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pathophysiology > diseases of the arteries - Sheet1 > Flashcards

diseases of the arteries - Sheet1 Flashcards

1
Q

What is arteriosclerosis?

A

A chronic disease of the arterial system characterized by abnormal thickening and hardening of the blood vessel walls.

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2
Q

What is the mechanism of arteriosclerosis?

A

Damage to the tunica intima leads to migration of smooth muscle cells and collagen fibers into the intima, causing changes in lipid, cholesterol, and phospholipid metabolism, which results in the stiffening and thickening of arterial walls and narrowing of arteries.

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3
Q

What is atherosclerosis?

A

A form of arteriosclerosis where thickening and hardening of the arterial walls is caused by the accumulation of lipid-laden macrophages, forming lesions (plaque) along the artery walls.

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4
Q

What is the leading cause of coronary artery and cerebrovascular disease?

A

Atherosclerosis.

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5
Q

What are the manifestations of atherosclerosis?

A

Symptoms depend on the affected organ and are typically a result of inadequate perfusion of tissues.

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6
Q

What is hypertension (HTN)?

A

A consistent elevation of systemic arterial blood pressure, with a sustained elevation of 140 mmHg systolic or higher, OR 90 mmHg diastolic or higher.

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7
Q

What are the classifications of hypertension?

A

Primary (essential) hypertension and Secondary hypertension.

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8
Q

What complications can arise from hypertension?

A

Myocardial infarction (MI), kidney disease, stroke, headaches, blindness.

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9
Q

Why is hypertension called the “silent killer”?

A

It often has no symptoms in the early stages, but overtime, it can damage blood vessels and organs without being noticed.

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10
Q

What are the risk factors for hypertension?

A

Family history, advancing age, gender (female >70, male <55), Black race, sodium intake, alcohol use, obesity, smoking.

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11
Q

What is the mechanism of hypertension?

A

Caused by increases in cardiac output or total peripheral resistance, or both. Cardiac output increases due to conditions affecting heart rate or stroke volume. Peripheral resistance increases due to factors that increase blood viscosity or reduce vessel diameter (vasoconstriction).

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12
Q

What is primary hypertension?

A

It is caused by complicated interactions between genetics, environment, and neurohumoral effects. It involves overactivity of the sympathetic nervous system, the renin-angiotensin-aldosterone system (RAAS), and alterations in natriuretic peptides.

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13
Q

What is secondary hypertension?

A

It is caused by systemic diseases that raise peripheral vascular resistance and/or cardiac output.

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14
Q

What is malignant hypertension (hypertensive crisis)?

A

A rapidly progressive form of hypertension where diastolic pressure exceeds 140 mmHg, leading to serious complications like encephalopathy, heart attacks, and stroke.

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15
Q

What are the early manifestations of hypertension?

A

Often no clinical manifestations in the early stages, just elevated blood pressure. Later stages include severe headaches, vision changes, organ failure, and angina pectoris.

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16
Q

How is hypertension diagnosed?

A

By measuring blood pressure on at least two separate occasions, averaging two readings at least 2 minutes apart, with the patient seated, arm supported at heart level, and after 5 minutes of rest, with no smoking or caffeine intake in the past 30 minutes.

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17
Q

What is orthostatic hypotension?

A

A decrease in systolic and diastolic blood pressure by 20 mmHg or more (SBP) and 10 mmHg or more (DBP) upon standing.

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18
Q

What causes orthostatic hypotension?

A

It is caused by reduced venous return and/or inadequate sympathetic adrenergic vasoconstriction, leading to excessive fall in cardiac output.

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19
Q

What are the types of orthostatic hypotension?

A

Primary (e.g., postural orthostatic tachycardia syndrome, POTS) and secondary (e.g., due to volume depletion or cardiac valvular diseases).

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20
Q

What are the manifestations of orthostatic hypotension?

A

Lightheadedness, dizziness, blurry vision, and/or syncope upon standing.

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21
Q

How is orthostatic hypotension diagnosed?

A

Through history and physical examination, and by measuring orthostatic vital signs (blood pressure and heart rate before and after standing).

22
Q

What is an aneurysm?

A

A local dilation or outpouching of a vessel wall or cardiac chamber.

23
Q

What are the most common causes of aneurysms?

A

Atherosclerosis, hypertension, and collagen and elastin disorders affecting artery strength.

