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Flashcards in Vascular Pathology Deck (132)
1

What is the innermost layer of the blood vessel?

tunica intima

2

What is the middle layer of the blood vessel?

tunica media

3

What is the outermost layer of the blood vessel?

tunica adventitia

4

What vessel(s) does large vessel vasculitis involve?

aorta and branches

5

What vessel(s) does medium vessel vasculitis involve?

muscular arteries

6

What vessel(s) does small vessel vasculitis involve?

arterioles/venules/capillaries

7

What are the two forms of Large Vessel Vasculitis?

Temporal Arteritis

Takayasu

8

What is another name for Temporal Arteritis?

Giant Cell Artiritis

9

What type of immune cell invades during temporal artiritis?

granuloma

10

Giant cell artiritis most often involves what artery?

branches of the carotid

11

What are the three presentations of Giant Cell Artiritis?

headache

visual disturbances

jaw claudication

12

What is the histological finding of Giant Cell Artiritis?

intimal fibrosis

13

What characteristic do the lesions ave during Temporal Artiritis? What does this mean?

segmental lesions

have to remove and examine long section of vessel

14

What is the Tx for Temporal Artiritis? What is the major risk in avoiding treatment?

corticosteoroids

blindness

15

Without treatment, temporal cell artiritis carries a high risk of what?

blindness

16

Takayasu Artiritis commonly involves what specifc point of the vessel?

aortic arch at branch points

17

What age and population is the classic presentation of Takayasu Artiritis?

young asian female

18

What are three major presenting symptoms of Takayasu Arteritis?

weak or absent pulse on upper extremity

19

What is the Tx for takayasu artiritis?

Corticosteroids

20

What are the three Medium vessel size vasculitis?

Polyartiritis Nodasa

Kawasaki Disease

Buerger Disease

21

What type of immune reaction takes place during Polyartiritis Nodosa?

Necrotizing

22

Which organ is spared during Polyarteritis Nodosa?

lungs

23

What marker is associated with Polyartiritis Nodsa?

serum HBsAg

24

What type of necrosis takes place during Polyarteritis Nodosa?

Fibrinoid

25

During Polyarteritis Nodosa forms after the fibrinoid necrosis heals? What is the sign for this?

fibrosis

String of Pearls

26

What two drugs are used to treat polyarteritis nodosa?

Corticosteroids and cyclophosphamide

27

What ethnicity is most often stricken with Kawasaki Disease?

Asian

28

What age is most often affected by Kawasaki Disease?

under age of 4

29

What are three the most obvious presentations of a child with Kawasaki Disease?

rash on palms and feet

conjuctivitis

enlarged cervical lymph nodes

30

What are the two risks involved with Kawasaki Disease if it effects the coronary arteries?

thrombosis with MI

Aneurysm with rupture

31

What are the two treatments of Kawasaki Disease?

Aspirin and IVIG

32

What type of inflammatory process takes place during Buerger Disease?

necrotizing

33

What body part is commonly affected during Buerger Syndrome?

fingers and toes

34

What disease is often also present during Buerger Syndrome?

Raynaud Phenomenom

35

What is the Tx for Buerger?

stop smoking

36

Wegener Granulomatosis often involves which three organs?

nasopharynx, lungs and kidneys

37

What age and sex is most often associated with Wegener Granulomatosis?

middle aged male

38

What nasal symptom does a person with Wegener Granulomatosis present with?

sinusitis or nasopharyngeal ulceration

39

What lung symptom does a person with Wegener Granulomatosis present with?

Hemoptysis

40

What renal symptom does a person with Wegener Granulomatosis present with?

necrotizing glomerulonephritis

41

Why does a patient with Wegener Granulomatosis present with Hematuria?

rapidly progressin glomerulonephritis

42

What vasculitis can present with serum c-ANCA? What is this used for?

