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Path Exam II > Chapter 9 > Flashcards

Chapter 9 Flashcards

1
Q 
common, disabling lethal disease
#1 cause of morbidity and mortality in US
A

vascular disease

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2
Q

vascular disease MC involves _______

2 types: NARROWING of ______ or WEAKENING of ________

A

arteries
lumen
vessel wall

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3
Q

hardening of arteries; non-specific

A

arteriosclerosis

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4
Q

dilation of vascular wall

A

aneurysm

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5
Q

passage of blood through layers of wall

A

dissection

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6
Q

blood clot in a vessel

A

thrombus

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7
Q

hardening of arteries, atheroma

A

atherosclerosis

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8
Q

dilation of vein

A

varicosity

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9
Q

open interior of a vessel

A

lumen

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10
Q

_____ is similar throughout cardiovascular system with 3 layers: ____, ____ & ______

A

vascular structure
intima
media
adventitia

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11
Q

smooth muscle in CVS is

A

involuntary

non-striated

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12
Q

intima is made of _______ and is the _____ layer

A

endothelia cells

deepest

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13
Q

media is made of ______ and is the ______ layer

A

smooth muscles

middle

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14
Q

adventitia is made of ______ and is the _____ layer

A

CT, nerves, vessels

superficial

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15
Q

DIFFUSION of blood from lumen occurs in _____ part of vascular wall

A

interior

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16
Q

_____ supplies the exterior vascular wall

A

vasa vasorum

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17
Q

tunica media is _____ in arteries than veins

A

larger (why cadavers have thicker arteries)

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18
Q

veins have ____ lumen and ____ walls; LOW pressure, leads to prone to dilation/compression

A

larger

thinner

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19
Q

lympathic vessels have ___ walls lined with _____ to drain ISF

A

thin endothelia

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20
Q

continuous lining of all vessels
non-thrombogenic interface
regulate vasoreactivity

A

endothelial cells

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21
Q

pro-inflammatory; trauma upsets homeostasis

A

endothelial activation

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22
Q

3 types of congenital anomalies

A

berry aneurysms
arteriovenous fistula (AVF)
fibromuscular dysplasia

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23
Q

dilation of cerebral vessels that leads to subdural hemorrhage

A

berry aneurysm

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24
Q

connection of arterial and venous systems, bypass capillaries

A

arteriovenous (AV) fistula

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25
Q

local thickening of medium/large artery walls thats leads to ischemia
may involve KIDNEYS
MC in adult females

A

fibromuscular dysplasia

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26
Q

kidneys detect decrease in blood supply –> INCREASE in Na absorption –> INCREASE in water retention –> INCREASE BP

A

renovascular HTN

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27
Q

’s for hypotension, which leads to _____

A

90/60 (or less)

decrease perfusion, dysfunction

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28
Q

’s for hypertension, which leads to _____

A

140/80 (or more)

atherosclerosis, hypertensive retinopathy

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29
Q

blood pressure regulation influences: ____ & ____

A

cardiac output

vascular resistance

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30
Q

INCREASE BP –> ____ heart –> _____

causes: _______ and ______

A

stretch
ANP
REDUCED sodium resorption
vasodilation

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31
Q

DECREASE BP –> ________

causes: ____ & _____

A

renin-angiotensin system
sodium resorption
vasoconstriction

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32
Q

normal #’s BP

A

120/80

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33
Q

BP > 140/90
damages vessels and end-organs
ASYMPTOMATIC -“SILENT KILLER”
25% of US adults

A

hypertension

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34
Q

95% of hypertensions cases are _______ aka “ESSENTIAL HTN”

risks: age, stress, obesity, smoking, inactivity

A

idiopathic

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35
Q

vascular wall response to injury:

A

1 endothelial injury/dysfxn
2 smooth muscle cel recruitment
3 growth of smooth muscle
4 irreversible intimal thickening (vessel stenosis)

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36
Q

benign HTN

CHRONIC hemodynamic stress

A

hyaline arteriosclerosis

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37
Q

severe HTN

A

hyperplasia arteriosclerosis

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38
Q

hardening of arteries, decrease elasticity

A

arteriosclerosis

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39
Q

hardening of SMALL arteries, possible ISCHEMIC INJURY

A

arteriOLOsclerosis

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40
Q

Ca++ within arteries, no stenosis, NOT clinically significant

A

monckenberg medial sclerosis

41
Q 
MC type of arteriosclerosis
atheroma (plaque)
stenosis
rupture
thrombosis
A

atherosclerosis

42
Q

99% of all arteriosclerosis is __________

A

atherosclerosis

43
Q

atheromas:

