X - The Blood Vessels Flashcards
(117 cards)
1
Q
Large or elastic arteries(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 340
A
In these arteries, elastic fibers alternate in layers with smooth muscle cells. Examples are the common carotid artery, iliac arteries and pulmonary arteries.
2
Q
Medium-sized or muscular arteries(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 340
A
In these arteries, tunica media is composed primarily of smooth muscle cells, with elastin limited to the internal and external elastic lamina. Examples are the coronaries and renal arteries.
3
Q
Arterioles(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 340
A
These are the principal control points for regulation of physiologic resistance to blood flow.
4
Q
Capillaries(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 341
A
These vessels are approximately the diameter of an RBC, have an endothelial cell lining but no media.
5
Q
7-8 um(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 341
A
Diameter of an RBC.
6
Q
Lymphatics(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 341
A
These are thin-walled, endothelium lined channels that drain excess interstitial tissue fluid, returning it to blood via the thoracic duct.
7
Q
Developmental/berry aneurysms(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 341
A
These are small spherical dilatations, typically in the circle of Willis.
8
Q
Arteriovenous fistulas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 341
A
These are abnormal, typically small, direct connections between arteries and veins that bypass the intervening capillaries.
9
Q
Fibromuscular dysplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 341
A
Focal, irregular thickening of the walls of medium and large muscular arteries. Segments of the vessel wall are focally thickened by combination of irregular medial and intimal hyperplasia and fibrosis, causing luminal stenosis.
10
Q
Arteriolosclerosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 343
A
Literally means hardening of the arteries, term reflecting arterial wall thickening and loss of elasticity, affecting small arteries and arterioles.
11
Q
Mockenberg medial calcific sclerosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 343
A
Characterized by calcific deposits in muscular arteries, typical in persons older than 50 yrs old. The radiographically visible, palpable calcifications do not encroach on the vessel lumen, and are not clinically significant. SEE SLIDE 10.1.
12
Q
Atherosclerosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 343
A
Characterized by intimal lesions called atheromas that protrude into vascular lumina.
13
Q
- Cells (SM cells, macrophages, T cells)2. Extracellular matrix (collagen, elastic fibers, proteoglycans)3. Intracellular and extracellular lipidFibrous cap, central lipid core, neovascularization(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 344
A
Three principal components of an atheromatous plaque.
14
Q
Increasing ageMale genderFamily historyGenetic abnormalities(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 344
A
Non-modifiable risk factors for atherosclerosis. (4)
15
Q
Fatty streaks(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 349
A
Composed of lipid-filled macrophages and smooth muscle cells (foam cells) but are not significantly raised and thus do not cause any disturbance in blood flow. Can appear as early as 1 year, and present in virtually all children older than 10 years old.
16
Q
Abdominal aorta (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 350
A
Most common site of atherosclerosis
17
Q
Rupture, ulceration or erosion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 351
A
Fate of an atheromatous plaque wherein the luminal surface exposes the bloodstream to highly thrombogenic substances and induces thrombus formation.
18
Q
Hemorrhage(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 351
A
Fate of an atheromatous plaque due to rupture of the overlying fibrous cap or the thin-walled vessels in the areas of neovascularization.
19
Q
Atheroembolism(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 351
A
Fate of an atheromatous plaque causing discharge of debris into the bloodstream, producing microemboli composed of plaque contents.
20
Q
Aneurysm formation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 351
A
Fate of an atherosclerotic plaque due to increased pressure or ischemic atrophy of the underlying media, with loss of elastic tissue, leading to weakness of the vessel wall.
21
Q
Idiopathic (essential hypertension)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 355
A
Most common cause of hypertension.
22
Q
Hyaline arteriolosclerosis. SEE SLIDE 10.2. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 356
A
HYALINE or HYPERPLASTIC Arteriosclerosis? Consists of a homogenous pink hyaline thickening of the walls of arterioles with loss of underlying structural detail and with narrowing of the lumen. SEE SLIDE 10.2. A major morphologic characteristic in benign nephrosclerosis.
23
Q
Hyperplastic arteriolosclerosis. SEE SLIDE 10.3. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 356
A
HYALINE or HYPERPLASTIC Arteriosclerosis? Characteristic of malignant hypertension, associated with “onion-skin” concentric, laminated, thickening of the walls of arterioles with luminal narrowing. SEE SLIDE 10.3. These laminations consist of smooth muscle cells and thickened duplicated basement membrane. Associated with necrotizing arteriolitis.
