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BHP Exam 2 > Cardiovascular 1 > Flashcards

Cardiovascular 1 Flashcards

1
Q

3 layers of a muscular artery?

A

intima, media, adventitia

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2
Q

What is the term describing the thickening and hardening of arterial walls?

A

Arteriosclerosis

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3
Q

Does arteriosclerosis imply a cause?

A

no

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4
Q

Arteriosclerosis effects on:arterial lumen
blood flow
elasticity

A

lumen narrowerblood flow and elasticity decreased

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5
Q

Arteriolosclerosis affects what?

A

Small arteries and arterioles, esp. kidneys

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6
Q

Arteriolosclerosis - what kinds of changes to walls?

A

Hyaline thickening & hardening, proliferation

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7
Q

Arteriolosclerosis - condition of wall?

A

Wall usually completely effaced, destruction of SMC layer

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8
Q

Arteriolosclerosis - most frequently caused by?

A

systemic hypertension or diabetes mellitus

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9
Q

Atherosclerosis - affects what vessels

A

large and medium arteries, NOT veins

small arteries show signs of arteriosclerosis from hypertension

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10
Q

Atherosclerosis begins with damage to…Then leads to…

A

tunica intimadamage, thickening and hardening of tunica media

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11
Q

Most common cause of arteriosclerosis of medium and large-sized arteries

A

atherosclerosis

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12
Q

Atherosclerosis increases risk of (2)

A

thrombus formation, aneurysm

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13
Q

Atheroma is what? Found where?

A

Fibrous, lipid-rich plaques in intima of high-pressure arteries

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14
Q

Atheromas especially found in what vessels (6)

A 
Coronary
Carotid
Circle of Willis
Legs (large vessels)
Renal
Mesenteric
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15
Q

Where are atheroma NEVER found unless in hypertension?

A

Pulmonary arteries

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16
Q

Atheroma composition - 2 layers, 4 things in each layer?

A 
Central core:1. cholesterol
2. foam cells (macrophages)
3. Calcium
4. necrotic debris
Subendothelial fibrous cap
1. SMCs
2. foam cells
3. Fibrin
4. ECM
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17
Q

What is a fatty streak?

A

focal accumulation of foam cells in intima

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18
Q

Fatty streaks appear as early as…

A

first year of life

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19
Q

Atheroma formation steps (4)

A
  1. foam cells accumulate
  2. myofibroblasts proliferate and secrete collagen –> plaque now fibrotic and under pressure
  3. fibrous cap forms
  4. collagenization of media
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20
Q

Consequences of atheromas (6)

A
  1. Restrict blood flow
  2. Hemorrhage
  3. Calcification
  4. Thrombus/embolization
  5. Ulceration
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21
Q

Consequences of atherosclerosis

A
  1. ischemic heart disease/MI
  2. ischemic renal disease
  3. ischemic bowel disease
  4. thrombus/stroke/peripheral vascular disease
  5. aneurysm
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22
Q

Risk factors for atherosclerosis

A
  1. age
  2. male or menopausal women
  3. Familial
  4. high cholesterol
  5. htn
  6. diabetes
  7. smoking
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23
Q

Normal ratio of Total/HDL cholesterol?LDL/HDL?

A

Total/HDL

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24
Q

How does HDL “protect” against atherosclerosis

A

removes cholesterol from tissues and plaques

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25
Q

What is the primary event leading to pathogenesis of atherosclerosis?

A

chronic, low-grade injury or dysfunction of arterial endothelium

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26
Q

Response to injury triggering atherosclerosis can be due to (6)

A
  1. hypercholesterolemia
  2. mechanical injury
  3. hypertension
  4. immune mechanisms
  5. toxins
  6. viruses
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27
Q

What happens after the initial primary event in athersclerosis (reaction to injury)?

A

Entry of monocytes and lipids into subendothelium–> mitogenic factors released –> proliferation

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28
Q

Definition of aneurysm

A

abnormal focal dilation of artery or vein

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29
Q

Main complications of aneurysms

A
  1. erode adjacent structures
  2. rupture
  3. predisposition to thrombosis
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30
Q

Atherosclerotic aneurysm most common site?

A

abdominal aorta

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31
Q

Berry aneurysm found where?

A

cerebral arteries

32
Q

Berry aneurysm cause? Related to atherosclerosis at all?

A

congenital defect in elastic lamina

NOT related

33
Q

Berry aneurysm leads to

A

intracranial bleeding

34
Q

Dissecting aneurysm is A?

A

longitudinal tear in intima that leads to a second arterial lumen, NOT a true aneurysm

35
Q

Dissecting aneurysm most commonly in…

A

aorta

36
Q

Predisposing factors of dissecting aneurysm

A
  1. Hypertension2. medial mucoid degeneration (marfan & ehlers-danlos syndromes)3. atherosclerosis4. instrumentation of artery
37
Q

Dissecting aneurysm sign?