  1. protrude into ________, decrease flow, macrophages, lipids aka _________ , _____ debris and have a fibrous cap
  2. prone to _____ plaque , –> massive THROMBOSIS
  3. WEAKENS _______ –> risk for aneurysm
A 
lumen
foam cells
Ca++
rupture
tunica media
44
Q

70% of occlusion of coronary arteries lead to _______ (build of up atheromatous plaque)

A

CAD (coronary artery disease)

45
Q

risks of atherosclerosis

A

family hx
age
males
GENETICS

46
Q

MI (myocardial infarction) risks of atherosclerosis

  • if you have 2 symptoms, ___ x MI risk
  • if you have all 3 symptoms, ____ x MI risk
A 
hyperlipidemia
HTN
smoking
4x
7x
47
Q

central obesity, insulin resistance, HTN, hypercoagulability are all symptoms of _______; a modifiable part of atherosclerosis

A

metabolic syndrome

48
Q

characteristics of TRUE aneurysms

A

all 3 layers of a vessel affected and heart wall

49
Q

characteristics of FALSE aneurysms

A

defect in vascular wall

50
Q

blood enters arterial wall, may lead to hematoma

A

DISSECTION

51
Q

Abdominal Aortic Aneurysm (AAA) is a dilation of >___% of normal; and a surgical diameter > ___ cm

A

50%

5 cm

52
Q

risks for AAA are

A 
male
smokers
>50 y.o.
caucasian
facial history of AAA
atherosclerosis
HTN
53
Q

____ may obstruct vessels branching off aorta, affects kidneys, legs, spinal cord, GI
50% of ruptured ones are LETHAL
4-5 cm: ___ % per year
>6 cm: _____ % per year

A

AAA
1
25

54
Q

blood splays apart the laminar planes of the media to form a blood-filled channel inside aortic wall –> massive hemorrhage
MALES
40-60 Y.O.
ADOLESCENTS with CT disorders (marfans, ehlers-danlos)

A

aortic dissections

55
Q

pain for aortic dissections is common ________

  • type ___ is MC, near ______ and MOST SEVERE
  • type ____ is distal to _________
A

between scapulae
type A
ascending aorta
left subclavian artery

56
Q

inflammation of the vascular wall that is MC in SMALL ARTERIES

A

vasculitis

57
Q

vascular invasion occurs in ______ vasculitis

example – ______

A

infectious

hepatitis B

58
Q

immune-mediated, ADRs is part of ______ vasculitis

examples– ____ & ____

A

non-infectious
SLE
penicilin

59
Q

misc factors that may lead to vasculitis

A

irradiation

trauma (physical or chemical)

60
Q

MC type of vasculitis in OLDER ADULTS

-idiopathic

A

giant cell arteritis (temporal arteritis)

61
Q 
artery affected with giant cell arteritis 
causes:
diplopia
sudden blindness
facial pain
HA
PYREXIA
A

ophthalmic artery

62
Q

MC vasculitis in YOUNGER INDIVIDUALS (<50 y.o.)

granulomatous vasculitis, possibly from autoimmune disease

A

takayasu arteritis

63
Q 
system-wide vasculitis, transmural necrosis
SMALL and MEDIUM sized arteries
in KIDNEYS, VISCERA, HEART, LIVER
2/3 is IDIOPATHIC
*treatment= corticosteroids*
A

polyarteritis nodosa (PAN)

64
Q 
MC vasculitis in YOUNG ADULTS
EPISODIC/paroxysmal
weight loss
fatigue
*END-ORGAN DAMAGE*
renal and GI tract
A

polyarteritis nodosa (PAN)

65
Q

_____ results in remission of cure in 90% of polyarteritis nodosa cases

A

immunosupression

66
Q 
pediatric vasculitis (80% ** MI
usually resolve within 2 years
A

kawaski disease

67
Q

characteristics of kawaski disease

A

idiopathic
fever
cervical lymphadenopahy
STRAWBERRY TONGUE

68
Q

uncommon type of vasculitis that causes inflammation
type II hypersensitivity
kidneys, upper/lower respiratory tract - nose, sinuses, trachea lungs
middle ages MALES
if untreated, lethal after 1 year

