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CV II Exam 2 > Blood Vessels IV > Flashcards

Blood Vessels IV Flashcards

1
Q

abdominal aortic aneurysm

A

below renal aa
male smokers >50yo
severe atherosclerosis with attenuated media

also - higher incidence of ischemic heart disease

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2
Q

inflammatory AAA

A

5-10%

-rich in lymphocytes, plasma cells, macrophages, giant cells

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3
Q

mycotic AAA

A

infected with salmonella gastroenteritis***

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4
Q

when to surgically repair AAA

A

5cm or greater in size

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5
Q

clinical consequences of AAA

A

rupture
obstruction
embolism
impingement adjacent structures

**pulsating abdominal mass

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6
Q

dysphagia, dyspnea, recurrent cough, vertebral body bone pain

A

could be thoracic aortic aneurysm

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7
Q

syphilitic aneurysm

A

luetic
-tertiary stage of syphilis - involves vasa vasorum of thoracic aorta

obliterative endarteritis of vasa vasorum - ischemic injury to media of aorta - aneurysmal dilation

TREE BARKING

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8
Q

tree barking

A

with syphilitic aneurysm

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9
Q

aortic dissection

A

blood into aortic media
-often to rupture - massive hemorrhage or cardiac tamponade

men age 40-60
younger individuals with marfans

may or may not occur with aneurysm

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10
Q

type A dissection

A

involves ascending aorta - debakey 1 and 2

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11
Q

type B dissection

A

involves descending aorta - debakey 3

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12
Q

sudden onset of excruciating pain - anterior chest radiates to back - moves downward

A

aortic dissection

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13
Q

Tx of dissection

A

aggressive treatment for HTN

surgical plication allows 65-75% survival

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14
Q

dissection unusual

A

substantial atherosclerosis or other cause of medial scarring such as syphilis

-fibrosis limits dissection propagation

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15
Q

marfan syndrome

A

LOF mutation in fibrillin - FBN1 gene
majority - autosomal dominant

increased TGF-beta activity - enhanced collagen production and ECM remodeling

overgrowth of bones and mitral valve changes

elastic fragmentation and areas devoid or elastin

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16
Q

loeys dietz syndrome

A

marfan type 2

-mutated TGF-beta receptor

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17
Q

decreased fibrillin 1

A

in marfans

-leads to increased TGF-beta activity

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18
Q

long slender skeleton, subluxation of lens in eye, aneurysm and aortic dissection, aortic valve ring dilation, floppy valve syndrome

A

in marfans

rupture of aorta - most common cause of death

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19
Q

vasculitis

A

inflammation of vessels wall

two main causes - immune-mediated, infection

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20
Q

C-ANCA

A

PR3

in wegener granulomatosis

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21
Q

P-ANCA

A

MPO

in churg strauss and microscopic polyangiitis

22
Q

kawasaki

A

anti-endothelial cell antibodies

anti-smooth muscle cell antibodies

23
Q

goodpasture

A

anti-GBM antibodies

-affects kidney and lungs

24
Q

constitutional symptoms

A

non-specific - seen with vasculitidies

-with fever, weight loss, myalgia, arthralgia, malaise, fatigue

25
Q

giant cell arteritis

A

aka temporal arteritis

  • large vessel vasculitis
  • patient > 50yo
  • associated with polymyalgia rheumatica
  • most common vasculitis of elderly in US
  • can lead to permanent blindness**

anti-endothelial or anti-smooth muscle antibodies

26
Q

permanent blindness

A

risk with giant cell arteritis

27
Q

patient with HA, visual disturbance, and bulging vessels on temples

A

giant cell arteritis

28
Q

takayasu arteritis

A

large vessel vasculitis

  • patient < 40)
  • thickened and narrowed aorta and major branches
  • weakened pulses of upper extremities**
  • ocular changes, neuro sx

possible pulmonary HTN, coronary artery, renal artery, aortic valve insufficiency pathologies

