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Pathoma > Chapter 7: Vascular Pathology > Flashcards

Chapter 7: Vascular Pathology Flashcards

1
Q

Large Vessel Vasculitis

A

Temporal Giant Cell Arteritis

Takayasu Arteritis

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2
Q

Medium Vessel Vasculitis

A

Polyarteritis Nodosa
Kawasaki Disease
Buerger Disease

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3
Q

Small Vessel Vasculitis

A

Wegener Granulomatosis(Granulomatosis with Polyangiitis)
Microscopic Polyangiitis
Churg-Strauss Syndrome
Henoch-Schonlein Purpura

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4
Q

MOST COMMON vasculitis in older adults

A

Temporal(Giant Cell) Arteritis

vasculitis in older adults(>50) usually affects females

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5
Q

Temporal Arteritis clinical symptoms?

A

Affects branches of carotid artery leading to headache, and visual disturbances(if it hits ophthalmic artery) and jaw claudication.

Vascular lesions are SEGMENTAL so a negative biopsy does NOT exclude disease

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6
Q

What is at risk to be damaged if Giant Cell Arteritis is not treated?

A

Ophthalmic Nerve ischemic damage causing blindness

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7
Q

Takayasu Arteritis demographic

A

Young Asian females less than 50 years old

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8
Q

Takayasu Arteritis clinical symptoms

A

involves the aortic arch at branch points, leading to upper extremity absent pulses(opposite to coarctation of aorta). Presents with visual and neurological symptoms similar to giant cell arteritis

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9
Q

Polyarteritis Nodosa demographic

A

young adults

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10
Q

Polyarteritis Nodosa clinical symptoms? Classic finding? a/w?

A

Hypertension(renal artery involvement), abdominal pain with melena(mesenteric artery involvement), neurologic symptoms and skin lesions.

‘String of Pearls’ appearance on imaging

a/w HBsAg

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11
Q

Diseases associated with ‘String of pearls’

A

Polyarteritis Nodosa

Fibromuscular Dysplasia

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12
Q

Polyarteritis Nodosa treatment

A

cyclophosphamide and corticosteroids

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13
Q

Kawasaki Disease demographic

A

Asian children less than 4 years old

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14
Q

Kawasaki Disease presentation

A

non-specific similar to infection in beginning but coronary artery involvement common leading to infarction and/or aneurysm

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15
Q

Kawasaki Disease clinical signs

A

Rash on the palms of their hands and soles of their feet.
(think of a kid on a motorcycle)
Coronary artery involvement is common! YOUNG CHILD with a thrombosis and MI or ruptured aneurysm

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16
Q

Kawasaki Disease treatment

A

Aspirin – prevents platelet aggregation via COX inhibitors which block TXA2.

DESPITE possibility of Reye syndrome which could cause encephalopathy

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17
Q

Buerger Disease HY associations

A

SMOKING disease. Treatment is to STOP smoking.

presents with necrotizing vasculitis involving digits. Associated with Raynauds(white-blue-red). autoamputation of digits without treatment

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18
Q

Wegener’s Granulomatosis

A

Involves nasopharynx, lungs and kidneys.
c-ANCA positive
Treatment is Cyclophosphamide

Rapidly Progressive Glomerulonephritis

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19
Q

middle aged male with nasopharyngeal ulceration, lung infiltrates and hematuria

What likely renal problem arises?

A

Wegener’s Granulomatosis

Renal problem is Rapidly Progressive Glomerulonephritis

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20
Q

Compare Wegener’s to Microscopic Polyangiitis

A

Microscopic Polyangiitis involves lung and kidney but NOT oropharynx. Also expresses p-ANCA NOT c-ANCA. Will also NOT have granulomas

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21
Q

Compare Microscopic Polyangiitis to Churg-Strauss Syndrome

A

Churg-Strauss presents with Asthma, Granulomas and peripheral eosinophilia.

They BOTH have lung involvement, both express p-ANCA

22
Q

What drug treats vasculitis?