A

wegner granulomatosis

69
Q 
vasculitis that affects MEDIUM sized arteries
thrombosis --> vascular insufficiency
affects HANDS & FEET
PAINFUL extremities
CYANOSIS
GANGRENE
CIGRARETTE SMOKING
A

thromboangiitis obliterans

70
Q 
exaggerated arteriole vasoconstriction
pallor and cyanosis
chronic --> atrophy of skin
ADOLESCENT/YOUNG ADULTS
MC IN FEMALES
*may be secondary to atherosclerosis, buerger disease, lupus, scleroderma
A

raynaud phenomenon

71
Q

broken heart syndrome or cardiac raynaud
stress cardiomyopathy
increase in catecholamine production (stress hormone)
may affect coronary arteries

A

takotsubo cardiomyopathy

72
Q

3 types of venous diseases that make up 90% of all cases

A

varicose veins
phlebothrombosis
thrombophlebitis

73
Q

venous thrombosis following inflammation

A

thrombophlebitis

74
Q

-superficial veins are DILATED and TORTUOUS LEGS (MC)
- increase in intraluminal pressure
-congestion/edema, pain, thrombosis
1/3 females

A

varicose veins

75
Q

varicose veins main risk is _____ & MC of _______ to people affected

A

obesity

cosmetic concern

76
Q

thrombophlebitis AKA

A

deep vein thrombosis (DVT)

77
Q

90% of all vein issues are _____; symptoms include cyanosis/rubor, edema, dolor
risks: recent surgery, pregnancy, surgery, obesity, immobolization
possible PULMONARY EMBOLISM

A

DVT

78
Q

bronchogenic carcinoma
mediastinal lymphoma
compression or invasion of area
congested UE veins, possible cyanosis, edema in arms, neck, head

A

superior vena cava syndrome

79
Q

hepatocellular carcinoma
renal cell carcinoma
compression or invasion
congestion of LE veins; edema, proteinuria

A

inferior vena cava syndrome

80
Q

obstruction –> tissue expansion
RARE
LYMPATHIC OBSTRUCTION

A

lymphedema

81
Q

primary lymphedema is ________

Kilroy disease, hypoplasia or agencies of lymph vessels

A

congenital

82
Q

secondary lymphedema is _____
neoplasia
infection
thrombosis

A

obstruction (of previously normal lymph vessel)

83
Q

two types of CHRONIC lymphedema

A

peau d’orange

brawny induration

84
Q

ACUTE lymphatic vessel inflammation
bacterial seeding
subcutaneous RED STREAKS, painful

A

lymphangitis

85
Q

vascular tumors are MC ______; occasionally fairly _____, rarely highly _______
originate from ______ or ______

A 
benign
aggressive
malignant
ENDOTHELIAL CELLS
CT tissue or vessels
86
Q

common benign tumor in 1:200 newborns
increase LOCAL CAPILLARY growth
usually on head/face
75-90% resolve by 7 y.o.

A

hemangioma

87
Q

malignancy of lymphatic endothelial cells
HUMAN HERPESVIRUS 8
AIDS
(rare in USA)

A

kaposi sarcoma

88
Q

MALIGNANT endothelial neoplasia
extremely variable
RECUR locally, spread widely (lymph nodes)
MC among OLDER adults

A

angiosarcoma

89
Q

2 types of angiosarcoma

A

differentiated

anaplastic – (INVASIVE, POOR PROGNOSIS)

90
Q

MC locations of angiosarcoma

A

skin
breast
liver

91
Q

irradiation, foreign bodies are risk for

A

angiosarcoma

92
Q

arsenic, PVC, irradtionation and lymphedema are symptoms for

A

hepatic angiosarcoma

93
Q

vascular interventions

A

endovascular stenting

94
Q

endovascular stenting preserves __________, common in ______ cases and risk of thrombosis w/ ongoing ________

A

luminal patency
CAD
antithrombotic meds

95
Q

vascular replacement

A

vascular grafts

96
Q

REPLACE or BYPASS arteries
LT vessel patency is LIMITATION
can be autologous (transplant) or synthetic

A

vascular grafts

97
Q

artery MC used in vascular grafts

A

internal mammary artery (USED TO BE great saphenous vein)

98
Q

synthetic vascular graft may lead to

A

increase thrombosis

Path Exam II (2 decks)

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