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Flashcards in Vascular Pathology Deck (82)
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1

biopsy of temporal giant cell arteritis will show...

inflamed vessel wall with giant cells fibrosis between media and intima BUT negative biopsy doesn't exclude disease...might not have been in that segment

1

how to treat takayasu arteritis?

corticosteroids

1

risk factors of essential HTN

age, race, obesity, smoking, stress, lack of physical activity, excess salt

2

micronodular cirrhosis

caused by alcoholism

2

complications of HTN?

renal (renal failure) CV (MI) brain (stroke) eye (hypertensive retinopathy)

2

three pathogenesis that weaken wall and lead to aneurym

CT disorders matrix metalloprotease (MMP breaks down elastin) antherosclerosis

3

igA?

henoch schonlein purpura

4

vasculitis with all lesions same stage? varying stages?

same stage = microscopic polyangiitis varying = polyarteritis nodosa

4

why is henoch schonlein purpura usually after upper respiratory tract infection?

because IgA levels are increased to protect mucosal surfaces

4

what does smoking increase?

CRP

4

what tumor is associated with PVC, arsenic, and thorotrast exposure?

angiosarcoma

5

HSP henoch schonlein purpura

small vessel vasculitis due to IgA immune complex deposition; children; palpable purpura on buttocks and legs, GI pain/bleeding, hematuria, post-respiratory tract infection, proteinuria treat w steroid or will self-resolve

6

complications of atherosclerosis

stenosis --> impaired blood flow and ischemia --> peripheral vascular disease, angina (coronary a), and IBD (mesenteric a) rupture --> emboli or thrombosis --> MI, stroke, aneurysm

7

fatty streak histology =

foam cells (macrophages full of lipid) and t lymphocytes

7

buerger disease

medium vessel, necrotizing vasculitis involving DIGITS symptoms - ulcers, gangrene, autoamputation of digits, raynauds phenomenon treat - stop smoking

8

hemoglobin A1c indicates

diabetes mellitus

8

diagnostic features of polyarteritis nodosa?

serum HBsAg (hep B surface antigen) segmental, lesions of varying stage string of pearls = dilatation + fibrous nodes(fibrinoid necrosis

9

churg strauss syndrome

small vessel necrotizing granulomatous vasculitis with eosinophils; multiple organs expecially lungs and heart serum p-ANCA

9

hyperplastic arteriolosclerosis is caused by

malignant HTN

10

elevated CRP and cholesterol crystals and foam cells indicate

atherosclerosis

11

polyarteritis nodosa

medium vessel necrotizing vasculitis involving most organs (LUNGS ARE SPARES) in young adults lesions of varying stages symptoms - HTN (renal a), abdominal symptoms (mesenteric a), neurologic issues, skin lesions

12

CRP

c reactive protein marker of inflammation

13

calcification of the media

monckeberg medial sclerosis

14

response to endothelium injury

injury --> lipid accumulation in intima --> t lymphocytes release interferon -->monocyte/platelet recruitment/adhesion/emigration --> macrophage activation and smooth m recruitment --> lipid/oxidized LDL is engulfed by both --> smooth m proliferation and ecm/collagen deposition + remodeling --> smaller lumen, weakened wall, scarring expansion encroaches on media and adventitia and narrows lumen --> nutrients not reaching full thickness --> necrosis

15

causes of aortic dissection

HTN is most common CT disorder - Marfans (fibrillin) or Ehlers Danlos (collagen)

16

two types of ANCA

cANCA is in cytoplasm periphery = Wegener granulomatosis pANCA is in nucleus periphery = microscopic polyangiitis and churg strauss syndrome

17

aortic dissection

intima tears and blood dissects through media creating false channel sharp radiating chest pain to back, proximal 10 cm of aorta due to preexisting media weakness due to HTN or genetic CT disorder

18

intimal plaque that obstruct blood flow --> chronic inflammation and progressive accumulation

atherosclerosis

19

ulcers, gangrene, raynauds, autoamputation of digits

beurgers disease

19

hyperplastic arteriolosclerosis

thickened vessel wall by hyperplasia of smooth muscle onion skinning appearance BP>20/120, leads to reduced vessel caliber and end organ ischemia, renal failure w flea bitten appearance