Wegener

correlate disease activity

43

What is the treatment for Wegener Granulomatosis?

cyclophosphamide and steroids

44

What two organs are involved with Microscopic Polyangitis?

lungs and kidneys

45

Lack of what two symptoms separate Wegener Granulomatosis from Microscopic Polyangitis ?

nasopharyngeal involvement

no necrotizing granulomatous formation

46

What antibody is present during Microscopic Polyangitis ?

p-ANCA

47

What is the Tx for microscopic polyangitis?

cyclophosphamide and corticosteroids

48

What type of inflammation is present during Churg Strauss?

necrotizing, granulomatous

49

What is notable about the inflammation of Churg Strauss?

presence of eosinophils

50

What two organs are most effected by Churg-Strauss?

heart and lungs

51

What antibody is found during Churg-Strauss?

p-ANCA

52

What is the disease of Henoch-Schonlein Purpura?

vasculitis

53

What causes Henoch-Schonlein Purpura?

IgA immune complex deposition

54

What is the most common vasculitis in children?

Henoch-Schonlein Purpura

55

What is notable about the physical examination of patient with Henoch Schonlein Purpura?

palpable purpura on buttocks and legs

56

What two locations does a patient commonly bleed from during Henoch-Schonlein Purpura?

GI tract

kidneys

57

What causes the hematuria during Henoch-Schonlein Purpura?

IgA nephropathy

58

What type of infection often preceedes Henoch-Schonlein Purpura?

upper respiratory tract infection

59

How is Henoch-Schonlein Purpura treated?

steroids

60

What two diseases cause renal artery stenosis? What patient populations?

Fibromuscular Dysplasia = young women

atherosclerosis = old men

61

What causes Hyaline Arteriosclerosis?

proteins leaking into vessel wall

62

What are the two causes of Hyaline Arteriosclerosis?

benign HTN and diabetes

63

What does long-term Hyaline Arteriosclerosis produce to the glomerulus? Leading to?

glomerular scarring

renal failure

64

What causes hyperplastic arteriosclerosis?

malignant HTN

65

What structure is produced during hyperplastic arteriosclerosis?

onion skin

66

What type of necrosis can hyerplastic arteriosclerosis lead to? Clasically causing? What structure?

fibrinoid necrosis

acute renal failure

flea bitten

67

What tears during an Aortic Dissection?

tunica intima

68

What layer of the vessel does blood go into during aortic dissection?

tunica media

69

Destruction of what structure can lead to an aortic dissection?

vaso vasorum

70

What two genetic diseases can lead to aortic dissection?

Marfan and Ehlers-Danlos

71

What two diseases can have cystic medial necrosis of vells?

Ehlers-Danlos and Marfan

72

Where does the pain of an aortic dissection radiate?

back

73

What is the most common cause of death during aortic dissection?

pericardial tamponade

74

What is the mechanism by which tertiary syphillis can produce a thoracic aneurysm?

endarteritis of vaso vasorum

75

What are the two major complications of tertiary syphillis on the heart?

dilation of aortic valve root

aortic regurg.

76

Greater than how large does a AAA increase in its chance of rupture? What measure?

5 cm

diameter

77

An angiosarcoma is a malignant proliferation of what cell type?

endothelial cells

78

What are the three primary causes of an angiosarcoma?

arsenic, vinyl chloride and thorotrast

79

Kaposi sarcoma is a malignant proliferation of what cell?

endothelial

80

Which virus is known to cause Kaposis Sarcoma?

HHV-8

81

What geographical region is Kaposis Sarcoma clasically present in?

older, eastern european males

82

What two immunosuppressed populations can Kaposi's Sarcoma be present in?

HIV

transplant patients

83

What is the ESR over during Temporal Cell arteritis?

100

84

What is a common presentation for a patient with Polyarteritis Nodosa?

young patient with HTN

85

What artery is most often affected during Kawasaki Disease?

