Vascular Pathology Flashcards
(132 cards)
1
Q
What is the innermost layer of the blood vessel?
A
tunica intima
2
Q
What is the middle layer of the blood vessel?
A
tunica media
3
Q
What is the outermost layer of the blood vessel?
A
tunica adventitia
4
Q
What vessel(s) does large vessel vasculitis involve?
A
aorta and branches
5
Q
What vessel(s) does medium vessel vasculitis involve?
A
muscular arteries
6
Q
What vessel(s) does small vessel vasculitis involve?
A
arterioles/venules/capillaries
7
Q
What are the two forms of Large Vessel Vasculitis?
A
Temporal Arteritis
Takayasu
8
Q
What is another name for Temporal Arteritis?
A
Giant Cell Artiritis
9
Q
What type of immune cell invades during temporal artiritis?
A
granuloma
10
Q
Giant cell artiritis most often involves what artery?
A
branches of the carotid
11
Q
What are the three presentations of Giant Cell Artiritis?
A
headache
visual disturbances
jaw claudication
12
Q
What is the histological finding of Giant Cell Artiritis?
A
intimal fibrosis
13
Q
What characteristic do the lesions ave during Temporal Artiritis? What does this mean?
A
segmental lesions
have to remove and examine long section of vessel
14
Q
What is the Tx for Temporal Artiritis? What is the major risk in avoiding treatment?
A
corticosteoroids
blindness
15
Q
Without treatment, temporal cell artiritis carries a high risk of what?
A
blindness
16
Q
Takayasu Artiritis commonly involves what specifc point of the vessel?
A
aortic arch at branch points
17
Q
What age and population is the classic presentation of Takayasu Artiritis?
A
young asian female
18
Q
What are three major presenting symptoms of Takayasu Arteritis?
A
weak or absent pulse on upper extremity
19
Q
What is the Tx for takayasu artiritis?
A
Corticosteroids
20
Q
What are the three Medium vessel size vasculitis?
A
Polyartiritis Nodasa
Kawasaki Disease
Buerger Disease
21
Q
What type of immune reaction takes place during Polyartiritis Nodosa?
A
Necrotizing
22
Q
Which organ is spared during Polyarteritis Nodosa?
A
lungs
23
Q
What marker is associated with Polyartiritis Nodsa?
A
serum HBsAg
24
Q
What type of necrosis takes place during Polyarteritis Nodosa?
A
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