A

tearing chest pain radiating through to back

38
Q

If a dissecting aneurysm ruptures, what 3 things might happen?External rupture…Retrograde spread…Internal rupture…

A

External rupture…massive fatal hemorrhage into thoracic
Retrograde spread…fatal hemopericardium
Internal rupture…double-channeled aorta

39
Q

Hypertension is when diastolic BP is below

A

90mmHg

40
Q

Htn can be benign when…

A

stable increase

41
Q

Htn is malignant when…

A

severe elevation over short period of time

42
Q

What is primary hypertension?

A

aka essential. Elevation of BP over age

43
Q

Determinants of primary Htn (7)

A

(1) genetics - African
(3) diet - obesity, sodium, alcohol
(3) lifestyle - inactivity, smoking, stress

44
Q

Primary htn can predispose to…

A

ischemic heart diseasestroke

45
Q

Primary htn will lead to what if left untreated (3)

A

retinal changesleft ventricular hypertrophy & heart failurebenign nephrosclerosis

46
Q

Secondary htn means it is due to..

A

OTHER CAUSES

47
Q

Most common cause of secondary htn?

A

renal disease

48
Q

Benign type hypertension leads to what changes in vessels?

A

Wall thickening, lumen thinning
tissue ischemiabrain vessel fragility
hemorrhage

49
Q

Malignant htn leads to (3)

A

destructive changes & proliferative response in intima
cessation of blood flow through small vessels
foci of tissue necrosis

50
Q

Malignant htn results in…

A

death through CHF, CVA, kidney failure

51
Q

Malignant htn % cases of htn

A

5%

52
Q

Htn pathology in brain?

A

rupture & microinfarcts/hypertensive lacunae

53
Q

Htn pathology in heart?

A

left ventricular hypertrophy & failure

54
Q

Htn pathology in kidney?

A

arteriosclerosis –> leads to progressive destruction of nephrons –> renal failure, benign hypertensive nephrosclerosis

55
Q

Htn pathology in aorta

A

severe atherosclerosis, abdominal and dissecting aortic aneurysms

56
Q

pulmonary arterial htn is a consequence of what?

A

Raised left atrial/ventricular pressure due to inadequate emptying of left heart, OR dstructino of lung capillary bed

57
Q

pulmonary arterial htn underlying cause?

A

from ischemic heart disease, aortic or mitral valve stenosis (left heart emptying failure) emphysema, fibrosis of lungs (capillary destruction)

58
Q

Vasculitis is what?

A

inflammation and damage to vessel wall

59
Q

3 groups of vasculitis?

A

Small - wegener’s, Churg Strauss, drug inducedMedium - polyarteritis nodosa, kawaski’slarge - takayasu, giant cell

60
Q

Hypersensitivity vasculitis…type, cause?

A

immune complex, often because of drug allergy

61
Q

Hypersensitivity vasculitis presents as what? mechanism?

A

skin rash due to antigen-antibody complex stuck in vessel walls promoting inflammation

62
Q

Polyarteritis nodosa - destruction of what?

A

arterial media and internal elastic lamella –> aneurysmal nodules

63
Q

Wegener’s - vasculitis of vessels of what organs?

A

respiratory tract, kidneys, others

64
Q

Wegener’s - characterized by what type of damage?

A

necrotizing granulomatous vasculitis, fibrinoid necrosis

65
Q

Buerger’s disease - results in what?

A

Acute inflammatory occlusion of small to medium-sized arteries of upper and lower limbs

66
Q

Buerger’s disease related to what behavior?

A

heavy smoking

67
Q

Buerger’s disease patients succumb to what?

A

peripheral vascular insufficiency

68
Q

Varicose veins - presentation?

A

persistent, distended, and tortuous superficial veins in lower limbs

69
Q

Varicose veins due to what?

A

valve incompetence allow them to fill due to gravity

70
Q

Varicose veins predisposed by?

A

increased venous pressure

71
Q

Esophageal varices - what are they?

A

distended venous channels that develop in portal hypertension secondary to cirrhosis of liver

72
Q

Venous thrombosis aka?

A

phlebothrombosis

73
Q

Venous thrombosis arises most often where?

A

deep veins of lower extremities

74
Q

Venous thrombosis predisposed by?

A

venous circulatory state or partially obstructed venous return

75
Q

Kaposi’s sarcoma 3 stages

A

patch, plaque, nodule

76
Q

Kaposi’s sarcoma - causative agent?

A

HSV8

BHP Exam 2 (6 decks)

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