Coronary arteries

86

What two type of vasculitis are found during Wegener?

necrotizing, granulomatous

87

Other than peripheral eosinophilia, what is another presenting symtpom of Churg-Strauss?

asthma

88

What is the most common age to develop Henoch-Schonlein Purpura?

children

89

Henoch-Schonlein Purpura usually follows what other disease?

upper respiratory tract infection

90

What is fibromuscular dysplasia?

developmental defect that results in thickening of blood vessel wall

91

What artery is especially affected by FIbromuscular Dysplasia?

renal

92

What patient group is especially affected by fibromuscular dysplasia?

young females

93

What type of necrosis takes place during malignant HTN?

fibrinoid

94

What part of the vessel thickens during atherosclerosis?

intima

95

What is the plaque of atherosclerosis composed up?

necrotic lipid core

96

What is the cap of atherosclerosis composed of?

fibromuscular cap

97

What is the necrotic lipid core composed of?

cholesterol

98

What process does an atherosclerotic cap undergo?

dystrophic calcification

99

What four arteries are most susceptible to atherosclerosis?

abdominal aorta>coronary>popliteal>internal carotid

100

What are the four modifiable risk factors for the development of atherosclerosis?

HTN, hypercholesterolemia, diabetes and smoking

101

Stenosis greater than what percent is necessary for atherosclerosis to beging manifesting as symptoms?

70%

102

What are the two types of arteriolosclerosis?

hyaline and hyperplastic

103

Why does benign HTN produce hyaline arteriolosclerosis?

pressure forces proteins into wall

104

Why does diabetes produce hyaline arteriolosclerosis?

glycosylation of basement membrane makes it leaky to proteins

105

Does hyaline arteriosclerosis cause the afferent or efferent arteriole to scar?

afferent

106

Why does malignant HTN produce hyperplastic arteriolosclerosis?

smooth muscle hypertrophies to contain pressure

107

What is fibrinoid necrosis?

death of vessel wall

108

What is Mockeberg Disease? Clinically significant?

calcification of tunica media

no

109

What are the two requirements for an aortic dissection to occur?

high stress

pre-existing weakness

110

What is the most common cause of an aortic dissection?

HTN

111

What specific protein of Marfan syndrome is defective?

fibrillin

112

Other than tamponade, how can an aortic dissection produce end organ damage?

obstruction of branching arteries

113

Why does a AAA become weak?

atherosclerosis

114

What are the three classic presentations of a ruptured AAA?

hypotension

pulsatile mass

flank pain

115

What structure can an aortic dissection compress?

ureter

116

What are the two most common locations of a hemangioma?

skin and liver

117

Is an angiosarcoma benign or malignant?

very malignant

118

Is Kaposi's Sarcoma benign or malignant?

low-grade malignant

119

What are the two locations Kaposi's Sarcoma may arise?

skin and visceral organs

120

What is the Tx of an eastern european man with Kaposi's Sarcoma?

surgical resection

121

How is Kaposi's treated in an AIDS patient?

antiretrovirals

122

How is Kaposi's treated in a transplant patient?

decrease immunosuppression

123

What type of inflammation is present during Takayasu Arteritis?

necrotizing granulomatous

124

What two vessels does Polyarteritis Nodosa primarily effect?

Renal and Visceral vessels

125

What lymph nodes are enlarged during Kawasaki Disease?

cervical

126

What are three differnces between Wegeners and Microscopic Polyangiitis?

Wegener = c-ANCA

Microscopic = no nasopharyngeal

microscopic = no granuloma

127

What two vessels are most effected during Fibromuscular Dysplasia?

Carotid and Renal

128

What layer of the vessel is affected during Monckenberg? What process?

media

calcification

129

What specific process caused by HTN can result in aortic dissection?

hyaline arteriolosclerosis of vasa vasorum

130

What happens to the kidney during Renal Artery Stenosis?

atrophy

131

Are the lesions in Polyarteritis Nodosa or varying stages of the same stage?

varying

132

What is the key histological finding of an embolus?

cholesterol clefts