24
Q
Aneurysm(TOPNOTCH)
A
It is a localized abnormal dilation of a blood vessel or heart.
25
Aneurysm(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
It is a localized abnormal dilation of a blood vessel or heart.
26
True aneurysm(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
Aneurysm which involves all three layers of the arterial wall, or the attenuated wall of the heart.
27
False aneurysm(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
A breach in the vascular wall leading to an extravascular hematoma that freely communicates with the intravascular space.
28
Arterial dissection(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
Arises when blood enters the wall of an artery, as a hematoma dissecting between its layers. Often, but not always aneurysmal in origin.
29
Saccular aneurysms(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
Aneurysms which are spherical outpouchings, involving only a portion of the vessel wall, varying in size from 5-20cm in diameter and often contain thrombi.
30
Fusiform aneurysms(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
Aneurysms which involve diffuse, circumferential dilation of a long vascular segment, varies in diameter and length, and can involve extensive portions of the aortic arch, abdominal aorta,and iliacs.
31
Atherosclerosis and hypertension(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 345
Two most important causes of aortic aneurysms.
32
Mycotic aneurysm(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 357
Infection of a major artery that causes weakness to its wall.
33
Abdominal aortic aneurysm (AAA)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 358
This disease can more commonly affects men >50 years old. Lesion usually positioned below the renal arteries and above the aortic bifurcation. Can be saccular or fusiform.
34
Inflammatory AAA(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 358
Abdominal aortic aneurysm characterized by dense periaortic fibrosis containing abundant lymphoplasmacytic infiltrate with many MACROPHAGES and GIANT CELLS.
35
Mycotic abdominal aortic aneurysm(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 358
Atherosclerotic lesions infected by lodging of circulating microorganisms in the wall, particularly in the setting of bacteremia from a Salmonella gastroenteritis. SUPPURATION further destroys the media, potentiating rapid dilation and rupture.
36
Syphilitic aortitis(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 359
Small blood vessels and vasa vasorum show luminal narrowing and obliteration (OBLITERATIVE ENDARTERITIS), scarring of the vessel wall and a dense surrounding rim of lymphocytes and plasma cells that may extend into the media. Characteristic of the tertiary stage of syphilis. SEE SLIDE 10.4.
37
Ascending aorta, 10 cms from the aortic valve(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 360
Most common point of origin of an aortic dissection.
38
Cystic medial degeneration(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 361
Most frequent pre-existing histologically detectable lesion in aortic dissection, characterized by elastic tissue fragmentation and separation of the elastic and smooth muscle cell elements of the media by cystic spaces filled with amorphous proteoglycan-rich extracellular matrix. SEE SLIDE 10.5.
39
Type A dissections (proximal) Type I DeBakey - ascending aorta only Type II DeBakey - ascending and descending aorta(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 361
Classification of aortic dissection involving either them ascending aorta only or both the ascending and descending aorta.
40
Type B dissection / type III DeBakey(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 361
Classification of aortic dissections involving the descending aorta only, usually distal to the subclavian artery.
41
Giant cell (Temporal) arteritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 363
Granulomatous inflammation frequently involving the temporal artery, occuring in patients >50 years old, associated with polymyalgia rheumatica.
42
Takayasu arteritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 364
Granulomatous inflammation usually occuring in patients younger than 50 years old. Classically involves the AORTIC ARCH, with intimal hyperplasia and irregular thickening of the vessel wall. Origin of great vessels are obliterated causing weakness of peripheral pulses.
43
Age of patient 40 Giant cell arteritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 364
Used to distinguish between giant cell arteritis and takayasu arteritis of the aorta.
44
Giant - cell/Temporal arteritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 364
In this disease, affected blood vessels develop nodular intimal thickening, granulomatous inflammation within the inner media, and fragmentation of the internal elastic lamina. Typically involves temporal and ophthalmic arteries. SEE SLIDE 10.6.
45
All stages of activity coexist in the vessels, suggesting ongoing and recurrent pathogenic insults (TOPNOTCH) Robbins Basic Pathology, 9th ed., p 352
Unique characteristic of PAN, apart from being lung-sparing.
46
Polyarteritis Nodosa (PAN) SEE SLIDE 10.7. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 365
A systemic vasculitis causing TRANSMURAL NECROTIZING INFLAMMATION of SMALL to MEDIUM SIZED ARTERIES sized vessels, with mixed infiltrate of neutrophils, eosinophils, and mononuclear cells, frequently accompanied by fibrinoid necrosis. SEE SLIDE 10.7. Typically involves renal arteries but spares pulmonary vessels.
