Flashcards in Vascular Pathology Deck (132)
What is the innermost layer of the blood vessel?
What is the middle layer of the blood vessel?
What is the outermost layer of the blood vessel?
What vessel(s) does large vessel vasculitis involve?
aorta and branches
What vessel(s) does medium vessel vasculitis involve?
What vessel(s) does small vessel vasculitis involve?
What are the two forms of Large Vessel Vasculitis?
What is another name for Temporal Arteritis?
Giant Cell Artiritis
What type of immune cell invades during temporal artiritis?
Giant cell artiritis most often involves what artery?
branches of the carotid
What are the three presentations of Giant Cell Artiritis?
What is the histological finding of Giant Cell Artiritis?
What characteristic do the lesions ave during Temporal Artiritis? What does this mean?
have to remove and examine long section of vessel
What is the Tx for Temporal Artiritis? What is the major risk in avoiding treatment?
Without treatment, temporal cell artiritis carries a high risk of what?
Takayasu Artiritis commonly involves what specifc point of the vessel?
aortic arch at branch points
What age and population is the classic presentation of Takayasu Artiritis?
young asian female
What are three major presenting symptoms of Takayasu Arteritis?
weak or absent pulse on upper extremity
What is the Tx for takayasu artiritis?
What are the three Medium vessel size vasculitis?
What type of immune reaction takes place during Polyartiritis Nodosa?
Which organ is spared during Polyarteritis Nodosa?
What marker is associated with Polyartiritis Nodsa?
What type of necrosis takes place during Polyarteritis Nodosa?
During Polyarteritis Nodosa forms after the fibrinoid necrosis heals? What is the sign for this?
String of Pearls
What two drugs are used to treat polyarteritis nodosa?
Corticosteroids and cyclophosphamide
What ethnicity is most often stricken with Kawasaki Disease?
What age is most often affected by Kawasaki Disease?
under age of 4
What are three the most obvious presentations of a child with Kawasaki Disease?
rash on palms and feet
enlarged cervical lymph nodes
What are the two risks involved with Kawasaki Disease if it effects the coronary arteries?
thrombosis with MI
Aneurysm with rupture
What are the two treatments of Kawasaki Disease?
Aspirin and IVIG
What type of inflammatory process takes place during Buerger Disease?
What body part is commonly affected during Buerger Syndrome?
fingers and toes
What disease is often also present during Buerger Syndrome?
What is the Tx for Buerger?
Wegener Granulomatosis often involves which three organs?
nasopharynx, lungs and kidneys
What age and sex is most often associated with Wegener Granulomatosis?
middle aged male
What nasal symptom does a person with Wegener Granulomatosis present with?
sinusitis or nasopharyngeal ulceration
What lung symptom does a person with Wegener Granulomatosis present with?
What renal symptom does a person with Wegener Granulomatosis present with?
Why does a patient with Wegener Granulomatosis present with Hematuria?
rapidly progressin glomerulonephritis
What vasculitis can present with serum c-ANCA? What is this used for?
correlate disease activity
What is the treatment for Wegener Granulomatosis?
cyclophosphamide and steroids
What two organs are involved with Microscopic Polyangitis?
lungs and kidneys
Lack of what two symptoms separate Wegener Granulomatosis from Microscopic Polyangitis ?
no necrotizing granulomatous formation
What antibody is present during Microscopic Polyangitis ?
What is the Tx for microscopic polyangitis?
cyclophosphamide and corticosteroids
What type of inflammation is present during Churg Strauss?
What is notable about the inflammation of Churg Strauss?
presence of eosinophils
What two organs are most effected by Churg-Strauss?
heart and lungs
What antibody is found during Churg-Strauss?
What is the disease of Henoch-Schonlein Purpura?
What causes Henoch-Schonlein Purpura?
IgA immune complex deposition
What is the most common vasculitis in children?
What is notable about the physical examination of patient with Henoch Schonlein Purpura?
palpable purpura on buttocks and legs
What two locations does a patient commonly bleed from during Henoch-Schonlein Purpura?
What causes the hematuria during Henoch-Schonlein Purpura?
What type of infection often preceedes Henoch-Schonlein Purpura?
upper respiratory tract infection
How is Henoch-Schonlein Purpura treated?
What two diseases cause renal artery stenosis? What patient populations?
Fibromuscular Dysplasia = young women
atherosclerosis = old men
What causes Hyaline Arteriosclerosis?
proteins leaking into vessel wall
What are the two causes of Hyaline Arteriosclerosis?
benign HTN and diabetes
What does long-term Hyaline Arteriosclerosis produce to the glomerulus? Leading to?
What causes hyperplastic arteriosclerosis?
