vascular disease Flashcards
(55 cards)
1
Q
what does atherosclerosis effect?
A
arteries
2
Q
what does thrombosis effect?
A
veins
3
Q
what will vasculitis (inflammation) and radiation damage effect?
A
all vessels
4
Q
age related vascular changes?
A
- fibrosis of intimate and media
- accumulation of ground substances
- fragmentation of elastic lamellae
5
Q
what can age related changes be mistaken for?
A
aneurysms
6
Q
atherosclerosis?
A
- also known as atheroma
- affects large and medium sized elastic and muscular arteries
7
Q
characteristics of atherosclerosis?
A
necrotic lipid deposition fibrosis and chronic inflammation
8
Q
risk factors of atherosclerosis?
A
- age
- sex
- hypertension
- hyperlipideamia
- diabetes
- smoking
- obesity
- sedentary life
- low birth weight
- low socioeconomic status
9
Q
what are complications that may arise from atherosclerosis? from head to toe
A
- cerebral infarction
- carotid atheroma (emboli)
- MI
- aortic aneurysms (rupture causes sudden death)
- peripheral vascular disease with intermittent claudication (particularly with diabetics)
- gangrene
10
Q
morphology of atherosclerosis?
A
- atheromatous (fibre fatty, fibre lipid) plaque
- patchy and raised white to yellow
- core of lipid
- fibrous cap
11
Q
what will the fibrous cap of the atheromatous contain?
A
- smooth muscle cells
- collagen
- macrophages
- foam cells
- lymphocytes
- elastin
- proteoglycans
- neurovascularised
12
Q
what will the necrotic centre of the atheromatous contain?
A
- cell debris
- cholesterol crystals
- foam cells
- calcium
13
Q
what will peripheral vascular disease cause?
A
- pain
- ulcers
- gangrene
- intermittent claudication
14
Q
what does peripheral vascular disease cause?
A
ischaemia of lower limbs
15
Q
what is peripheral vascular disease?
A
atheroma of distal aorta/ iliac/ femoral arteries
16
Q
what are aneurysms?
A
localised, permanent, abnormal dilation of blood vessels or the heart
17
Q
what are the different types of aneurysms?
A
- atherosclerotic
- dissecting
- berry
- micro aneurysms
- syphilitic
- mycotic
18
Q
describe atherosclerotic aneurysms?
A
- usually happens in the abdominal aorta, distal to the renal arteries
- more common in men than women
- and smokers, aged over 50
19
Q
morphology of atherosclerotic aneurysms?
A
- saccular or fusiform
- 15 to 25cm in length
- wall diameter > 50%
- frequently contains mural thrombus
20
Q
clinical consequences of atherosclerotic aneurysms?
A
- thrombus
- embolism
- rupture
- obstruction of a branch vessel (ischameic injury)
- impingement of an adjacent structure
21
Q
how does atherosclerotic aneurysms present?
A
as an abdominal pulsating mass
22
Q
who is most prone to dissecting aortic aneurysms?
A
- men x3 more likely than women aged 40 to 60 with hypertension
- younger patients with systemic or localised abnormalities of connective tissue
23
Q
morphology of dissecting aneurysms?
A
- usually initiates with an intimal tear
- 1-2cm from aortic valve
- dissection can extend along the aorta retrograde towards the heart or distally, sometimes into the iliac and femoral arteries
24
Q
where can blood go if the dissecting aortic aneurysms leaks?
A
pericardial sac
25
clinical symptoms of aortic aneurysms?
- the sudden onset of excruciating pain
- beginning in the anterior chest, radiating to the back between the scapula and moving downwards as the dissection progresses
26
what can the pain of an aortic aneurysm be confused with?
MI
27
most common cause of death with dissecting aortic aneurysms?
rupture of the dissection outwards into the pericardial, pleural or peritoneal cavities
28
where would a berry aneurysm be found?
circle of willis
- most commonly seen in the anterior cerebral artery
29
who is most at risk of berry aneurysms?
young people with hypertension
30
what are berry aneurysms often associated with?
subarachnoid haemorrhage
31
what are capillary micro aneurysms associated with?
- hypertension
- diabetes mellitus
32
what are capillary micro aneurysms associated with?
intra cerebral haemorrhage
33
where will you most commonly see a capillary micro aneurysm?
small aneurysms of branches of middle cerebral artery
34
syphilitic aneurysms?
usually effects the thoracic aorta
35
mycotic aneurysms?
- wall of artery weakened by infection
- caused by bacteria or fungus
- often in brain or secondary to embolism
36
varicose veins?
abnormally dilated, tortuous veins produced by prolonged, increased intraluminal pressure and loss of vessel wall support
37
risk factors of varicose veins?
age
sex
heredity
posture
obesity
38
what can varicose veins cause?
- cosmetic problems
- aching in legs
- stasis dermatitis
- skin ulceration and bleeding
39
what is vasculitis?
inflammation and necrosis of blood vessels
40
pathogenesis of vasculitis?
- cell immune-mediated inflammation
- deposition of immune complexes
- direct attack by circulating antibodies
- invasion of vascular walls by infectious pathogens
- often part of a multi system disease
41
what happens to the venous valve in varicose veins?
it becomes incompetent and leads to stasis, congestion, oedema, pain and thrombosis.
42
what can varicose veins lead to?
- oesophageal varices (in patients with portal hypertension)
- haemorrhoids
- varicocele (plaque around testes in men , can cause infertility)
43
what are the 4 different types of vasculitis?
1- giant cell (temporal) arteritis
2- takayasu arteritis (pulseless disease)
3- polyarteritis nodosa (PAN)
4- Kawasaki disease (children < age 4)
44
what are the 3 different types of haemangioma?
1- juvenile (strawberry) - effects skin
2- capillary (ruby spots) - effects skin, spleen, kidneys
3-cavernous (port wine stains) - effects skin, spleen, liver, pancreas
45
what are the different types of vascular tumours?
angioma
heamangioma
lympahngioma
46
what are the 2 different malignant vascular tumours?
angiosarcoma
Kaposi's sarcoma
47
kaposi's sarcoma?
- associated with HIV/AIDS
- this is an angioproliferative tumour derived from endothelial cells of blood vessels (it will look brown/purple on the skin)
48
where will angiosarcomas effect?
skin
soft tissue
breast
bone
liver
spleen
49
who will giant cell (temporal) arteritis effect?
>age 50, average onset is age 70 and women are more prone than men.
50
who will takayasu arteritis (pulseless disease) effect?
when <30
51
what is giant cell arteritis?
granulomatous inflammation of large to small sized arteries (in the temporal, vertebral and ophthalmic arteries)
- it is cord like nodular thicking
- patchy lesion
- throbbing temporal pain
- malaise
- fever
52
what is Takaysu arteritis?
granulomatous vasculitis of medium and large arteries of upper limbs and aortic arch.
- very rarely you'll feel the pulse in the limbs because of the narrowing of the vessels coming out of the aortic arch especially the subclavian
53
signs of takayasu arteritis?
how to treat?
- dizziness
- visual disturbances
- dyspnea
- intermittent claudication upper limbs
- asymmetric BP
- give steroid treatment
54
what is polyarteritis nodosa (PAN)?
MEDIUM SMALL SIZE MUSCULAR ARTERIES OF THE KIDEYS, HEART, LIVER AND GI TRACT ARE INVOLVED.
- FIBRINOID NECROSIS COULD BE FATAL WITHOUT steroid TREATMENT
55
what would you see Kawasaki disease?
- a higher fever, conjunctival and oral lesions.
- self limiting.
