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Systemic pathology > Disorder of blood vessels > Flashcards

Disorder of blood vessels Flashcards

0
Q

Atherosclerosis 3 types

A

Coronary artery disease
Peripheral vascular disease - arteries supplying the extremities and organs
Cerebrovascular disease - arteries supply the brain

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1
Q

Arteriosclerosis (3 types)

A
  1. Atherosclerosis - fatty deposit in inner layer (tunica intima). MOST COMMON
  2. Monckeberg’s arteriosclerosis - middle layer (tunica media) of arteries with destruction of mm and elastic fibers, formation of calcium deposit. “SENILE”
  3. arteriolosclerosis (arteriolar sclerosis) - Thickening of the walls of small arteries (arterioles). HYPERTENSION RELATED. Doesn’t involve atheromas (depositing of plaque)
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2
Q

Atherosclerosis clinical manifestation

A

Asymptomatic
Ischemia
Infarct

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3
Q

Atherosclerosis risk factors

A 
High LDL
High BP
Smoking 
Diabetes
Obesity
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4
Q

Peripheral vascular/arterial disease (PVD/PAD)

A 
Any disease of the circulating system outside of heart and brain
LE>UE
Most common atherosclerosis
Intermittent claudication, cyanosis, 
Men>Women
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5
Q

Vasculitis 3 types

A

Arteritis - inflammation of arteries
Infective arteries - inflammation of an artery due to infection
Rheumatoid arteries - inflammation of an artery associated with RHD (Rheumatoid heart disease)

Rheuma - move, flow, pain moves around

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6
Q

Most common vasculitis

A

Giant cell arteritis (GCA) Cranial or temporal arteritis, multiple sites of temporal and cranial arteries affected
Female>male>age 50

Menopause, smoking heart murmurs, Idiopathic

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7
Q

Which vasculitis mimic migrane

A

Giant cell arteritis (severe, continuous, unilateral throbbing HA)
Visual disturbance, enlarged temporal artery, scalp sensitivity respiratory tract problem
Onset is usually sudden

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8
Q

Where does Giant cell arteritis pain radiate?

A

Radiated pain to Occipital area, face, side of neck.

Pain/paralysis of shoulder, claudication of arm and jaw,

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9
Q

Which vasculitis loses radial pulse

A

Giant cell arteritis

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10
Q

Which vasculitis loses tibial and dorsal pedis pulse

A

Thromboangiitis obliterans

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11
Q

What is Thromboangiitis obliterans

A

AKA Burger’s disease
Producing obstruction due to inflammation and fibrosis, peripheral blood vessels, primarily in extremities (hands and feet)
Idiopathic, episodic, move around, intermittent claudication

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12
Q

What is the first sign of Thromboangiitis obliterans

A

Intermittent claudication of center of arch of foot, palm of hand

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13
Q

Sign and Symptoms of Thromboangiitis obliterans

A

Edema, rubor (redness of the skin from dilated capillaries under the skin), cyanosis, thin shiny hairless skin,
Inflammation of superficial thrombophelebitis is common

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14
Q

Who gets Thromboangiitis obliterans

A

men Heavy smokers

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15
Q

Which vasculitis associated with Hepatitis B

A

Polyarteritis nodusa often invovle kidneys, heart, liver, GI tracts, muscles testes

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16
Q

Who gets Polyarteritis nodusa

A

Common among IV drug abusers - sensitivity III

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17
Q

What does Giant cell arthritis lead to

A

Blindness, stroke, heart attack, aortic dissection (type of aneurysm blood flows between layers (media, interna)

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18
Q

What does Thromboangiitis obliterans lead to

A

Inflammation superficial thrombophelebitis si common as is ulceration, amputation
Can result in progressive disability from pain and loss of function

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19
Q

what does Polyarteritis nodusa lead to

A

Pericarditis, myocarditis, arrhythmias, MI, aneurysm, hemorrhage, thrombosis, fibrosis
Prognosis poor without treatment, excellent with treatment
Treatment meds (corticosteroids, immunosuppressants)

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20
Q

What is aneurysm

A

An abnormal stretching (dilation or dilitation) in the wall of an artery, a vein or the heart with a diameter that is at least 50% greater than normal

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21
Q

3 types of Aneurysm

A

Aortic: MOST COMMON for an arterial aneurysm
(Thoracic - ascending, transverse or first part of descending portion of the aorta)
Mycotic: caused by bacterial or fungal infection. Salmonella and syphilis most common
Atherosclerotic: Due to the build up of fatty deposits on the inner wall of the arteries

22
Q

Aneurysm etiology

A 
age >50
Atherosclerosis
Congenital connective tissue weakness such as marfan
Genetics
Trauma to the vessels
Inflammatory disease
infections
23
Q

3 types of aneurysm formation

A

saccular, fusiform, raputered

24
Q

Pathogenesis of aneurysm

A

Plaque formation - erosion of vessel wall - stretching of the inner and outer layer of the artery -formation of a sac- become more fibrotic-force of blood pressure can tear or rupture

25
Q

Clinical manifestation of aneurysm

A 
Asymptomatic, 
Distended neck veins 
MI
Stroke (hemorrhagic stroke)
Renal failure, 
paraplegia (impairment in motor or sensory function of the LE) , etc
26
Q

Disorders of the small vessels (4 types)

A

Telangiectasia
Frostbite
Diabetic microangiopathy (3 types)
Decompression sickness (2 types)

27
Q

What is telangiectasia

A

AKA spider veins
Vascular lesion formed by dilatation of a group of small blood vessels
May appear as a birth mark in young children
maybe associate with long term sun exposure, standing, age, varicose veins, gender, pregnancy, trauma, steroid teratment

28
Q

Where is telangiectasia most commonly seen?

