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GM Systems Path > Chapter 9 > Flashcards

Chapter 9 Flashcards

1
Q

What are the 2 categories of vascular disease

A
  1. Narrowing/obstruction

2. Damaged vessel wall

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2
Q

What are some types of narrowing/obstructing vascular diseases

A
  • atherosclerosis=gradual

- thromboembolism=rapid

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3
Q

What are some types of vascular diseases involving damaged vessel wall

A
  • dilation=aneurysm

- rupture=dissection

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4
Q

List the layers of vascular structures

A
  1. Intima: endothelia cells (internal elastic lamina)
  2. Media: smooth muscles (external elastic lamina)
  3. Adventitia: CT, nerves, vessels
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5
Q

How does the interior and exterior of a blood vessel produce blood supply

A
  • interior=diffusion

- exterior=vasa vasorum

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6
Q

What produce vascular resistance

A

Arterioles

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7
Q

Where is the site for edema and WBC diapedesis

A

Post-capillary venules

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8
Q

What are functions of endothelial cells

A
  • regulate clots
  • vasoreactivity
  • regulates smooth muscle cell growth
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9
Q

What produces endothelial activation

A

Trauma causing pro-inflammatory effects

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10
Q

What is a berry aneurysm

A

Subarachnoid hemorrhage

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11
Q

What is it called when an artery inappropriately connects to a vein

A

Arteriovenous (AV) fistula

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12
Q

What is fibromuscular dysplasia

A

Local thickening of an arterial wall producing ischemia (renovascular HTN associated with this)

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13
Q

What are the numbers for hypotension and what happens

A

<90/60, decreased perfusion

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14
Q

What are the numbers for hypertension and what happens

A

Greater than or equal to 130/80, damages vessels/organs

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15
Q

What regulated blood pressure

A

Cardiac output and peripheral vascular resistance

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16
Q

In the heart and kidneys what is involved with vascular tone/blood volume in peripheral vascular resistance

A
  • Heart: atrial natriuretic peptide (ANP)

- kidney: renin-angiotensin-aldosterone system

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17
Q

What happens in blood pressure regulation in increased BP

A

Stretch and ANP is released producing diuresis ad vasodilation

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18
Q

What happens in blood pressure regulation when there is a decreased BP

A

The renin angiotensin system is activated producing sodium resorption and vasoconstriction

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19
Q

What medications impact blood pressure regulation

A

ACE inhibitors, angiotensin 2 receptor blockers, diuretics

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20
Q

What are the categories and their numbers for blood pressure

A
  • normal = <120, <80
  • elevated = 120-129, <80
  • HTN 1 = 130-139, 80-89
  • HTN 2 = 140+/90+
  • hypertensive crisis = >180,>120
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21
Q

What happens in HTN vascular disease without treatment

A
  • 50% die of ischemic HA

- another 1/3 die of stroke

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22
Q

What happens to vascular system in HTN

A

Bp >140/90

Damages vessels and organs

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23
Q

What happens in HTN

A

Increased vascular resistance, decreased sodium excretion

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24
Q

What are factors influencing HTN

A

Age, stress, obesity, smoking, inactivity, increased salt intake, genetics (African Americans)

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25
Q

What is essential HTN and malignant HTN

A
  • Essential HTN = about 90% of all HTN

- Malignant HTN = >180/120 (lethal, <5% cases)

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26
Q

What is a common identifier of malignant HTN

A

Papilledema, a retinal hemorrhage

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27
Q

What happens to endothelial in response to injury

A

Irreversible intimal thickening which produces stenosis creating tissue ischemia

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28
Q

What is arteriolosclerosis

A
  • ischemic injury
  • affects small arteries (arterioles)
  • chronic HTN or diabetes
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29
Q

What is it called when the is Ca++ into the media, with no stenosis

A

Monckeberg Medial Sclerosis

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30
Q

What happens in atherosclerosis

A
  • atheromas(plaques)
  • stenosis, aneurysm, dissection, thrombus
  • heart (CAD), brain, kidneys, GI
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31
Q

What happens if atherosclerosis ruptures

A

Thrombosis = macrophages + lipids(foam cells), debris which is MC cause of MI

32
Q

What are foam cells

A

Fat laden macrophages

33
Q

What produces 70% occlusion of coronary arteries in CAD

A

Artheromatous plaque

34
Q

What is hemodynamic stress

A

Branch points or areas of turbulence

35
Q

What happens when atherosclerosis weakens walls and what happens when it ruptures