47
Kawasaki disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 366
Arteritis associated with mucocutaneous lymph node syndrome, which usually occurs in children. Coronary arteries can be involved with aneurysm formation or thrombosis. Fibrinoid necrosis usually less prominent.
48
Wegener granulomatosis SEE SLIDE 10.8 (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 367
Causes necrotizing granulomatous vasculitis with fibroblastic proliferation. Involves small vessels most notable in the upper and lower respiratory tract and kidneys. Can cause cresencteric glomerulonephritis. Associated with c-ANCA. SEE SLIDE 10.8
49
Microscopic polyangiitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 368
A necrotizing vasculitis that generally affects capillaries, arterioles and venules, with few or no immune deposits. Necrotizing glomerulonephritis and pulmonary capillaritis are common. Associated with p-ANCA. Histologically similar but does not affect medium-large arteries.
50
Churg-Strauss syndrome. SEE SLIDE 10.9 (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 368
Eosinophil-rich and granulomatous inflammation involving the respiratory tract and necrotizing vasculitis affecting small vessels. Associated with asthma and blood eosinophilia. Associated with p-ANCA. SEE SLIDE 10.9
51
Thromboangiitis obliterans (Buerger disease)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 368
Characterized by sharply segmental avute and chronic vasculitis of medium sized and small arteries, predominantly of the extremities. There is acute and chronic inflammation accompanied by luminal thrombosis, containing microabscess composed of neutrophils surrounded by granulomatous inflammation. Stromg relationship with cigarette smoking. SEE SLIDE 10.10.
52
Raynaud phenomenon(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 369
Results from an exaggerated vasoconstriction of digital arteries and arterioles, inducing paroxysmal pallor or cyanosis of the digits of the hands and feet.
53
Primary Raynaud phenomenon (Raynaud disease)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 369
Reflects an exaggeration of central and local vasomotor responses to cold or emotion. Structural changes in the arterial walls are absent except late in course when intimal thickening can appear.
54
Secondary Raynaud phenomenon(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 370
Reflects vascular insufficiency of the extremities in the context of arterial disease caused by other entities including SLE, Buerger disease, or atherosclerosis.
55
Varicose veins(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 370
Abnormally dilated, tortous veins produced by prolonged increase in intraluminal pressure and loss of vessel wall support. Veins show wall thinning at the points of maximal dilation with smooth muscle hypertrophy and intimal fibrosis. Focal thrombosis and venous valve deformities are common.
56
Superficial veins of the upper and lower leg(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 370
Most common blood vessels involved in development of varicose veins.
57
GEJ (Esophageal varices)Rectum (Hemorrhoids)Periumbillical veins (Caput medusae)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 370
Three sites of varices produced in the presence of portal hypertension.
58
Pulmonary embolism(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 371
Common and serious complication of of deep vein thrombosis (DVT).
59
Lymphangitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 371
The acute inflammation elicited when bacterial infections spread into and through the lymphatics.
60
Capillary hemangiomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 372
These are bright red to blue lesions, that vary from a few millimeters tomseveral centimeters in diameter. Unencapsulated aggregates of closely packed, thin-walled capillaries, usually blood-filled and lined by flattened endothelium. Vessels are separated by scant connective tissue stroma. SEE SLIDE 10.11.
61
Cavernous hemangioma(TOPNOTCHRobbins Basic Pathology, 8th Ed p. 372
Appears as red-blue, soft, spongy masses 1-2 cm in diameter, which can affect large subcutaneous areas of the face, extremities, and othe body regions. Mass is sharply defined but not encapsulated, composed of large, cavernous, blood-filled spaces. SEE SLIDE 10.12.
62
Pyogenic granuloma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 373
This form of capillar hemangioma is a rapidly growing peduncular red nodule on the skin, gingival, or oral mucosa, bleeds easily and is often ulcerated.
63
Glomus tumor (Glomangioma). SEE SLIDE 10. 13. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 373
These are round, slightly elevated, red-blue firm nodules, less than 1 cm diameter that can resemble a minute focus of hemorrhage UNDER THE NAIL. SEE SLIDE 10.13. Histologically, these are aggregates, nests, and masses of tumor cells intimately associated with branching vascular channels.
64
Glomus body(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 373
A specialized arteriovenous structure involved in thermoregulation.
