences of AAA

A

rupture
obstruction
embolism
impingement adjacent structures

**pulsating abdominal mass

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6
Q

dysphagia, dyspnea, recurrent cough, vertebral body bone pain

A

could be thoracic aortic aneurysm

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7
Q

syphilitic aneurysm

A

luetic
-tertiary stage of syphilis - involves vasa vasorum of thoracic aorta

obliterative endarteritis of vasa vasorum - ischemic injury to media of aorta - aneurysmal dilation

TREE BARKING

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8
Q

tree barking

A

with syphilitic aneurysm

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9
Q

aortic dissection

A

blood into aortic media
-often to rupture - massive hemorrhage or cardiac tamponade

men age 40-60
younger individuals with marfans

may or may not occur with aneurysm

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10
Q

type A dissection

A

involves ascending aorta - debakey 1 and 2

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11
Q

type B dissection

A

involves descending aorta - debakey 3

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12
Q

sudden onset of excruciating pain - anterior chest radiates to back - moves downward

A

aortic dissection

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13
Q

Tx of dissection

A

aggressive treatment for HTN

surgical plication allows 65-75% survival

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14
Q

dissection unusual

A

substantial atherosclerosis or other cause of medial scarring such as syphilis

-fibrosis limits dissection propagation

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15
Q

marfan syndrome

A

LOF mutation in fibrillin - FBN1 gene
majority - autosomal dominant

increased TGF-beta activity - enhanced collagen production and ECM remodeling

overgrowth of bones and mitral valve changes

elastic fragmentation and areas devoid or elastin

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16
Q

loeys dietz syndrome

A

marfan type 2

-mutated TGF-beta receptor

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17
Q

decreased fibrillin 1

A

in marfans

-leads to increased TGF-beta activity

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18
Q

long slender skeleton, subluxation of lens in eye, aneurysm and aortic dissection, aortic valve ring dilation, floppy valve syndrome

A

in marfans

rupture of aorta - most common cause of death

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19
Q

vasculitis

A

inflammation of vessels wall

two main causes - immune-mediated, infection

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20
Q

C-ANCA

A

PR3

in wegener granulomatosis

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21
Q

P-ANCA

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A

MPO

in churg strauss and microscopic polyangiitis

22
Q

kawasaki

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A

anti-endothelial cell antibodies

anti-smooth muscle cell antibodies

23
Q

goodpasture

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A

anti-GBM antibodies

-affects kidney and lungs

24
Q

constitutional symptoms

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A

non-specific - seen with vasculitidies

-with fever, weight loss, myalgia, arthralgia, malaise, fatigue

25
giant cell arteritis
aka temporal arteritis - large vessel vasculitis - patient > 50yo - associated with polymyalgia rheumatica - most common vasculitis of elderly in US - can lead to permanent blindness** anti-endothelial or anti-smooth muscle antibodies
26
permanent blindness
risk with giant cell arteritis
27
patient with HA, visual disturbance, and bulging vessels on temples
giant cell arteritis
28
takayasu arteritis
large vessel vasculitis - patient < 40) - thickened and narrowed aorta and major branches - weakened pulses of upper extremities** - ocular changes, neuro sx possible pulmonary HTN, coronary artery, renal artery, aortic valve insufficiency pathologies
29
pulseless disease
diminished radial pulses | -with takayasu arteritis
30
polyarteritis nodosa
medium sized vessel vasculitis - young adults - renal a involvement - Hep B surface Ag/Ab complexes - acute lesions - arterial fibrinoid necrosis - healed lesions - marked fibrotic thickening of artery - presentation depend on tissue involved - hematirua, albuminuria, hypertension untreated - fatal disease Tx - steroids and cyclophosphamide
31
hep B surface Ag/Ab complexes
polyarteritis nodosa
32
kawasaki disease
medium vessel vasculitis - anti-endo and smooth m autoantibodies - coronary arteritis association*** - decreased with IV gamma globumin and aspirin - rash on palms and soles of feet - strawberry tongue - mucocutaneous lymph node syndrome
33
mucocutaneous lymph node syndrome
with kawasaki disease
34
microscopic polyangiitis
small vessel disease - aka leukocytoclastic vasculitis - rxn to drugs, organisms, proteins - elevated P-ANCA (MPO) -palpable purpura -necrotizing GN -pulmonary capillaritis -hemoptysis arthralgia abdomen pain/bleeding hematuria proteiuria muscle pain/weakness
35
churg strauss syndrome
small vessel vasculitis - allergic granulomatosis - eosinophil rich granulomas** - associated with allergic rhinitis, asthma, lung infiltrates P-ANCA (MPO) palpable purpura coronary arteritis and eosionphilic myocarditis
36
behcet disease
small vessel vasculitis - recurrent oral apthous ulcers - genital ulcers - uveitis (inflammation of eye) also GI, pulmonary, neuro symptoms associated with HLA-B51 positive pathergy test
37
pathergy test
pinprick - minor trauma -causes exaggerated rxn in behcet disease
38
granulomatosis with polyangiitiis
wegener granulomatosis -small vessel vasculitis triad: 1 - acute necrotizing granulomas of resp tract 2 - necrotizing/granulomatous vasculitis affecting small/medium vessels in lungs and upper airways 3 - renal disease - focal crescent GN - hematuria and proteinuria C-ANCA (PR3)
39
triad of wegener
resp tract necrotizing granulomas small-medium vessel necrotizing granulomas renal disease - necrotizing crescentic GN
40
40yo male, persistent pneumonitis, bilateral cavitary infiltrates, chronic sinusitis, mucosal ulcers, renal disease, skin rash, muscle pain, articular involvement, fever
with wegener granulomatosis
41
untreated wegener
80% of patients die within 1 year Tx - immunosuppression
42
thromboangiitis obliterans
buerger disease - medium/small arteries and veins, nerves - cigarette smoking men - before age 35 - ulcerations of toes, feet, fingers - raynaud - exercise induced claudication - severe pain at rest Tx - stop smoking
43
vasculitis with smoking cigarettes
buerger disease | -thromboangiitis obliterans
44
infectious vasculitis
aspergillus and mucormycosis | -may lead to mycotic aneurysm
45
hypothermia
prolonged exposure to low temperature - 90 degrees - loss of consciousness - bradycardia and atrial fib at lower temps direct effects - physical disruptions and high salt concentrations indirect effects - circulatory changes
46
alcohol
causes vasodilation | -lowers body temp faster
47
frostnip
vasoconstriction | -nose, ear, hands, feet
48
chillblain
perniones, perniosi - nonfreezing temp and damp conditions - chronic recurrent vasculitis with red raised lesions
49
immersion foot
trench - feet wet - not freezing - chronic pain, edema, blotchy discoloration - superficial, moist, liquefactive gangrene
50
frostbite
sudden drop in temp that persists - vasoconstriction and increased blood viscosity - hyperemia and edema, large clear blisters, vesicles filled with hemorrhagic fluid to complete gangrene
51
raynaud phenomenon
pallor or cyanosis of digits - primary - cold/emotion induced - secondary - arterial insufficiency - SLE, scleroderma, atherosclerosis, buerger disease red, white, blue of digits

CV II Exam 2 (18 decks)

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