A

Cyclophosphamide

23
Q

Nephropathy following Upper Respiratory infection?

A

IgA nephropathy associated with Henoch-Schonlein Purpura

24
Q

Henoch-Schonlein Purpura demographic

A

most common vasculitis in children

25
Q

Henoch-Schonlein Purpura clinical signs

A

palpable purpura on buttocks and legs, GI pain and bleeding, IgA nephropathy.

26
Q

Important cause of stenosis in young females?

A

fibromuscular dysplasia(frequently involves renal artery)

27
Q

Arteriolosclerosis types…

A

Hyaline and hyperplastic type

Hyaline arteriolosclerosis caused by proteins leaking into vessel wall causing vascular thickening.

Hyperplastic arteriosclerosis caused by malignant hypertension

28
Q

Hyaline Arteriolosclerosis caused by…

A

Benign Hypertension and diabetes.
Hypertension forces protein into membrane.

Diabetes – non-enzymatic glycosylation of basement mebrane making them more leaky to proteins

29
Q

Hyaline Arteriolosclerosis classically causes…?

A

Glomerular Scarring(arteriolonephrosclerosis) This is what causes chronic renal failure in chronic hypertension/diabetes

30
Q

Hyperplastic arteriosclerosis caused by

A

malignant hypertension

31
Q

Hyperplastic arteriosclerosis leads to…

A

end organ ischemia due to reduced vessel caliber. FIBRINOID necrosis with possible hemorrhage. “onion skin” appearance

Classically causes acute renal failure with ‘flea bitten’ appearance

32
Q

‘flea bitten’ appearance of kidney

A

acute renal failure due to hyperplastic arteriolosclerosis in response to malignant hypertension

33
Q

Describe clinical syndromes that could predispose to aortic dissection

A

Marfan’s Syndrome(fibrillin defect) or Ehlers-Danlos Syndrome(collagen defect)

34
Q

Most common cause of death due to aortic dissection

A

pericardial tamponade

35
Q

Classically causes thoracic aneurysm

A

tertiary syphilis which causes endartertis of the vaso vasorum resulting in ‘tree barkin’ of the aorta

36
Q

Major complication of thoracic aneurysm

A

dilation of the aortic valve root, resulting in regurgitation

37
Q

Abdominal Aortic Aneurysm demographic

A

male smokers >60 with history of hypertension

etiology: Atherosclerosis increases the diffusion barrier to the media, resulting in atrophy and weakness of vessel wall

38
Q

Reddish growth that blanches on pressure

A

Hemangioma – will go away with growth of child

39
Q

Reddish rash that does not blanch on pressure

A

Kaposi’s Sarcoma

40
Q

Kaposi’s Sarcoma demographic

A

Older Eastern European males – tumor remains localized to skin

AIDS and Transplant patients – tumor spreads early

41
Q

Associated with exposure to PVC?

A

Liver angiosarcoma

also a/w arsenic and Thorotrast

42
Q

Liver angiosarcoma association?

A

Poly-vinyl Chloride

43
Q

high risk of blindness without treatment in this disorder. What treatment?

A

Giant Cell Temporal Arteritis

Prednisone, or other corticosteroid

44
Q

Weak or absent pulse in upper extremities

A

Takayasu’s Arteritis

45
Q

Takayasu involves which branches of vasculature?

A

Branch points of Aortic Arch

46
Q

Organ spared in PAN

A

lungs

47
Q

associated with HBsAg

A

PAN

48
Q

transmural inflammation with fibrinoid necrosis

A

PAN

49
Q

intimal fibrosis with _______ is what?

A

with giant cells is

Giant Cell Temporal Arteritis

50
Q

Which vasculitis is fatal if not treated

A

PAN - treat with cyclophosphamide and corticosteroids

51
Q

myocardial infarction in young asian child

treat with?

A

Kawasaki Disease - can also result in aortic aneurysms with rupture

aspirin and IVIG

52
Q

large necrotizing granulomas with adjacent necrotizing vasculitis

A

Wegeners

Pathoma (7 decks)

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