24
Q

How do aneurysms form?

A

Over time, damage weakens the arterial walls, causing them to bulge with systole.

25
Q

What are the types of aneurysms?

A

True aneurysms (involve all three layers of the arterial wall) and False aneurysms (extravascular hematoma communicates with the intravascular space).

26
Q

What are common manifestations of aneurysms?

A

Often found incidentally before rupture. When they rupture, they can cause severe symptoms.

27
Q

What are symptoms of a thoracic aneurysm?

A

Dysphagia and dyspnea due to pressure on surrounding organs.

28
Q

What are symptoms of an abdominal aneurysm?

A

Can impair blood flow to extremities, causing ischemia.

29
Q

What are symptoms of a cerebral aneurysm?

A

Can cause stroke-like symptoms.

30
Q

How are aneurysms diagnosed?

A

Through history and physical examination, ultrasound, CT, MRI, or angiography.

31
Q

What is a major complication of an aneurysm?

A

Aortic dissection, a surgical emergency where the aorta (ascending, arch, or descending) ruptures, disrupting arterial flow.

32
Q

What is an arterial thrombus?

A

A blood clot that remains attached to a vessel wall.

33
Q

How does an arterial thrombus form?

A

Damage to the tunica intima by atherosclerosis causes plaque rupture, activating coagulation and forming a clot around the ruptured plaque cap.

34
Q

What are the complications of an arterial thrombus?

A
  1. The thrombus can occlude the artery, causing ischemia. 2. The clot can detach and become a thromboembolism, traveling to block other vessels.
35
Q

What is an embolism?

A

A bolus of matter (such as a clot, air, or fat) that circulates in the bloodstream and obstructs blood flow, causing ischemia or infarction of distal tissue.

36
Q

Where do most arterial emboli originate?

A

Many originate in the heart due to endocarditis or dysrhythmias (especially atrial fibrillation).

37
Q

What are potential complications of a cardiac embolism?

A

Occlusion of coronary arteries (leading to myocardial infarction) or cerebral arteries (leading to stroke).

38
Q

What are the types of embolisms?

A
  1. Thromboembolism 2. Air embolism 3. Amniotic fluid embolism 4. Bacterial embolism 5. Fat embolism 6. Foreign matter embolism
39
Q

What is peripheral artery disease (PAD)?

A

Atherosclerotic disease of arteries that supply blood to the limbs, especially the lower extremities.

40
Q

What are the risk factors for PAD?

A

Diabetes, hypertension, smoking, and dyslipidemia.

41
Q

How does PAD develop?

A

Narrowing of the iliofemoral arteries leads to diminished blood flow to the lower extremities, causing tissue hypoxia and necrosis.

42
Q

What are the manifestations of PAD?

A

Intermittent claudication (pain with ambulation), loss of pulses, and skin color changes in the affected extremities.

43
Q

How is PAD diagnosed?

A

Through history and physical examination, duplex doppler scan, or angiogram.

44
Q

What is Buerger disease?

A

Thromboangiitis obliterans, an inflammatory disease of small and medium-sized peripheral arteries that causes thrombi formation and vasospasms, leading to occlusion of blood flow.

45
Q

What arteries are affected in Buerger disease?

A

Digital, tibial, plantar, ulnar, and palmar arteries.

46
Q

What are the risk factors for Buerger disease?

A

Heavy smoking and being a young male.

47
Q

What are the manifestations of Buerger disease?

A

Pain and tenderness in the hands and feet, redness of the skin, cyanosis, thinning and mottling of skin due to chronic hypoxia.

48
Q

How is Buerger disease diagnosed?

A

History and physical examination, duplex doppler scan, and angiogram.

49
Q

What is Raynaud’s disease?

A

Episodic vasospasm of the arterioles in the fingers (and less commonly toes) of unknown origin, primarily affecting young women, triggered by cold or emotional stress.

50
Q

What is Raynaud phenomenon?

A

Vasospasm of arterioles in the fingers and toes secondary to systemic diseases (like scleroderma), malignancy, or long-term cold/vibration exposure.

51
Q

What are the manifestations of Raynaud’s disease?

A

Changes in skin color of digits, often affecting different fingers, and paresthesias.

52
Q

How is Raynaud’s disease diagnosed?

A

History and physical examination, and blood tests to evaluate for systemic diseases.

pathophysiology (56 decks)

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