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Cardiovascular > Pathology > Flashcards

Pathology Flashcards

1
Q

what is hypercholestrolaemia?

A

the condition in which a patient has elevated blood concentrations of LDL cholestrol

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2
Q

describe the process of atherosclerosis

A
  1. LDL get out membrane and are modified and interact with macrophages and other inflammatory mediators
  2. smooth muscle cells migrate into lesion and form a fibrous plaque - protective
  3. this keeps on growing in a vicious circle and reduces lumen size
  4. the plaque often ruptures and induces formation of thrombus
  5. thrombus can completely block flow of blood
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3
Q

what can hypertension do to the heart (conditons)?

A

LV hypertrophy, angina, CHF, coronary disease

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4
Q

what can hypertension do to the vessels?

A

peripheral vascular disease

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5
Q

where does atherosclerosis affect?

A

large and medium arteries

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6
Q

where does arteriolosclerosis affect?

A

small arteries and arterioles

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7
Q

what can hypertension do to the brain?

A

TIA, stroke, vascular dementia

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8
Q

what can hypertension do to the kidneys?

A

chronic kidney disease

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9
Q

what can hypertension do the eyes?

A

retinopathy

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10
Q

what are the physiological effects of hypertension to the heart?

A

remodelling of the heart - due to pressure/ volume
hypertrophy (increase cell size)
increased mechanical work- more protein synthesis
increase in pressure - cross sectional area increased
in volume overload - new sarcomeres/ increased length
left ventricular failure from longstanding hypertrophy

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11
Q

what is the most common cause arteriosclerosis in large/ medium arteries?

A

atheroma

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12
Q

what is a major risk factor in atheroscelerosis?

A

hypertension

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13
Q

what can damage to aorta result in?

A

atheroma, aortic dissection, abdo aortic aneurysm

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14
Q

what pathologies are common within arterioles?

A

hyaline arteriolosclerosis
hyperplastic arteriolosclerosis
hyperplasia of intima (onion skin)
fibrinoid necrosis

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15
Q

what is hyaline arteriolosclerosis?

A

common vascular lesion
accumulation of serum proteins in subendothelial space

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16
Q

what pathologies are common within small arteries?

A

hyperplastic sclerosis
hypertrophy of media
reduplication of internal elastic lamina
fibrotic thickening of intima

17
Q

how does an aortic dissection occur?

A

pressure/ ischaemia
blood enters media causing a split in vessel wall
can rupture into adventitia causing haemorrhage into mediastinum or pericardium

18
Q

what is an anuerysm?

A

focal dilation of artery
enlarging plaque leads to atrophy of media
muscle and elastic fibres replaced with collagen (no contractile or recoil)
vessel wall stretches

19
Q

what are the risk factors for an atheroma?

A

ATHEROMA
a- arterial hypertension
t - tobacco
h - hereditary
e - endocrine (diabetes, hypothyroidism, postmenopausal oestrogen deficiency)
r - reduced physical activity
o - obesity
m - male gender
a - age

20
Q

what is thrombosis?

A

damaged and ulcerated endothelium leads to thrombus
occludes lumen

21
Q

what is plaque fissure formation?

A

blood seeps into atheromatous plaque and causes expansion
blood may seep into plaque and clot

22
Q

what is restonosis?

A

when vessel returns to be thinned after stenting/ angioplasy

23
Q

what is venous insufficiency?

A

when veins have trouble sending blood back from limbs to heart – causing blood to pool

24
Q

what does venous return equal?

A
  • Venous return to flow of blood from peripheries back to RA and this equals cardiac output
25
Q

what is chronic venous insufficiency (CVI)?

A

Chronic venous insufficiency (CVI): occurs when leg veins become damaged and can not work as normal and blood pools in legs causing swelling and ulcers

26
Q

what structures can be affected by CVI?

A
  • Can occur in deep, superficial and perforating veins
27
Q

how many people are affected by varicose veins?

A

Venous disease is very general and varicose veins affects 1 in 3 adults and each year 1 in 50 of those with varicose veins will develop CVI
- CVI usually affects those over 50

28
Q

what does CVI do to capillaries?

A

Pathophysiology: CVI raises pressure in legs and this can cause the tiniest capillaries to burst

29
Q

what can CVI do to the skin?

A
  • Skin goes a reddish-brown colour and can easily break open if bumped or scratches
  • Resulting in: tissue inflammation, damage and venous stasis ulcers – open sores on skins surface (they do not heal easily and can lead to cellulitis)
30
Q

what are symptoms of CVI?

A
  • Achy/ tired legs
  • Burning, tingling – pins and needles
  • Cramping at night
  • Discoloured skin that looks reddish-brown
  • Oedema in lower legs and ankles
  • Flaking or itching skin on legs and feet
  • Full or heavy feeling eet
  • Leathery looking feet
  • Ulcers – usually on or near ankles
  • Varicose veins
31
Q

what therapies can be used to treat CVI?

A

compression therapy
medications
sclerotherapy
ligation and stripping
vein bypass

32
Q

what does compression therapy do in CVI?

A
  • Compression therapy: helps ease swelling and discomfort in legs – compression socks and bandages
33
Q

what medications can be used to treat CVI?

A
  • Medications: AB to clear skin infections, anticoagulants, medicated wrap – unna boot – multicompression with zinc oxide gel based wound cover to that forms a semi rigid bandage
34
Q

what is sclerotherapy?

A
  • Sclerotherapy: infects foma or liquid solution into spider veins causing it to collapse or disappear
35
Q

what is endovenous thermal ablation?

A
  • Endovenous thermal ablation: targets large veins and uses lasers with intense heat to close up deceased veins and leaves minimal bleeding or bruising
36
Q

what is ligation and stripping?

A
  • Ligation and stripping: surgeon will cut and tie off problem veins and then surgically remove larger veins through two small incisions
37
Q

what is a vein bypass?

A
  • Vein bypass: takes part of a healthy vein from else where and uses that to reroute around damaged vein  used in most severe cases
38
Q

describe janeway lesions

A

painless flat red macules on palms of hands and soles of feet

39
Q
A

Cardiovascular (14 decks)

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