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Systems Pathology Exam Two > Chapter 9 - Blood Vessels Pt. 2 > Flashcards

Chapter 9 - Blood Vessels Pt. 2 Flashcards

1
Q

What causes giant cell arteritis?

A

Idiopathic but T cell activity and autoimmune hypothesis

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2
Q

Giant cell arteritis involves what arteries?

A

Large and small arteries of the head (patchy involvement)

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3
Q

What artery is most commonly affected during giant cell arteritis (50% of cases)?

A

Ophthalmic artery

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4
Q

What are signs of ophthalmic artery involvement in giant cell arteritis?

A

Diplopia and/or sudden blindness

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5
Q

What is usually the quick treatment for giant cell arteritis?

A

Corticosteroids (especially to prevent blindness)

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6
Q

What kind of inflammation is present in giant cell arteritis?

A

Granulomatous

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7
Q

What is also known as the “pulseless disease”?

A

Takayasu arteritis

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8
Q

What form of arteritis is exclusively seen in the aortic arch and its branches?

A

Takayasu

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9
Q

Takayasu arteritis produces what kind of inflammation?

A

Granulomatous

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10
Q

What causes the loss or minimized pulse of Takayasu arteritis?

A

Narrowing of the lumen of branches off of the aortic arch

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11
Q

What arteries are affected by Takayasu arteritis?

A

Radial, carotid, renal, pulmonary

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12
Q

Takayasu arteritis is most common among what population?

A

Younger individuals

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13
Q

What are some results of Takayasu arteritis?

A

Various neurological defects and possibly visual disturbances

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14
Q

What kind of necrosis is seen with polyarteritis nodosa?

A

Transmural necrosis

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15
Q

What is polyarteritis nodosa?

A

System wide vasculitis of small and medium sized arteries

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16
Q

What can happen with polyarteritis nodosa?

A

Tissue atrophy, ischemia, infarction

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17
Q

Polyarteritis nodosa affects what tissues?

A

Kidneys, viscera, heart, liver, GI tract

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18
Q

What arteries are avoided by polyarteritis nodosa?

A

Pulmonary

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19
Q

Polyarteritis nodosa is most common among what population?

A

Young adults

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20
Q

What chronic infection is seen among 1/3 of polyarteritis nodosa cases?

A

Hepatitis B

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21
Q

Around what fraction of polyarteritis nodosa cases are said to be autoimmune or idiopathic in nature?

A

2/3

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22
Q

What is seen with polyarteritis nodosa of the renal artery?

A

Rapidly increasing blood pressure (renovascular hypertension)

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23
Q

What is seen with polyarteritis nodosa of the GI arteries?

A

Abdominal pain, blood stools

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24
Q

What is the treatment for polyarteritis nodosa?

A

Corticosteroids

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25
Q

What happens if polyarteritis nodosa is left untreated?

A

Fatal

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26
Q

What can be one of the first visual indications of polyarteritis nodosa?

A

Widespread vascular lesions

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27
Q

Segmental fibrinoid necrosis and thrombosis is seen among what widespread vascular condition?

A

Polyarteritis nodosa

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28
Q

The “rosary sign” is seen among what vascular condition?

A

Polyarteritis nodosa

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29
Q

Kawasaki disease primarily affects what population?

A

Pediatrics (80% under 4 years)

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30
Q

If a child has a heart attack, it is usually because of what condition?

A

Kawasaki disease

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31
Q

What is the fatality rate of Kawasaki related heart attacks in children?

A

Only 1%

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32
Q

How does CAD influence the prognosis of Kawasaki disease?

A

Patients without CAD recover fully

Severity of CAD determines prognosis

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33
Q

What is the cause of Kawasaki disease?

A

Idiopathic but suggestive of type IV hypersensitivity and possibly viral antigens, genetics

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34
Q

What gender and race are more likely to get Kawasaki disease?

A

Asian descent and males

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35
Q

What is unique about the fever associated with Kawasaki disease?

A

Unresponsive to ibuprofen or acetaminophen

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36
Q

What is the hallmark sign of Kawasaki disease?

A

Acute/persistent fever

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37
Q

What are the unique signs of the skin and tongue seen with Kawasaki disease?

A

Desquamation of extremities, strawberry tongue (oral erythema)

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38
Q

What type of hypersensitivity is seen with Wegener granulomatosis?

A

Type II

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39
Q

Wegener granulomatosis is seen in what locations?

A

Kidneys and upper/lower respiratory tracts

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40
Q

What is seen with Wegener granulomatosis?

A

Granulomas, systemic vasculitis of small/medium arteries, glomerulonephritis

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41
Q

What population is more likely to be affected by Wegener granulomatosis?

A

Middle aged (40 years old), males

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42
Q

What is the treatment for Wegener granulomatosis?