29
Q

pulseless disease

A

diminished radial pulses

-with takayasu arteritis

30
Q

polyarteritis nodosa

A

medium sized vessel vasculitis

  • young adults
  • renal a involvement
  • Hep B surface Ag/Ab complexes
  • acute lesions - arterial fibrinoid necrosis
  • healed lesions - marked fibrotic thickening of artery
  • presentation depend on tissue involved - hematirua, albuminuria, hypertension

untreated - fatal disease

Tx - steroids and cyclophosphamide

31
Q

hep B surface Ag/Ab complexes

A

polyarteritis nodosa

32
Q

kawasaki disease

A

medium vessel vasculitis

  • anti-endo and smooth m autoantibodies
  • coronary arteritis association*** - decreased with IV gamma globumin and aspirin
  • rash on palms and soles of feet
  • strawberry tongue
  • mucocutaneous lymph node syndrome
33
Q

mucocutaneous lymph node syndrome

A

with kawasaki disease

34
Q

microscopic polyangiitis

A

small vessel disease

  • aka leukocytoclastic vasculitis
  • rxn to drugs, organisms, proteins
  • elevated P-ANCA (MPO)

-palpable purpura
-necrotizing GN
-pulmonary capillaritis
-hemoptysis
arthralgia
abdomen pain/bleeding
hematuria
proteiuria
muscle pain/weakness

35
Q

churg strauss syndrome

A

small vessel vasculitis

  • allergic granulomatosis
  • eosinophil rich granulomas**
  • associated with allergic rhinitis, asthma, lung infiltrates

P-ANCA (MPO)

palpable purpura
coronary arteritis and eosionphilic myocarditis

36
Q

behcet disease

A

small vessel vasculitis

  • recurrent oral apthous ulcers
  • genital ulcers
  • uveitis (inflammation of eye)

also GI, pulmonary, neuro symptoms
associated with HLA-B51

positive pathergy test

37
Q

pathergy test

A

pinprick - minor trauma
-causes exaggerated rxn

in behcet disease

38
Q

granulomatosis with polyangiitiis

A

wegener granulomatosis
-small vessel vasculitis

triad:
1 - acute necrotizing granulomas of resp tract
2 - necrotizing/granulomatous vasculitis affecting small/medium vessels in lungs and upper airways
3 - renal disease - focal crescent GN - hematuria and proteinuria

C-ANCA (PR3)

39
Q

triad of wegener

A

resp tract necrotizing granulomas

small-medium vessel necrotizing granulomas

renal disease - necrotizing crescentic GN

40
Q

40yo male, persistent pneumonitis, bilateral cavitary infiltrates, chronic sinusitis, mucosal ulcers, renal disease, skin rash, muscle pain, articular involvement, fever

A

with wegener granulomatosis

41
Q

untreated wegener

A

80% of patients die within 1 year

Tx - immunosuppression

42
Q

thromboangiitis obliterans

A

buerger disease

  • medium/small arteries and veins, nerves
  • cigarette smoking men - before age 35
  • ulcerations of toes, feet, fingers
  • raynaud
  • exercise induced claudication
  • severe pain at rest

Tx - stop smoking

43
Q

vasculitis with smoking cigarettes

A

buerger disease

-thromboangiitis obliterans

44
Q

infectious vasculitis

A

aspergillus and mucormycosis

-may lead to mycotic aneurysm

45
Q

hypothermia

A

prolonged exposure to low temperature

  • 90 degrees - loss of consciousness
  • bradycardia and atrial fib at lower temps

direct effects - physical disruptions and high salt concentrations

indirect effects - circulatory changes

46
Q

alcohol

A

causes vasodilation

-lowers body temp faster

47
Q

frostnip

A

vasoconstriction

-nose, ear, hands, feet

48
Q

chillblain

A

perniones, perniosi

  • nonfreezing temp and damp conditions
  • chronic recurrent vasculitis with red raised lesions
49
Q

immersion foot

A

trench

  • feet wet - not freezing
  • chronic pain, edema, blotchy discoloration
  • superficial, moist, liquefactive gangrene
50
Q

frostbite

A

sudden drop in temp that persists

  • vasoconstriction and increased blood viscosity
  • hyperemia and edema, large clear blisters, vesicles filled with hemorrhagic fluid to complete gangrene
51
Q

raynaud phenomenon

A

pallor or cyanosis of digits

  • primary - cold/emotion induced
  • secondary - arterial insufficiency - SLE, scleroderma, atherosclerosis, buerger disease

red, white, blue of digits

CV II Exam 2 (18 decks)

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