A

Aneurysm and thromboembolism

36
Q

What are the 3 major MI risk factors

A

Hyperlipidemia, HTN, smoking, any 2 risk increases 4x, any 3 risk increases 7x

37
Q

What is metabolic syndrome

A

When you have any 3 of these 5 things: central obesity, HTN, insulin resistance, dyslipedemia

38
Q

What is the difference between a true aneurysm and a false aneurysm

A

True is all 3 layers, false is defect in the inner wall causing extravascular hematoma

39
Q

What happens in abdominal aortic aneurysm

A

The aorta is dilated by >50%. AAA is about 5cm normal is about 3cm

40
Q

Who is more likely to get an AAA

A

Males, >50, smokers, caucasian, family history of HTN, atherosclerosis found by ultrasound

41
Q

What are the chances of rupture for an AAA

A

4-5cm = 1% per year
>6cm = 25% per year
If ruptured 50% are fatal, decreasing by 5% during surgery

42
Q

Who is most likely to have an aortic dissection

A

Males 40-60 years old

43
Q

Early onset of aortic dissection is indicative of what

A

Marfans syndrome, ehlers danlos, wilson disease

44
Q

Where does an aortic dissection project

A

May project posteriorly b/w scapulae

45
Q

What describes an aortic dissection

A

Sudden severe tearing or stabbing

46
Q

What are the two types of aortic dissections

A

Type A = proximal

Type B = distal

47
Q

What is vessel wall inflammation

A

Vasculitis

48
Q

What type of hypersensitivity is vasculitis

A

Type 3 immune mediated

49
Q

What causes vasculitis

A

ADR’s (penicillin), irradiation, trauma

50
Q

What is another name for temporal arteritis

A

Giant cell arteritis

51
Q

What does temporal arteritis affect

A

50% of time ophthalmic artery

52
Q

Who is effected by temporal arteritis

A

Elderly >50

53
Q

What indicates temporal arteritis

A

Facial pain, HA, diplopia/sudden blindness, fever

54
Q

What is polyarteritis nodosa

A

Autoimmune vasculitis affecting systemic, small/medium sized arteries

55
Q

What is not affected by polyarteritis nodosa

A

Pulmonary arteries

56
Q

What does polyarteritis nodosa produce and what are the symptoms

A

Ischemia/infarction; weight loss, fatigue, fever, malaise

57
Q

Who is affected by polyarteritis nodosa

A

MC in young adults, 2/3 are idiopathic/autoimmune

58
Q

What happens to the kidney and GI tract from polyarteritis nodosa

A

Sudden HTN (renovascular) and in GI abdominal pain and bloody stools

59
Q

What is a symptom on the skin caused by polyarteritis nodosa

A

Widespread vascular lesions

60
Q

What is kawasaki disease and who does it affect

A

Pediatric vasculitis and 80% are less than 4 years old

61
Q

What are people with kawasaki’s disease at risk for?

A

Lethal MI (aneurysm or thrombi)

62
Q

What causes kawasaki disease

A

It is rare and idiopathic mostly caused by genetics and viral antigens

63
Q

What are indicators of kawasaki’s disease

A

Conjunctivitis, swollen extremities, desquamation, cervical lymphadenopathy

64
Q

What symptom of the tongue is indicative of kawasaki disease

A

Oral erythema or “strawberry tongue”

65
Q

What is reye syndrome

A

Damage to liver and brain by combination of aspirin and viral infection

66
Q

What happens in reye syndrome

A

Encephalopathy and hepatic steatosis

67
Q

What is a necrotizing vasculitis of kidneys and respiratory tract

A

Wegener granulomatosis

68
Q

What type of hypersensitivity is wegener granulomatosis

A

Type 4 treated with immunosuppression

69
Q

What are symptoms of wegener granulomatosis

A

Pneumonitis, sinusitis, kidney damage, nasopharyngeal inflammation/ulcers

70
Q

What is another name for buerger disease

A

Thromboangiitis obliterans

71
Q

Who is most affected by buerger disease

A

Tobacco smokers, males(3x), 25-35 years old show signs of vasculitis in hands and feet

72
Q

What is raynaud phenomenon

A

Exaggerated arteriole vasoconstriction showing as pallor and cyanosis

73
Q

What is primary raynaud phenomenon

A

Idiopathic, cold or strong emotions

74
Q

What is secondary raynaud phenomenon

A

Atherosclerosis, SLE, buerger disease, or systemic sclerosis

75
Q

Who is more likely to experience raynaud phenomenon

A

Onset during adolescent or young adult MC in females

GM Systems Path (4 decks)

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