Vasculitis, Hyperreactivity, Veins and Lymphatics, Vascular Tumors Flashcards
(37 cards)
1
Q
Nonspecific signs of vasculitis
A
Fever, malaise, joint and muscle aches
2
Q
Noninfectious vasculitis
A
Via immunologic (complex or autoantibody) injury
3
Q
Infectious vasculitis
A
Pathogenic organisms invading the vessel wall
4
Q
Treatment for NONINFECTOUS vasculitis
A
Immunosuppression
5
Q
Large vessel vasculitis possibilities
A
- Giant cell (temporal) arteritis (>50)
- Takayasu arteritis (
6
Q
Medium vessel vasculitis possibilities
A
- Polyarteritis nodosa (immune complexes)
- Kawasaki disease (anti-endothelial Ab’s)
7
Q
Small vessel vasculitis possibilities (7)
A
- Microscopic polyangiitis (no asthma or granulomas)
- Wegener’s granulomatosis (granulomas, no asthma)
- Churg-Strauss (granulomas, asthma, eosinophilia)
- SLE (complex)
- HSP (IgA complex)
- Goodpasture’s (complex)
- Cryoglobulin vasculitis (complex)
8
Q
Anti-proteinase-3
A
C-ANCA
9
Q
Anti-myeloperoxidase
A
P-ANCA
10
Q
T or F: ANCA levels correlate w/ disease severity
A
TRUE
11
Q
MOA of ANCAs
A
Activate neutrophils that then release ROS
12
Q
Giant cell (temporal) arteritis
A
- Vision loss and/or headache, non-specific symptoms
- T-cell inflammation of arteries in head (temporal, ophthalmic)
- Granulomatous inflammation w/ multinucleated giant cells
- PATCHY and FOCAL inflammation
- Scarring of media, thickening of intima
13
Q
Takayasu arteritis
A
- Weak pulse and low BP in upper extremities
- Similar inflammation to temporal arteritis, but involving aortic arch and major branch vessels
- Younger age group (
14
Q
Polyarteritis nodosa
A
- Young adult (could be any age though)
- Systemic vasculitis via immune complexes
- Renal > coronary > liver > GI tract
- LUNGS ARE SPARED
- Transmural necrotizing inflammation w/ fibrinoid necrosis
- 1/3 have Chronic Hepatitis B (HBsAg-Ab complexes)
15
Q
Kawasaki’s disease
A
- Infants and small children ( aneurysm, rupture
- RISK OF ACUTE M.I.
- Anti-endothelial antibodies
16
Q
Treatment of Kawasaki’s disease
A
Aspirin + IVIg (lower risk of coronary artery event)
17
Q
Microscopic polyangiitis
A
- Necrotizing vasculitis of SMALL vessels
- Fibrinoid necrosis
- Renal glomeruli and lung capillaries
- P-ANCA
- Many apoptotic neutrophils
18
Q
Churg-Strauss syndrome
A
- Necrotizing vasculitis of SMALL vessels
- ASTHMA, ALLERGIES, EOSINOPHILIA
- GRANULOMAS
- Otherwise similar inflammation to M.P. or PAN
19
Q
Behcet disease
A
- Vasculitis of small/medium vessels
- ULCERS of ORAL CAVITY
- GENITAL ULCERS
- UVEITIS
- Neutrophilic, nonspecific inflammation
- HLA-B51 association
20
Q
Granulomatosis w/ polyangiitis (Wegener’s)
A
- Males, 40’s
- Persistent pulmonary, URI, and renal disease
- Necrotizing vasculitis
- Granulomas of upper and lower respiratory tract
- Crescentic glomerulonephritis (RPGN)
- C-ANCA
- Treat w/ corticosteroids and cyclophosphamide
21
Q
Thromboangiitis obliterans (Buerger’s disease)
A
- THROMBOSING vasculitis of small/medium vessels
- Tibial aa.
- Radial aa.
- Vascular insufficiency of DIGITS/extremities
- SMOKERS, young adults
- Adjacent veins and nerves can get inflammation too
- Chronic ulceration –> GANGRENE
22
Q
Primary vs. Secondary Raynaud’s
A
Primary = COLD --> symmetric digits (benign) Secondary = part of arterial disease (SLE, scleroderma, Buerger's disease) (worsens with time)
23
Q
2 causes of myocardial artery vasospasm
A
- Excess epinephrine (pheochromocytoma)
- Cocaine
24
Q
Varicose veins
Risks?
A
- Dilation of veins via valvular incompetence
- Stasis, congestion, thrombus, edema, ischemia of skin
25
Portal hypertension can cause what 3 venous dilations?
- Esophageal varices (can fatally rupture)
- Hemorrhoids (rectal veins --> pain, bleeding, ulcerate)
- Caput medusa (periumbilical veins)
26
- Sitting for long period of time
- Venous congestion in deep leg
Risk?
DVT
Risk = pulmonary embolism
27
Trousseau sign
Migrating thrombophlebitis
- Often due to paraneoplastic hypercoaguability
- Usually MUCIN-producing ADENOcarcinomas of LUNG, OVARY, PANCREAS
28
Hemangioma
Common sites?
Local increased neoplastic blood vessel growth
- Skin, mucus membranes, liver
29
3 types of hemangioma (w/ descriptions)
- Capillary hemangioma (thin-walled capillaries tightly packed)
- Cavernous hemangioma (irregular, dilated vascular channels making lesion w/o distinct border; deep tissue)
- Pyogenic granuloma (LOBULAR capillary hemangioma) (NOT pyogenic, NOT a granuloma) (rapidly growing, oral mucosa)
30
Lymphangioma vs. hemangioma
Lymphangioma = NO RBCs
31
2 types of lymphangioma (w/ descriptions)
- Simple lymphangioma (head/neck and axilla)
| - Cavernous lymphangioma (cystic hygroma) (neck or axilla of children, can be large) (TURNER'S SYNDROME)
32
Glomus tumor
Benign tumor via glomus bodies (distal fingers)
- PAINFUL
- SM origin
33
Bacillary angiomatosis
Vascular proliferation via Gram (-) Bartonella species
- IMMUNOCOMPROMISED
- Skin, localized, red papules, capillary proliferation
- Treat w/ macrolide antibiotics
34
Epithelioid hemangioendothelioma
Neoplastic endothelial cells resembling epithelium (cuboidal, plump)
35
Kaposi sarcoma - associated w/ what?
HHV8
36
4 types of Kaposi's sarcoma (w/ descriptions)
- AIDS-associated KS (spread to LNs and viscera)
- Classic KS (no AIDS, older men of mediterranean descent, skin only)
- African KS (no AIDS,
37
Angiosarcoma
Malignant endothelial tumor
- Commonly in skin, soft tissue, breast, liver
- Older people
- Locally invasive and metastatic
- Relatively deadly
- CD31 marker
