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Clin Med: Final Material > Vascular Pathology > Flashcards

Vascular Pathology Flashcards

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1
Q

Vascular pathology =

A

Obstruction or occlusion leads to ischemia = which causes cell death

atherosclerosis, aneurysm, vasculitis, hypertension, aortic dissection

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2
Q

Most common cause of obstruction of blood vessels =

A

arteriosclerosis

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3
Q

Arteriosclerosis =

A

Sclerosis or “hardening” of the arteries

Narrowing of the arteries caused by a thickening of the artery wall = stiff artery with decreased capacity to move blood through the body

Arteries carry oxygen and nutrients from the heart to the rest of the body

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4
Q

Atherosclerosis is a type of ___ = often used interchangeably

A

arteriosclerosis

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5
Q

Atherosclerosis =

A

Pathogenesis: build up of plaque in medium vessels causing intramural thickening of arterial lumen

Chronic endothelial cell injury and inflammation due to hyperlipidemia, hypertension, toxins

Endothelial cells regulate vasodilation and vasoconstriction, promote hemostasis and prevent thrombosis

Low-density lipoprotein (LDLs) accumulate in blood vessels = plaque

Smooth muscle cell migration to blood vessel lumen = secrete extracellular components that contribute to the development of plaque

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6
Q

Atherosclerosis begins with:

A

changes in the lumen and intima = due to endothelial injury = translates to formation of Fatty Streaks

Macrophage, lipids, smooth muscle cells, T cells

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7
Q

HDL and LDL

A

Macrophages engulf LDL = oxidized LDL contributes to plaque buildup

HDL are protective = remove LDL from blood vessel walls, remove cholesterol, limit the inflammatory process

Plaque & Fibrous caps form = well defined lipid core covered by a fibrous cap

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8
Q

Vasa vasorum =

A

vascular network that travels through blood vessel layers from the adventitia to thickened intima = increased risk of hemorrhage = progression of atherosclerosis and formation of thrombus

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9
Q

Atherosclerosis modifiable risk factors:

A

Smoking
Obesity
Diabetes Mellitus
Hypertension
Hyperlipidemia

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10
Q

Diabetes Mellitus:

A

chronic condition affecting the bodies ability to use glucose = can result in prolonged elevated blood glucose level

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11
Q

Hypertension:

A

elevated blood pressure

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12
Q

Hyperlipidemia

A

elevated level of lipids in the blood

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13
Q

Metabolic Syndrome =

A

cluster of 3 out of 5

obesity, hypertension, high blood sugar, hyperlipidemia, low HDL

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14
Q

Atherosclerosis nonmodifiable risk factors:

A

Gender
Advanced Age
Family History

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15
Q

atherosclerosis
Vessels Affected:

A

Elastic and medium-sized muscular arteries

Areas where laminar flow is disrupted = damage to endothelium

pathologic process that causes disease of the coronary, cerebral, and peripheral arteries and the aorta

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16
Q

Atherosclerosis Complications:

A

Occlusion of vessel
Disruption of plaque
Emboli
Aneurysm
Peripheral Artery Disease
Coronary Artery Disease

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17
Q

Occlusion of vessel:

A

signs and symptoms vary depending up blood vessel and target organ

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18
Q

Disruption of plaque:

A

can lead to thrombus formation

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19
Q

Emboli:

A

thrombus/plaque can break free and travel through the blood vessel

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20
Q

Aneurysm:

A

bulge that forms in a blood vessel

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21
Q

Peripheral Artery Disease PAD:

A

build up of plaque or fatty deposits in the peripheral arteries restrict blood supply

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22
Q

Coronary Artery Disease CAD:

A

build up of plaque or fatty deposits in the coronary arteries restrict blood supply