What structure is produced during hyperplastic arteriosclerosis?
What type of necrosis can hyerplastic arteriosclerosis lead to? Clasically causing? What structure?
acute renal failure
What tears during an Aortic Dissection?
What layer of the vessel does blood go into during aortic dissection?
Destruction of what structure can lead to an aortic dissection?
What two genetic diseases can lead to aortic dissection?
Marfan and Ehlers-Danlos
What two diseases can have cystic medial necrosis of vells?
Ehlers-Danlos and Marfan
Where does the pain of an aortic dissection radiate?
What is the most common cause of death during aortic dissection?
What is the mechanism by which tertiary syphillis can produce a thoracic aneurysm?
endarteritis of vaso vasorum
What are the two major complications of tertiary syphillis on the heart?
dilation of aortic valve root
Greater than how large does a AAA increase in its chance of rupture? What measure?
An angiosarcoma is a malignant proliferation of what cell type?
What are the three primary causes of an angiosarcoma?
arsenic, vinyl chloride and thorotrast
Kaposi sarcoma is a malignant proliferation of what cell?
Which virus is known to cause Kaposis Sarcoma?
What geographical region is Kaposis Sarcoma clasically present in?
older, eastern european males
What two immunosuppressed populations can Kaposi's Sarcoma be present in?
What is the ESR over during Temporal Cell arteritis?
What is a common presentation for a patient with Polyarteritis Nodosa?
young patient with HTN
What artery is most often affected during Kawasaki Disease?
What two type of vasculitis are found during Wegener?
Other than peripheral eosinophilia, what is another presenting symtpom of Churg-Strauss?
What is the most common age to develop Henoch-Schonlein Purpura?
Henoch-Schonlein Purpura usually follows what other disease?
upper respiratory tract infection
What is fibromuscular dysplasia?
developmental defect that results in thickening of blood vessel wall
What artery is especially affected by FIbromuscular Dysplasia?
What patient group is especially affected by fibromuscular dysplasia?
What type of necrosis takes place during malignant HTN?
What part of the vessel thickens during atherosclerosis?
What is the plaque of atherosclerosis composed up?
necrotic lipid core
What is the cap of atherosclerosis composed of?
What is the necrotic lipid core composed of?
What process does an atherosclerotic cap undergo?
What four arteries are most susceptible to atherosclerosis?
abdominal aorta>coronary>popliteal>internal carotid
What are the four modifiable risk factors for the development of atherosclerosis?
HTN, hypercholesterolemia, diabetes and smoking
Stenosis greater than what percent is necessary for atherosclerosis to beging manifesting as symptoms?
What are the two types of arteriolosclerosis?
hyaline and hyperplastic
Why does benign HTN produce hyaline arteriolosclerosis?
pressure forces proteins into wall
Why does diabetes produce hyaline arteriolosclerosis?
glycosylation of basement membrane makes it leaky to proteins
Does hyaline arteriosclerosis cause the afferent or efferent arteriole to scar?
Why does malignant HTN produce hyperplastic arteriolosclerosis?
smooth muscle hypertrophies to contain pressure
What is fibrinoid necrosis?
death of vessel wall
What is Mockeberg Disease? Clinically significant?
calcification of tunica media
What are the two requirements for an aortic dissection to occur?
What is the most common cause of an aortic dissection?
What specific protein of Marfan syndrome is defective?
Other than tamponade, how can an aortic dissection produce end organ damage?
obstruction of branching arteries
Why does a AAA become weak?
What are the three classic presentations of a ruptured AAA?
What structure can an aortic dissection compress?
What are the two most common locations of a hemangioma?
skin and liver
Is an angiosarcoma benign or malignant?
Is Kaposi's Sarcoma benign or malignant?
What are the two locations Kaposi's Sarcoma may arise?
skin and visceral organs
What is the Tx of an eastern european man with Kaposi's Sarcoma?
How is Kaposi's treated in an AIDS patient?
How is Kaposi's treated in a transplant patient?
What type of inflammation is present during Takayasu Arteritis?
What two vessels does Polyarteritis Nodosa primarily effect?
Renal and Visceral vessels
What lymph nodes are enlarged during Kawasaki Disease?
What are three differnces between Wegeners and Microscopic Polyangiitis?
Wegener = c-ANCA
Microscopic = no nasopharyngeal
microscopic = no granuloma
What two vessels are most effected during Fibromuscular Dysplasia?
Carotid and Renal
What layer of the vessel is affected during Monckenberg? What process?
What specific process caused by HTN can result in aortic dissection?
hyaline arteriolosclerosis of vasa vasorum
What happens to the kidney during Renal Artery Stenosis?
Are the lesions in Polyarteritis Nodosa or varying stages of the same stage?