Pathology

Question 1

Beaded Appearance

Stenosis or occlusion of one or both renal arteries, resulting in Renovascular Hypertension. ICA & VA can also be affected. Almost always bilateral when ICA involved.

Most common in Caucasian females.

Answer 1

Fibromuscular Dysplasia (FMD)

Question 2

Smooth, long & concentric stenoses

Giant-cell necrotizing arteritis that affects the aorta and its major branches, often affecting pulmonary arteries and proximal portion of the BC vessels. Pulseless upper extremities.

Most common in young Asian females.

Answer 2

Takayasu’s Arteritis
(Aortic Arch Syndrome)
(Pulseless Disease)

Question 3

Caused by blockage of the SCA, near VA resulting in backflow of blood. Flow is usually reversed in the VA. There will be different BP reading in LUE/RUE.

Answer 3

Subclavian Steal Syndrome (SSS)

Question 4

Occurrence of transient monocular blindness caused by temp ischemia.

Answer 4

Amaurosis Fugax

Question 5

Cluster of tangled vessels, Large hypertrophied tortuous vessels leading to cluster, rapid filling vessels.

Answer 5

Atriovenous Malformation (AVM)

Question 6

Weak or thin spot on a blood vessel in the brain that balloons out and fills with blood.

Headache, weakness, dizziness, confusion, facial pain, ears ringing, & vision problems. 50% eventually rupture.

Answer 6

Cerebral Aneurysm

Intracranial/Intracerebral Aneurysm

Question 7

Congenital condition in which a portion of the bony spinal canal is absent.

Answer 7

Spina Bifida

Question 8

Increased intracranial pressure that results in distention of the optic disc.

Answer 8

Papilledema

Question 9

The #1 cause of renal artery narrowing.

Lesions often bilateral and vary from smooth to irregular, concentric or eccentric.

Stenosis due to ASD is most prevalent in the proximal 2 cm of the renal artery

Typically affects older patients.

Answer 9

Atherosclerosis

Question 10

A malignant tumor of the kidney that occurs in pedi patients, usually before the age of 5.

Signs/Symptoms: hypertension, hematuria, pain

Tumor can be palpated

Answer 10

Wilms’ Tumor (Nephroblastoma)

Question 11

A term describing a group of symptoms:
pain, vomiting, cramping, diarrhea, weight loss.

Caused by chronic poor blood flow (mesenteric artery arterial ischemia.

Cholesterol buildup (atherosclerosis) in mesentery is most common cause.

Answer 11

Intestinal Angina

Question 12

Obstruction of the hepatic portal system, caused by blockage in the liver’s blood supply that may be caused by cirrhosis, liver disease, or cardiac disease, and can result in backflow of blood into the veins of the esophagus which results in bleeding.

Answer 12

Portal Hypertension

Question 13

Swelling (inflammation), scarring, and destruction of the bile ducts inside and outside of the liver.

Appears as either “SHAGGY” lesions or alternating short “BEADED” stenoses.

Answer 13

Sclerosing Cholangitis

Question 14

Enlarged arteries with “CORKSCREW” shape with irregular venous filling of the branches

Peripheral occlusions with a “PRUNED-TREE” appearance

Answer 14

Alcoholic Cirrhosis

Question 15

Chronic congestive enlargement of the spleen resulting in premature destruction of the red blood cells by the spleen.

Form of portal hypertension involving several organ systems

Appearance of hepatic hepatic veins at acute angles, or a “WEEPING WILLOW” configuration.

Answer 15

Banti Syndrome

Question 16

Heavy bleeding follows a break in the mucous membrane of the esophaghus.

Caused by repeated vomiting.

Surgery usually necessary to repair membrane.

Answer 16

Mallory-Weiss Syndrome

Question 17

A localized bulging of the artery wall, usually caused by atherosclerosis and increased blood pressure.

Often involve the abdominal aorta.

Answer 17

Aneurysm

3 types:
Fusiform, Saccular, Dissecting

Question 18

Bulging of the entire circumference of the vessel wall.

Answer 18

Fusiform Aneurysm

Question 19

Bulging of one side of the vessel wall.

