Blood Vessels

Question 1

What arteries are affected in Atherosclerosis?

Answer 1

Lg, Medium sized elastic and muscular arteries

Question 2

What accumulates in the intima of atherosclerotic arteries?

Answer 2

Inflammatory cells
Hyperplastic smooth muscle cells
lipids
connective tissue

Question 3

Atheroma

Answer 3

lipid plaque [consists of extracellular lipid and lipid-laden macrophages aka foam cells……..Cholesterol carried by serum lipoproteins is deposited in the atheroma, where it is endocytosed by macropahges]

A mature atheroma is highly thrombogenic

Question 4

Obliterative endarteritis is associated with what infection?

What other findings are expected upon microscopic examination of this infection?

Answer 4

Syphillis. Obliteration of the vasa vasoram causes focal necrosis and scarring of the media, with disruption and disorganization of the elastic lamellae. The inner surface of the affected aorta shows a typical TREE BARK appearance?

Endarteritis of the vasa vasorum / Syphilitic Aneurysm is associated with syphiliitic aneurysm of the Ascending Aorta.
The vasa vasorum ramify in the adventiia and penetrate the outer and middle third of the aorta.

Periarteritis of the vasa vasorum can also be seen

Question 5

What organ specific disorders are seen with patients with severe atherosclerosis?

Answer 5

Intermittent claudication
Abdominal Aortic Aneurysms
CAD (chest pain)
Cerebrovascular Disease
PVD

Question 6

On H&E stain, how would calcification appear?

Answer 6

As an irregular BLUE material

Question 7

Xanthoma

Answer 7

papules or nodules of lipid-laden macrophages

Question 8

What does the cell surface glycoprotein, the LDL receptor, regulate?

Answer 8

It regulates plasma choleseterol by mediating endocytosis and recycling of apolipprotein (apo)E.

Without the LDL receptor, accumulated LDL in plasma and are taken up by macrophages

Question 9

Athereosclrotic “Restenosis”

Answer 9

atherosclerotic plaques that develop in venous grafts after 5-10 yrs. (Saphenous veins are used as autografts in coronary artery bypass surgery)

Question 10

What orgnas are often damaged as a result of malignant HTN?

Answer 10

brain, heart, and kidney

Question 11

What is the pathology seen in MH?

Answer 11

Injury of endothelial cells causes increased vascular permeability, which leads to the insudation (accumulation) of plasma proteins into the vessel wall and fibrinoid necrosis.

Question 12

Filarial worm infestation of inguinal lymph node causes what clinical manifestation?

Answer 12

Elephantiasis- Lymphedema of the extremity or scrotum. It is high in protein content (lymph is the means by which proteins and IS cells are returned to the circulation)

The normal pattern of filtration is disrupted (Normal: more fluid is filtered into the IS than is reabsorbed into vascular bed and excess IS fluid is removed by lymphatics)

Question 13

Indurated edema

Answer 13

Increased protein concentration may be a fibrogenic stimulus in the ormationof dermal fibrosis in chronic eedema

Question 14

End result of autoregulation in patIents with systemic HTN is:

Answer 14

increased peripheral resistance

Question 15

What imabalance is often seen in HTN cases?

Answer 15

renal function and sodium homeostasis

Question 16

What is Conn Syndrome?

Answer 16

An endocrine disorder most commonly caused by an adrenal cortical adenoma that secretes Aldosterone.

Causes: HTN, Hypernatremia, Hypokalemia

Question 17

What terms refer to vascular lesions confined to the skin?

Answer 17

Leukocytoclstic Vasculiitis
Cutaneous Vasculitis
Cutaneous Necrotizing Venulitis

Question 18

Name the tumor seen in this pt ““48yom with painful, raised, red lesion on dorsal surface of left hand/Skin biopsy: round regular cells within connective tissue associated with branching vascular spaes”

Answer 18

Glomus tumor

lesions are usually smaller than 1 cm in diameter

Question 19

Glomus bodies

Answer 19

normal neuromyoarterial receptors that are sensitive to temperature and regulate arteriolar blood flow

Question 20

How would the arteries of a Monckeberg Medial Sclerosis appear on gross examination?

Answer 20

Involved arteries are HARD and DILATED. The MEDIA OF LG AND MEDIUM SIZED ARTERIES of NON-ATHEROSCLEROTIC persona are CALCIFIED.

(These arterial changes are usually asymptomatic)

Question 21

What characterizes a Congenital cavernous hemangioma?

Answer 21

It’s a benign lesion
It consists of large vascular channels, frequently interpersed with small capillary-type vessels
They can undergo changes: thrombosis, fibrosis,cystic cavitations, intracystic hemorrhage

In the skin, they are called port-wine stains
In the brain, they can enlarge and cause neurologic symptoms

Question 22

How does claudication occur in an atherosclerotic patient?

Answer 22

Chronic ischemia of the lower limbs due to Atherosclerosis causes hypoperfusion of the leg muscles. . When th eblood supply becomes inadequate, usually upon exertion, the muscles develop cramps (claudication)

Intermittent claudication is associated with PVD (atherosclerosis)

Question 23

What characterizes Angiosarcoma?

Answer 23

MALIGNANT TUMOR
composed of masses of endothelial cells (malignant) most commonly in the skin, breast, bone, liver, and spleen.

Varies froom distinct vascular elements to undifferentiated tumors with nucleaer pleomorphism and frequent mitosis.

Question 24

How do cystic spaces develop in dissecting aneurysms?

Answer 24

They are spaces filled with pools of metachormatic myxoid material from focal loss of elastic and muscle fibers in the aortic media.

Question 25

Chilblains

Answer 25

itchy or tender red or purple bumps that occur as a reaction to cold

Question 26

Hyaline arteriolosclerosis is \\ has markedly thickened ____ and ACCUMULATION OF ____

Answer 26

bASEMENT MEMBRANE MATERIAL AND accumulation of pLASMA PROTEINS

Question 27

Diseases that affect the veins are mainly:

Answer 27

Thrombophlebitis (thrombosis-induced local inflammation)
and Varicosities (enlarged/tortuous blood vessel)

Question 28

What are Hemorrhoidsd?

Answer 28

Dilations of the beins of the rectum and anal canal, which may occur inside or outside the anal sphincter.

Can be aggravated by constipation and pregnancy

Can result from benous obstruction by rectal tumors

Question 29

Which hemorrhoids bleed and/or pain?

Answer 29

Thrombosis of hemorrhoids is equistiely painful

Internal hemorrhoidsd typically bleed without pain

External hemorrhoids typically hurt but do not bleed.

Question 30

describe the kidneys of a scleroderma patient?

Answer 30

In Sceroderma, MH can be manifested and lead to fatal renal failure .

Its interlobular ateries and affrent arterioles are severely affected vessels. Early fibromuscular thickening of the subintima causes luminal narrowing followed by fibrosis

Question 31

What are the four fates of a thrombus?

Answer 31

1. lysis
2. growth and prpagation
3. Detachment and embolization
4. Organization or Canalization