65
Nevus flammeus. SEE SLIDE 10.14. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 374
This lesion is the ordinary "birthmark" and is the most common form of ectasia. Characteristically a flat lesion on the head or neck, ranging in color from light pink to deep purple.
66
Spider telangiectasia. SEE SLIDE 10.14. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 374
This non-neoplastic vascular lesion grossly resembles a spider. There is radial, often pulsatile array of dilated subcutaneous arteries or arterioles about a central core, that blanches when pressure is applied to its center.
67
Bacillary angiomatosis. SEE SLIDE 10.15. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 374
An opportunistic infection in immunocompromised persons that manifest as vascular proliferations involving skin, bone, brain and other organs. Characterized grossly by red papules and nodules, or rounded subcutaneous masses. Histologically, there is capillary proliferation with prominent epitheloid EC's showing nuclear atypia and mitoses. Lesions contain stromal neutrophils, nuclear dust nd purplish granular material.
68
Kaposi sarcoma. SEE SLIDE 10.16 (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 375
Common in patients with AIDS, caused by HHV 8, causing skin lesions that progress from patches, to plaques, to nodules. There are usually plump spindle cells with extravasated erythrocytes and hemosiderin-laden magrophages in the lesions. SEE SLIDE 10.16
69
CD31 and vWF (TOPNOTCH) Robbins Basic Pathology, 9th ed. P 362
Endothelial cell markers that can be used in diagnosing angiosarcoma
70
Angiosarcoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 376
These are malignant endothelial neoplasms, with varying histology from plump, anaplastic but recognizable endothelial cells producing vascular channels to widely undifferentiated tumors having solid, spindle cell appearance and producing nondefinite blood vessels. SEE SLIDE 10.17.
71
Malignant Hypertension (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 488
Form of hypertension characterized by systolic pressure more than 200 mmHg or diastolic pressure more than 120 mmHg, renal failure, and retinal hemorrhages and exudates.
72
Family history(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 492.
The most important independent risk factor for atherosclerosis.
73
Endothelial injury and dysfunction. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 494
The initial event in the pathogenesis of atherosclerosis
74
LDL(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 494
The major lipoprotein involved in the pathogenesis of atherosclerosis.
75
Hemodynamic disturbances and hypercholesterolemia. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 494
2 most important causes of endothelial dysfunction
76
Intimal thickening and lipid accumulation (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 496
Two key feaures of an atherosclerotic plaque
77
Collagen(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 500
The major structural component of fibrous cap in an atheromatous plaque
78
Cystic medial degeneration. SEE SLIDE 10.5. (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 502
Medial ischemia leading to degenerative changes of aorta, leading to scarring, loss of elastic fibers, inadequate extracellular matrix synthesis, and production of amorphous ground substance. This can be seen in Marfan syndrome and scurvy.
79
Hypertension (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 502
Most common etiology associated with ascending aortic aneurysm
80
Abdominal aortic aneurysm(TOPNOTCH)
A 70 y/o male, hypertensive, present with sudden severe abdominal pain. On physical examination, there is a presence of pulsatile abdominal mass. The most likely diagnosis is:
81
Cystic medial degeneration(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 504
The most frequent preexisting histologically detectable lesion in aortic dissection
82
Aortic dissection(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 505
Presents with sudden onset of excruciating pain, usually beginning in the anterior chest, radiating to the back between the scapulae, and moving downward.
83
Rupture of the dissection into the pericardial, pleural or peririthoneal cavities.(TOPNOTCH) Robbins Basica Pathology, 9th ed., p. 505
Most common cause of death in aortic dissection.
84
Giant cell arteritis (TOPNOTCH)
A 38 y/o male presents with severe headache and diplopia associated with fever and fatigue. Area along the course of the superficial temporal artery was painful to palpation. Biopsy done revealed intimal thickening of the artery, granulomatous inflmmation of the internal elastic lamina with infiltrate of T cells and macrophages. SEE SLIDE 10.6. What is the most likely diagnosis?
85
Takayasu arteritis(TOPNOTCH)
Patient initially present with fatigue, weight loss and fever and then reduced blood pressure and weak pulses in the carotids and upper extremities, ocular disturbances and neurologic deficits. The most likely diagnosis is:
86
Aortic arch (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 509
Most common involved blood vessel in Takayasu arteritis.
