7. Vascular Pathoma

Question 1

What is the most common form of vasculitis and who does it usually effect? what are some symptoms? Tx?

Answer 1

Temporal (giant cell) arteritis Granulomatous Vasculitis Older women Headache (temporal), visual disturbances (ophthalmic), jaw claudication Tx-corticosteroids

Question 2

Takayasu Arteritis

Answer 2

Same as temporal arteritis (granulomatous vasculitis) But its usually in younger asain females (less than 40) “pulseless dz” Tx=corticosteroids

Question 3

Polyarteritis Nodosa

Answer 3

Necrotizing vasculitis, involving most organs except the lungs usually a Serum Hep. B surface antigen String of pearls

Question 4

Kawasaki Dz. What is it and who does it affect, and which artery does it mainly fuck up? How do you treat it

Answer 4

Vasculitis affecting asain children less than 4 yrs old. CRASH and Burn Conjunctival injection, Rash, Adenopathy, Strawberry tongue, Hand (foot) edema and fever

Coronary Artery

IV immunoglobulin and ASPIRIN

Question 5

Buergers DZ what is it/ the main cause? and whats the clinical finding

Answer 5

Medium vessel vasculitis Caused by heavy smoking Autoamputation of digits

Question 6

Wegener Granulomatosis We’C’ener Whats the tx

Answer 6

Small vessel vasculitis involves the C’s Nasopharynx/lungs/kidney Triad -necrotizing vasculitis, necrotizing granuloma in the lung/upper airway, necrotizing glomerulonephritis C-ANCA tx- Cyclophosphamide

Question 7

Microscopic Polyangiitis? which organ does it affect? similar to which other small vessel vasculitis except for? how do you treat it?

Answer 7

Small vessel vasculitis affects lung and kidney no granulomas and no nasopharyngeal involvement Tx-Cyclophosphamide P-ANCA

Question 8

Churg-Strauss? Which organ does it affect? Which small vasculitis is it similar to? how do they differ?

Answer 8

Small vessel vasculitis Necrotizing granulomatous vascuilits w/ eosinophils involves lungs and heart Similar to microscopic polyangiitis (Both have p-ANCA but differ bc it has granulomas and ASTHMA and no peripheral eosinophilia)

Question 9

HSP (Henoch Schönlein Purpura)? what population is most common? whats the clinical presentation what infection does it usually follow

Answer 9

Small vessel vasculitis due to IgA immune complex deposition (IgA nephropathy) most common in children Palpable purpura on BUTT/LEGS Follows Upper Respiratory Infection

Question 10

What is the defined limits of Hypertension and risk factors

Answer 10

BP >140/90 age,race, obesity, high salt diet

Question 11

What is atherosclerosis? which size vessels does it effect? what are the 4 main arteries it hits (in order of occurrence) how much occlusion do you need to have symptoms

Answer 11

A buildup of cholesterol plaque in medium/large muscular arteries Abdominal Aorta > coronary a.> popliteal A. > carotid greater than 70%

Question 12

What is the progression of Atherosclerosis

Answer 12

1. endothelial cell fuck up 2. macrophage and LDL accumulation 3.Foam cell formation 4. Fatty streaks 5. Fibrous plaque

Question 13

What are the two types of ArteriOLOsclerosis

Answer 13

Hyaline:Vascular thickening of vessel wall with protein caused by Hypertension and diabetes Hyperplastic: Onion Skinning caused by sever HTN

Question 14

What causes Hyaline ArteriOLOsclerosis What does it lead to?

Answer 14

HTN and Diabetes HTN increased BP forces protein into the vessel wall Diabetes- Causes vessel wall to be leaky so protein leaks in leads to ischemia and glomerular scarring

Question 15

What causes Hyperplastic AteriOLOsclerosis

Answer 15

Thickening of vessel wall due to hyperplasia of smooth muscle due to malignant HTN

Question 16

Where do you see fibrinoid necrosis (beads on string)

Answer 16

Malignant HTN