A

Immunosuppression

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43
Q

What lung condition is seen in 95% of cases of Wegener granulomatosis?

A

Bilateral pneumonitis

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44
Q

How are the kidneys affected by Wegener granulomatosis?

A

Hematuria, proteinuria, possible renal failure

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45
Q

How is the nasopharyngeal area affected by Wegener granulomatosis?

A

Rhinitis, sinusitis, nose bleeds

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46
Q

What is another name for Buerger disease?

A

Thromboangiitis obliterans

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47
Q

What group of people are at risk for thromboangiitis obliterans?

A

Heavy tobacco smokers

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48
Q

Vascular insufficiency of what arteries and locations is seen with thromboangiitis obliterans?

A

Radial and tibial arteries, leading to cold feet and hands

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49
Q

What gender and age group are more at risk for thromboangiitis obliterans?

A

Males ages 25-35 years

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50
Q

What can result from the cold feet and hands due to ischemia seen with thromboangiitis obliterans?

A

Ulcerations, gangrene

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51
Q

What is unique about the pain felt with thromboangiitis obliterans?

A

Seen at rest

52
Q

Raynaud phenomenon is possible with what vascular condition?

A

Thromboangiitis obliterans

53
Q

Temporal region involvement is seen with what vascular condition?

A

Giant cell arteritis

54
Q

What is the most common vasculitis in older adults?

A

Giant cell arteritis (temporal arteritis)

55
Q

What kind of condition is Raynaud phenomenon?

A

Exaggerated arteriole vasoconstriction

56
Q

What body parts are affected by Raynaud phenomenon?

A

Most commonly the fingers but also toes, nose, earlobes, lips

57
Q

In chronic conditions, what can result from Raynaud phenomenon?

A

Atrophy of skin, connective tissue, and/or muscles

58
Q

Who is more at risk for Raynaud phenomenon?

A

Adolescent/young adults, most commonly females

59
Q

What are traditional triggers for primary Raynaud phenomenon?

A

Cold and emotional triggers (5% of the U.S.)

60
Q

Raynaud phenomenon can be secondary to what other conditions?

A

Atherosclerosis, Buerger disease, Lupus, scleroderma

61
Q

What condition is also known as “broken heart syndrome”, stress cardiomyopathy, or “cardiac Raynaud”?

A

Takotsubo cardiomyopathy

62
Q

What is the location of exaggerated vasoconstriction of Takotsubo cardiomyopathy?

A

Coronary arteries

63
Q

What is usually the cause of broken heart syndrome?

A

Psychological stress

64
Q

What kinds of hormones are produced more heavily with cardiac Raynaud?

A

Catecholamine (stress hormones)

65
Q

What occurs with Takotsubo cardiomyopathy?

A

Vasospasm, increased heart rate and contractility, fatal arrhythmia (ventricular fibrillation), possible ischemia and heart attack in severe cases

66
Q

What is the term for venous inflammation?

A

Phlebitis

67
Q

90% of venous disease fall into what three categories?

A

Varicose veins, phlebothrombosis, thrombophlebitis

68
Q

What is phlebothrombosis?

A

Venous thrombosis without previous inflammation

69
Q

What is thrombophlebitis?

A

Venous thrombosis following inflammation

70
Q

What is the most common location of varicose veins?

A

Legs (lower extremities)

71
Q

What are varicose veins?

A

Torturous dilation of superficial veins

72
Q

What is the cause of varicose veins?

A

Increase in intraluminal pressure leading to dilation and then incompetent valves

73
Q

What are the risks for varicose veins?

A

Obesity, genetics, pregnancy

74
Q

What is the frequency per gender for varicose veins?

A

1/3 females, 1/5 males

75
Q

Varicose veins is most commonly presenting what kind of concern?

A

Cosmetic (rarely pathological)

76
Q

What is a risk factor for thrombophlebitis?

A

Immobilization (examples: recent surgery, pregnancy, obsesity), congestive heart failure, genetics, any pro-thrombotic medication, oral contraceptive

77
Q

What condition is involved with 90% of all thrombophlebitis cases?

A

Deep vein thrombosis

78
Q

What could be the first indication of thrombophlebitis?

A

Pulmonary embolism

79
Q

What test can be used to diagnosis thrombophlebitis?

A

Dorsiflexion of the foot (Homan sign)

80
Q

What is important to note with the Homan sign?

A

Could produce clot or embolism (only about 50% sensitive to thrombophlebitis)

81
Q

What are signs of superior vena cava syndrome?

A

Congested upper extremity veins, edema in head, neck, and arms

82
Q

What conditions are associated with superior vena cava syndrome?

A

Bronchogenic carcinoma, mediastinal lymphoma

83
Q

What conditions are associated with inferior vena cava syndrome?