87
Polyarteritis nodosa(TOPNOTCH)
This disease presents with rapidly accelerating hypertension, abdominal pain, bloody stool, myalgia and peripheral neuritis. The most likely diagnosi:
88
Coronary artery aneurysm which may lead to acute MI. (Case of Kawasaki Disease) (TOPNOTCH)
A 4 y/o female presented with fever and maculopapular rash on her trunk and extremities. This is associated with conjunctival erythema, edema of the hands and feet, and cervical lymph node enlargement. The patient is at risk for what type of blood vessel involvement?
89
Churg-Strauss syndrome(TOPNOTCH)
Patient presents with asthma, allergic rhinitis, palpable purpura, GI bleeding, renal disease, and cardiomyopathy. Histologic findings showed vascular granulomata and hypereosinophilia. SEE SLIDE 10.9. The most likely diagnosis is:
90
Behcet Disease(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 511
It presents as a clinical triad of recurrent oral apthous ulcers, genital ulcers, and uveitis.
91
Granulomatosis with polyangitis/Wegener granulomatosis. SEE SLIDE 10.8. (TOPNOTCH)
This disease presents with persistent pneumonitis with bilateral nodular infiltrates, chronic sinusitis, mucosal ulceration of the nasopharynx, and renal disease. Histologic findings of upper respiratory tract lesion showed mucosal granuloma with geographic patterns of central necrosis and vasculitis. SEE SLIDE 10.8. The most likely diagnosis:
92
Thromboangiitis obliterans (Buerger disease)(TOPNOTCH)
A 30 y/o male, smoker, presents with severe leg pain aggravated by exercise and relieved on rest. It further progressed to extremity ulcerations. What is the most likely diagnosis?
93
Prolonged immobiliztion resulting in venous stasis. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 514
Most imprortant risk factor for DVT
94
Superior vena cava syndrome (TOPNOTCH)
A 50 y/o male, diagnosed with lung cancer, presented with edema and cyanosis of the head , neck, and arms with cyanosis. This is a case of:
95
Group A beta hemolyitc streptococcus. (TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 515
The most common etiologic agent in lymphangitis.
96
Hereditary hemorrhagic telengiectasia/Osler-Weber-Rendu disease (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 516
An autosomal dominant disorder caused by mutations in genes that encode components of TGF-B signaling pathway. Presents with telengiectasia that are widely distributed over the skin and mucus membranes.
97
Capillary hemangioma(TOPNOTCH) Robbins Basic Pathology, 9th ed. p. 516
Most common type of hemangioma
98
expected in his age group ("fatty streak" (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp 348-349)
A 13 year old male dies of a stray bullet to the head on New Year's Eve. At autopsy, there is a flat yellowish streak seen on the intimal surface of his abdominal aorta, near the bifurcation of the renal arteries. This streak (A) causes minor disturbance in blood flow (B)is expected in his age group (C) is composed of hemosiderin-filled foam cells (D) would have certainly evolved into an atheromatous plaque if he lived to old age
99
there are differences in vascular hemodynamics at various points (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 349
Early atherosclerotic lesions are usually focal, patchy, and eccentric because (A) there are differences in the vascular hemodynamics at various points (B) the expression of LDL receptors along the blood vessels is varied (C) concentrations of macrophage-activating cytokines are different along blood vessels (D) certain endothelial cells are more sensitive to toxins and hyperglycemia than others
100
a ruptured fibrous cap with thrombus formation (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.351
A 65 year old diabetic female with poor glycemic control and a 5 year history of intermittent chest pain develops pallor, shortness of breath and diaphoresis. She dies 16 hours later. At autopsy, the left ventricular wall is thickened, with dark mottling of the anterior portion, along with the septum and apex. Which of the following describes the likely histology of her left anterior descending artery? (A) an eccentric atheromatous plaque with a fibrous cap (B) a ruptured fibrous cap with calcifications in the lumen of the vessel (C) a ruptured fibrous cap with thrombus formation (D) complete occlusion of the original lumen by fibrous tissue, with neovascularization in the periphery
101
atherosclerosis (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 358
What is the most common cause of aneurysms?
102
abdominal aorta(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 358
What is the most common site of atherosclerotic aneurysms?