A

Face and thighs

29
Q

What is frost bites

A

localized medical condition whereby damage is caused to skin and other tissue due to extreme cold

30
Q

Frost bite two classification

A

Superficial frostbite -affects skin and subcutaneous tissue

Deep frostbite - extends beyond the superficial tissue white skin, pain blisters, tissue necrosis, gangrene

31
Q

What is Diabetic microangiopathy

A

poorly controlled hyperglycemia leads to vascular complications that affect small (microvascular) vessels, large vessels or both

32
Q

Diabetic microangiopathy 3 types

A

Diabetic retinopathy: MOST COMMON cause of ADULT BLINDNESS, characterized by retinal capillary microaneurysm
Diabetic neuropathy: nerve ischemia from microvascular disease, direct effects of hyperglycemia on neurons, and intracelluar metabolic changes that impair nerve function
Diabetic nephropathy: glomerular (part of kidney)sclerosis and fibrosis caused by metabolic and hemodynamic changes of DM. #1 cause of RENAL FAILURE

33
Q

Diabetic Microangiopathy MOI

A

Glycosylation of serum and tissue protein
Superoxide production
activation of signaling molecules that increases vascular permeability and cause endothelial dysfunction
Hypertension and dyslipidemias
arterial microthromboses
Profinflammatory and prothrombotic effect of hyper glycemia and hyperinsulinemia that impair vascular autoregulation

34
Q

What is decompression sickness

A

The bends, divers disease
Rapid pressure reduction causes gas previously dissolved in blood or tissues to form bubbles in blood vessles
N2 dissolves in fat, tissues with a high lipid content (e.g. CNS) are particularly susceptible.

35
Q

Henry’s law

A

Amount of gas solved in a liquid is proportional to the pressure exerted on the gas and liquid

36
Q

Type I and Type II Decompression sickness

A

Type I - progressively worsening pain in the joints and muscles. Pain intensifies during movements. Lymphadenopathy, skin mottling, itching

Type II-neurologic/respiratory, paresis, numbness, tingling, difficult urinate, Headache, dizziness, seizure, massive pulmonary embolism can result in circulatory collapse and death

37
Q

What is Varicose vein

A

AKA varicosities
Abnormal dilation of veins leading tortuosity (twist and turn) of the vessel, incompetence of the valves, and a propensity to thrombosis

38
Q

Who gets varicose vein

A

Women>men till 70 years old

70 % of women ages 60-70 have varicose vein.

39
Q

Where is the common site for varicose vein?

A

LE, saphenous vein, rectum and anal canal (hemorrhoids), Variocele (scrotum), esophagus

40
Q

What does varicose vein lead to

A

Ulcers, thrombosis, phlebitis (inflammation of the vein)

41
Q

partial or full occlusion of a vein by a clot

A

Venous thrombosis

42
Q

Partial or complete occlusion of a vein by a thrombus with a secondary inflammatory reaction in the wall of the vein

A

Thrombophlebitis

43
Q

inflammation of a vein, predisposing a person to clot formation

A

Phlebothrombitis

44
Q

Deep Vein Thrombosis

A

3rd MOST COMMON Cardiovascular disease after coronary artery episode (heart attack), Cerebrovascular accidents (stroke)
Usually in calf. lead to pulmonary emboli. Popliteal, femoral, iliac vein, inferior venacava

45
Q

What does deep vein thrombosis associate with

A

Pulmonary emboli

46
Q

What causes DVT?

A

Genetics, pills, smoking, venous stasis, hyper coagulability,

47
Q

What is chronic venous insufficiency

A

AKA post phlebitis syndrome, venous stasis
Edema, reddish brown pigmentation at ankles and ulcers with white creamy to fibrous slough over a base of granulation tissue

48
Q

what is Rhaynaud’s disease (2 type)

A

Raynad’s phenomenon: secondary to another disease or underlaying cause
Raynaud’s disease: primary vaso spastic

49
Q

Raynaud’s color change

A

Blue - white - red

50
Q

When does the person likely to get Chronic venous insufficiency

A

Secondary to Varicose veins, or severe cases of DVT, leg trauma, neoplasms

51
Q

who gets Raynaud’s

A

Idiopathic, but smoking (men) marital status, alcohol (women) maybe the factor. More common in women.

52
Q

What is Raynauds’ associated with

A

occlusive arterial disease, neurogenic lesions, TOS, frostbite, trauma, chronic use of vibrating equipment, injury to the small vessels of hands, repetitive stress

53
Q

what is Raynaud’s

A

intermittent episodes of small artery or arteriole constriction of the extremities causing temporary pallor and cyanosis of the digits and changes in skin temperature
Occurs in response to cold temperature, anxiety or excitement

Systemic pathology (4 decks)

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