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23
Q

PAD: Clinical presentation

A

Claudication

Ache or cramping in the extremities with exertion = relieved by rest

Diminished distal pulse

Cool extremities

Shiny, hairless skin

Severe PAD = pain at rest, ulceration

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24
Q

Intermittent claudication =

Study These Flashcards
A

characterized by cramp-like pain the legs on exercise

muscles deprived of oxygen = lactate production = pain

occurs after a certain distance and settles on rest after a certain time

caused by atherosclerosis of one or more of the arteries supplying the LE

25
Pulse locations:
temporal artery facial artery carotid artery brachial artery radial artery femoral artery popliteal artery posterior tibial artery dorsalis pedis artery
26
normal blood pressure
systolic: less than 120 diastolic: less than 80
27
elevated blood pressure
systolic: 120 -129 diastolic: less than 80
28
hypertension stage 1
systolic: 130-139 diastolic: 80-89
29
hypertension stage 2
systolic: 140 or higher diastolic: 90 or higher
30
hypertensive crisis
systolic: higher than 180 diastolic: higher than 120
31
Systemic hypertension
15-30% of adults Incidence increases with age = 60% > 65 years of age have hypertension Males > Females African Americans > Caucasians
32
Primary hypertension =
Not associated with an underlying disease Associated with genetics, lack of physical activity, poor diet 90-95% of cases
33
Secondary hypertension =
Associated with another disease Typically renal, cardiac, neurologic, or stress induced
34
Idiopathic:
Slow onset = 10-20 year survival
35
Malignant:
Rapid onset Death with 1-3 years
36
Systemic hypertension during pregnancy =
Chronic: Present prior to 20 weeks gestation Gestational: Occurring after 20 weeks and resolves within 2 weeks of delivery Preeclampsia: Occurring after 20 weeks and associated with significant proteinuria, edema is common Severe preeclampsia: same as preeclampsia with end-organ dysfunction Eclampsia: same as severe preeclampsia with seizures
37
causes of eclampsia =
increased blood pressure and the presence of proteins in urine = main signs can affect the brain if its gets worse affected brain causes convulsions = eclampsia
38
pre-eclampsia
pregnancy induced hypertension >20/40 associated proteinuria +/- edema
39
severe pre-eclampsia
systolic >160mmHg or diastolic > 100 mmHg +/- symptoms or abnormal bloods
40
eclampsia
convulsions on a background of pre-eclampsia
41
Systemic hypertension Complications
Atherosclerosis Arteriosclerosis Cardiac hypertrophy Compensated vs uncompensated Intracerebral hemorrhage Aortic Dissection Retinopathy
42
Cardiac hypertrophy:
compensatory mechanism for decreased cardiac output = compensation becomes inadequate = concentric hypertrophy of the heart = congestive heart failure = sudden death
43
Intracerebral hemorrhage:
type of intracranial bleed = occurs within the brain tissue
44
Aortic Dissection:
leakage of blood through the Innermost lining of the aorta between the layers of the aortic wall
45
Retinopathy:
damage to the retina from high blood pressure
46
Elevated pulmonary arterial pressure =
affects the blood pressure in arteries of the lungs and right side of the heart Pulmonary arteries and capillaries narrow due to atherosclerosis Decreased blood flow and increased pressure As the pressure increases the right side of the heart works harder to pump blood Leading to right sided heart pathology
47
Pulmonary hypertension Clinical Presentation:
Exertional dyspnea Weakness Cyanosis Jugular venous distension Chest pain
48
Aortic Dissection =
Separation of the aortic media by blood entering the wall through an intimal tear Risk Factors > Hypertension: most aortic dissections are due to systemic hypertension > Connective tissue disorder Clinical presentation > Severe, sharp “tearing” pain that radiates to the back > Asymmetrical pulses
49
Aortic Dissection Complications:
Initial tears lead to secondary tears Enlargement of aortic diameter Aortic hemorrhage
50
Aneurysms =
Dilation of the wall of a blood vessel involving all layers > Saccular: outpouching from one side of the vessel > Fusiform: generalized dilation > Mycotic: occurs as the result of an infection from septic emboli or an aneurysm that has subsequently become infected Clinical Presentation - pulsating mass
51
aneurysm Pathogenesis =
Atherosclerosis is the most common cause of aneurysm - Due to intima changes within a blood vessel Congenital weakness of the vessel wall Trauma
52
aneurysm Complications:
Formation of an emboli that form the aneurysm Narrowing of the blood vessel causes a decrease in blood flow and increase in blood pressure Rupture of the aneurysm = hemorrhage Obstruction, tissue damage, necrosis
53
Ruptured aortic aneurysm
abdominal pain hypotension pulsating abdominal mass Abdominal aortic aneurysms larger than 5 cm = significant increase of rupture Abdominal aortic aneurysms larger than 4 cm = surgical repair
54
vasculitis =
Inflammation of the blood vessels Most often due to Immune-mediated response Antibodies bind to antigens that deposit within the vessel walls Stimulates an immune response resulting in vasculitis
55
Vascular tumors
Hemangioma Kaposi Sarcoma Angiosarcoma
56
Hemangioma =
Benign proliferation of blood vessels Most commonly infantile hemangioma Most often on the face, scalp, chest, or back
57
Kaposi Sarcoma =
Malignant tumor of the blood Most commonly associated with infection with human herpes virus 8
58
Angiosarcoma =
High-grade malignant tumor of the blood vessels Risk factors: > Environmental toxins > Radiation > Following axillary dissection with breast cancer
59
Raynaud disease =
Pallor and cyanosis of the digits due to cold-induced vasoconstriction Young Females = typically benign Older males = due to atherosclerosis, and lupus

Clin Med: Final Material (6 decks)

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