103
history of sexually transmitted infection (tertiary/cardiovascular syphilis) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.359, 703
A 75 year old male with heart failure symptoms of 10 years dies. At autopsy, his aortic trunk is dilated, with fibrous scars and wrinkling of the intima. The aortic valve is also dilated, and the left ventricle is markedly enlarged. Microscopic examination of the aorta shows narrowed or obliterated vasa vasorum to be narrowed, with a dense rim of lymphocytes and plasma cells, some extending into the media. SEE SLIDE 10.4. Which of the following can suggest the etiology of the patient's findings? (A) family history of diabetes (B) chronic alcohol intake (C) history of sexually transmitted infection (D) occupational exposure to benzene
104
age (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 364-365
A 30 year old female with 3 year history of fever, weight loss and fatigue presents with right eye blindness. PE showed weak pulses in the upper extremities. Which of the following suggests that she has Takayasu arteritis, rather than temporal arteritis? (A) age (B) constitutional symptoms (C) giant cells in the large blood vessels (D) giant cells in the medium blood vessels
105
kidneys (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 365
Classic polyarteritis nodosa affects small to medium sized vessels most commonly in which organ? (A) kidneys (B) heart (C) liver (D) GI tract
106
intravenous immunoglobulin (Kawasaki disease) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.366
A 2 year old boy presents with erythema of the conjunctiva, oral mucosa, palms and soles, with focal erosions. Palpation shows enlarged cervical lymph nodes. He suddenly dies a few hours after ER admission. Autopsy showed marked mononuclear infiltration of his left anterior descending artery, with fibrinoid necrosis and lumen occlusion. What could have prevented this fatal sequela? (A) low dose corticosteroids (B) Hepatitis B vaccine (C) Beta-lactam and aminoglycoside combination (D) intravenous immunoglobulin
107
positive C-ANCA (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 367-368
A 42 year old man with 2 weeks of epistaxis undergoes an intranasal biopsy, which showed chronic granulomatous inflammation with giant cells. Xray showed cavitary lung lesions. He is treated with anti-Koch's for 6 months, but the epistaxis recurred. He also developed hematuria. Which of the following can help support a diagnosis of Wegener's granulomatosis, rather than TB? (A) positive P-ANCA (B) positive C-ANCA (C) urinalysis with RBC morphology (D) biopsy of the lung lesion
108
thrombus with neutrophil aggregates and necrosis (Buerger disease) SEE SLIDE 10.10. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.368
A 27 year old Israeli expat presents with intermittent pain and pallor of the right index and middle fingers, precipitated by smoking and cold temperature. He reports symptomatic relief whenever he stops smoking. What is expected in the arteries of the involved fingers? (A) thrombus with neutrophil aggregates and necrosis (B) histiocytes and giant cells (C) ruptured fibrous cap and underlying foamy cells (D) eosinophils and lymphocytes in the media and intima
109
may spontaneously regress or fibrose after pregnancy (granuloma gravidarum/pregnancy tumor/pyogenic granuloma) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.373
A 21 year old G1P0, 24 weeks AOG, has a reddish 1.0 cm diameter nodule on her left lower gum. She reports that the nodule appeared at 1 month of pregnancy. A biopsy showed shows capillaries with an acute and chronic inflammatory infiltrate and stromal edema. There is no pleomorphism, necrosis, or atypical mitosis. This nodule (A) can be found in 20% of pregnant women (B) is malignant (C) may spontaneously regress or fibrose after pregnancy (D) is metastatic from an ovarian primary
110
more extensive vascular malformations (Sturge-Weber syndrome) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.374
A 3 year old female with a large "port wine stain" on the right side of her face has occasional seizures. Further examination showed mental developmental delay. She may also have (A) more extensive vascular malformations (B) multiple colonic polyps (C) color blindness (D) alpha thalassemia
111
HHV8 (Kaposi Sarcoma). SEE SLIDE 10.16. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 375
A 38 year old HIV-positive man has multiple reddish-purple plaques and nodules on his arms and legs. He has never been on antiretroviral therapy. Biopsy of one of the nodules showed sheets of plump spindle cells encompassing small vessels and slit-like spaces, with focal hemorrhage, hemosiderin deposits, lymphocytes, and macrophages. Mitotic figures are common. SEE SLIDE 10.16. This neoplasm has been shown to be infected with (A) HPV 16 (B) HHV 8 (C) Hepatitic C (D) HPV 18
112
Dilator (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 331
VASODILATOR or CONSTRICTOR: Prostaglandin
113
Dilator (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 331
VASODILATOR or CONSTRICTOR: Kinins
114
Dilator (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 331
VASODILATOR or CONSTRICTOR: NO
115
Constrictor (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 331
VASODILATOR or CONSTRICTOR: Endothelin
116
Constrictor (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 331
VASODILATOR or CONSTRICTOR: Thromboxane
117
TGF-beta (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 345
Cytokine that regulates smooth muscle cell proliferation and synthesis