Answer 19

Saccular Aneurysm

Question 20

Disruption of the intima (inner layer) where blood enters the wall & separates its layers.

Answer 20

Dissecting Aneurysm

Question 21

Blood enters the wall and separates the layers of the aorta

Majority occur @ aortic isthmus, small percent present @ aortic root.

In patients under 40, aortic disruption is commonly associated with Marfan’s Syndrome, Coarctation of the aorta, or pregnancy

Answer 21

Aortic Dissection

2 Classifications: Type A & B

Question 22

Involving the ascending aorta & usually requiring immediate graft placement to prevent mortality.

Answer 22

Type A: Aortic Dissection

Question 23

All others, which can be managed medically or with surgical intervention.

Answer 23

Type B: Aortic Dissection

Question 24

Inherited condition with excess length of the bones, associated with changes in the circulatory system, including abnormal connective tissue and tearing of the aorta (dissection).

Answer 24

Marfan’s Syndrome

Question 25

Nerve disorder that features abnormal sensation of the fingers, often associated with pain & weakness. May be caused by nerve root pressure from a disc, or pressure of a middle nerve in the carpal tunnel (carpal tunnel syndrome), with resulting compression of the arteries, veins, and nerves in the upper extremity. Diagnosis confirmed by performing an aortic arch or selective subclavian exam, and maneuvering the upper extremity in various positions.

Answer 25

Thoracic Outlet Syndrome

Question 26

Narrowing of the Aorta. Congenital condition causing stenosis of the thoracic aorta resulting in increased pressure on the side of the effect and decreased pressure on the opposite side. Elevated bp in arms & head Low bp in lower extremities Surgical repair needed.

Answer 26

Coarctation of the Aorta

Question 27

A gradual blockage of the infrarenal abdominal aorta, associated with atherosclerotic disease. Symptoms: butt, thigh, and/or calf claudication, and impotence in males.

Answer 27

Leriche Syndrome | Aortoiliac Occlusive Disease

Question 28

Excessivey reduced blood flow in response to cold or emotionalstress, causing discoloration of the fingers, toes, and occasionaly other areas.

Answer 28

Raynaud's Phenomenon 2 Types: Primary or Secondary

Question 29

Presence of bilateral episodes with symptoms occurring over a period of 2 years and an absence of gangrene. Cause is unknown.

Answer 29

Primary Raynaud's Phenomenon

Question 30

Excessivey reduced blood flow in response to cold or emotional stress, causing discoloration of the fingers, toes, and occasionaly other areas. Linked to underlying disease such as connective tissue disorder.

Answer 30

Secondary Raynaud's Phenomenon

Question 31

A condition in which the small & medium arteries are inflamed and clotted and veins close. caused by smoking SYMPTOMS: burning, tingling, numbness, gangrenous ulcerations in fingertips/feet

Answer 31

Thromboangiitis Obliterans (Buerger's Disease)

Question 32

Flow is shunted through CoW to the VA & SCA to supply muscles in the involved limb. SYMPTOMS: Attacks of paralysis, pain behind ear & back of skull.

Answer 32

Subclavian Steal Syndrome

Question 33

Pain in the lower limbs with cramps in the calves caused by poor circulation. Related to atherosclerotic disease.

Answer 33

Claudication

Question 34

Involves the lower extremities; it often progresses in severity from claudication to ischemic pain at rest, and finally to tissue necrosis.

Answer 34

Arteriosclerotic Occlusive Disease (AOD) AKA: Arteriosclerotic Obliterans

Question 35

Tissue necrosis caused by bacterial infection and/or the loss of blood supply to a tissue.

Answer 35

Gangrene

Question 36

Dilated, tortuous veins, usually involving the superficial veins. Valves become less serviceable, and the increased blood volume in these areas cause calcified clots (phleboliths) that are radiographically visible.

Answer 36

Varicose Veins

Question 37

A group of symptoms associated with obstruction of the SVC that include head, neck, and periorbital edema; cyanosis; venous distention; and syncope. Caused by tumor masses & mediastinal fibrosis.

Answer 37

Superior Vena Cava Syndrome | SVC Syndrome