A

Hepatocellular carcinoma, renal cell carcinoma

84
Q

What are some signs of inferior vena cava syndrome?

A

Congestion of lower extremity veins, edema, proteinuria

85
Q

Which form of lymphedema is congenital?

A

Primary

86
Q

What is another name for congenital lymphedema?

A

Milroy disease

87
Q

What can cause secondary lymphedema?

A

Neoplasia, infection (filariasis), thrombosis, fibrosis (surgery)

88
Q

What appearance of the skin is associated with acute lymphedema?

A

Peau d’orange

89
Q

What skin appearance is seen with chronic lymphedema?

A

Brawny induration (hardening of the skin)

90
Q

What pattern is seen with lymphangitis?

A

Inflammation following the course of the lymphatic channel externally seen on the skin

91
Q

What type of infection may be allowed with lymphangitis?

A

Bacterial infection (sepsis)

92
Q

Vascular tumors originate from what cells or tissues?

A

Endothelial cells, connective tissue or vessels

93
Q

Most vascular diseases involve what vascular structures?

A

Arteries

94
Q

What is the term for when there is passage of blood through layers of a vascular wall?

A

Dissection

95
Q

Which have thicker walls: arteries or veins?

A

Arteries (therefore increased blood pressure and pulsations)

96
Q

What makes up the tunica intima?

A

Endothelial cells

97
Q

What makes up the tunica media?

A

Smooth muscle

98
Q

What makes up the tunica adventitia?

A

Connective tissue, nerves, vessels

99
Q

How is the blood supply to the interior of a blood vessel wall given?

A

Diffusion of blood from lumen (tunica intima and inner portion of the tunica media)

100
Q

How is the blood supply to the exterior of a blood vessel wall given?

A

Vasa vasorum (outer tunica media and tunica adventitia)

101
Q

What is the order from smallest to largest of artery-based vessels?

A

Capillary beds, arterioles, small arteries, medium-sized muscular arteries, large elastic arteries

102
Q

What is the order from the smallest to largest of vein-based vessels?

A

Capillary beds, postcapillary venules, collecting venules, progressively larger veins

103
Q

Activation of what part of the vascular vessel wall via vascular lesions or thrombosis is pro-inflammatory?

A

Endothelial lining

104
Q

What is the function of the endothelial cells?

A

Regulate vasoreactivity by NO & endothelin

Regulate cell growth

105
Q

When are vascular anomalies relevant?

A

During surgery

106
Q

What is a Berry aneurysm?

A

Dilation of cerebral vessels that rupture and lead to subarachnoid hemorrhage

107
Q

What is an arteriovenous (AV) fistula?

A

Connection of arterial and venous systems that bypass capillaries

108
Q

What is fibromuscular dysplasia?

A

Local thickening of medium/large artery walls that leads to ischemia (non-atherosclerotic and non-inflammatory)

109
Q

Fibromuscular dysplasia is more common with what gender?

A

Females

110
Q

What level of blood pressure is characteristic of hypotension?

A

Below 90/60

111
Q

What level of blood pressure is characteristic of hypertension?

A

> 140/80

112
Q

What does blood pressure regulate?

A 
Cardiac output (heart rate + stroke volume)
Vascular resistance
113
Q

Sodium and the renin-angiotensin system help regulate vascular tone and blood volume in what organs?

A

Kidneys

114
Q

Aldosterone helps regulate blood volume and vascular tone in what area?

A

Adrenals

115
Q

Atrial natriuretic peptide (ANP) helps regulate vascular tone and blood volume in what organ?

A

Heart

116
Q

How does atrial natriuretic affect the heart and blood pressure?

A

Stretches heart and decreases blood pressure (reduced sodium resorption)

117
Q

Is ANP a vasodilator or vasoconstrictor?

A

Vasodilator

118
Q

How does the renin-angiotensin system affect blood pressure?

A

Increases it (sodium resorption and blood volume increased)

119
Q

Does the renin-angiotensin system act as a vasodilator or vasoconstrictor?

A

Vasoconstrictor

120
Q

The kidney can produce what substances that initiate vasodilation and decrease blood pressure?

A

Prostaglandins and NO

121
Q

What blood pressure level is indicative of malignant hypertension and is a hypertensive emergency?

A

Systolic over 200 or diastolic over 120

122
Q

What are general treatment recommendations for hypertension?

A

Healthier diet, quit smoking, exercise, medication

123
Q

Without treatment, 50% of those with hypertension will die from what complication?

A

Ischemic heart disease (myocardial infection)

124
Q

Without treatment, 1/3 of those with hypertension will die from what complication?

A

Stroke

125
Q

What percentage of US adults have hypertension?

A

25%

126
Q

Why is hypertension called the “silent killer”?

A

Asymptomatic until almost deadly

Systems Pathology Exam Two (6 decks)

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