Flashcards in Card - Path (Part 6: Vascular Disorders) Deck (62)
What is Raynaud's phenomenon? What is the mechanism, and to what is it a response?
Decreased blood flow to the skin due to arteriolar vasospasm in response to cold temperature or emotional stress
Where is Raynaud's phenomenon most often found on the body? What type of vessels does it affect?
Most often in the fingers and toes; Affects small vessels
What are the 2 different names given to Raynaud's phenomenon, and in what contexts?
(1) Raynaud's disease: primary (idiopathic) (2) Raynaud's syndrome: secondary to a disease process (such as mixed connective tissue disease, SLE, or CREST [limited form of systemic sclerosis] syndrome)
What is Raynaud's syndrome? What are some disease processes with which it may be associated?
Raynaud's phenomenon (decreased blood flow to skin due to arteriolar vasospasm in response to cold temperature of emotional stress) secondary to a disease process (such as mixed connective tissue disease, SLE, or CREST [limited form of systemic sclerosis] syndrome)
Give 9 examples of vascular tumors.
(1) Strawberry hemangioma (2) Cherry hemangioma (3) Pyogenic granuloma (4) Cystic hygroma (5) Glomus tumor (6) Bacillary angiomatosis (7) Angiosarcoma (8) Lymphangiosarcoma (9) Kaposi sarcoma
What is a Strawberry hemangioma? When does it appear, and what is its incidence? How does it develop and/or resolve over time?
Benign capillary hemangioma of infancy. Appears in first few weeks of life (1/200 births); grows rapidly and regresses spontaneously at 5 to 8 years old
What is a Cherry hemangioma? Does it regress? How does it change with age?
Benign capillary hemangioma of the elderly. Does not regress. Frequency increased with age.
What defines a pyogenic granuloma? With what 2 conditions is it associated?
Polypoid capillary hemangioma that can ulcerate and bleed. Associated with trauma and pregnancy.
What is a cystic hygroma? With what condition is it associated?
Cavernous lymphangioma of the neck. Associated with Turner syndrome.
What is a glomus tumor? From where does it arise?
Benign, painful, red-blue tumor under fingernails. Arises from modified smooth muscle cells of glomus body.
What defines bacillary angiomatosis? What causes this? For what is this frequently mistaken?
Benign capillary skin papules found in AIDS patients. Caused by Bartonella henselae infections. Frequently mistaken for Kaposi sarcoma.
What is angiosarcoma? Where does it typically occur, and in what patient population?
Rare blood vessel malignancy typically occurring in the head, neck, and breast areas. Usually in elderly, on sun-exposed areas.
With what 2 exposures is angiosarcoma associated?
Associated with radiation therapy and arsenic exposure.
Briefly discuss the progression and resection of angiosarcoma.
Very aggressive and difficult to resect due to delay in diagnosis.
What is lymphangiosarcoma, and with what is it associated? Give an example of a context in which this may occur.
Lymphatic malignancy associated with persistent lymphedema (e.g., post-radical mastectomy)
What is Kaposi sarcoma, and where in the body is it most commonly found? Where else it found?
Endothelial malignancy most commonly of the skin, but also mouth, GI tract, and respiratory tract
With what 2 pathogens is Kaposi sarcoma associated?
Associated with HHV-8 and HIV
For what is Kaposi sarcoma frequently mistaken?
Frequently mistaken for bacillary angiomatosis
What are the 3 major categories of vasculitis?
(1) Large-vessel vasculitis (2) Medium-vessel vasculitis (3) Small-vessel vasculitis
What are 2 types of large-vessel vasculitis?
(1) Temporal (giant cell) arteritis (2) Takayasu arteritis
What is another name for temporal arteritis? What patient population is generally affected by it?
Temporal (giant cell) arteritis; Generally elderly females
What are 3 symptoms/signs in the presentation of Temporal (giant cell) arteritis? Where applicable, give the cause. With what other condition is Temporal (giant cell) arteritis associated?
(1) Unilateral headache (temporal artery), (2) Jaw claudication (3) May lead to irreversible blindness due to opthalmic artery occlusion.; Associated with polymyalgia rheumatica
Which vessels are most commonly affected by Temporal (giant cell) arteritis?
Most commonly affects branches of carotid artery
What are 2 histological/lab findings that characterize Temporal (giant cell) arteritis?
(1) Focal granulomatous inflammation (2) High ESR
How is Temporal (giant cell) arteritis treated, when, and why?
Treat with high-dose corticosteroids prior to temporal artery biopsy to prevent vision loss
What patient population does Takayasu arteritis affect?
Asian females < 40 years old
What are 7 signs/symptoms that characterize the presentation of Takayasu arteritis?
(1) "Pulseless disease" (weak upper extremity pulses), (2) fever, (3) night sweats, (4) arthritis, (5) myalgias, (6) skin nodules, (7) ocular disturbances
What are 2 histologic/lab findings that characterize Takayasu arteritis?
(1) Granulomatous thickening and narrowing of aortic arch and proximal great vessels (2) High ESR
How is Takayasu arteritis treated?
Treat with corticosteroids