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Systems Path 1 > Exam 3: Vessels > Flashcards

Exam 3: Vessels Flashcards

1
Q

Narrowing of vessels can be due to ___, which is gradual, or ___, which is rapid

A

Atherosclerosis

Thromboembolism

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2
Q

Weakening of arteries can occur from __ or ___

A

Aneurysm (dilation)

Dissection (rupture)

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3
Q

Lumen

A

Interior of vessel

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4
Q

Arteriosclerosis

A

Hardening

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5
Q

Atherosclerosis

A

Atheromas

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6
Q

Aneurysm

A

Dilation of Artery

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7
Q

Varicosity

A

Dilation of vein

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8
Q

Dissection

A

Blood in vascular wall

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9
Q

Thrombus

A

Clot in vessel

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10
Q

____ walls are thicker

A

Arterial

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11
Q

___ have valves

A

Veins

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12
Q

Layers of vessels

A

Tunica intima
Tunica media
Tunica adventitia

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13
Q

Tunica intima

A

Endothelial cells

Internal elastic lamina

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14
Q

Tunica media

A

Smooth muscles

External elastic lamina

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15
Q

Tunica adventitia

A

CT
Nerves
Vessels

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16
Q

Blood supply to interior cells occurs via

A

Diffusion

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17
Q

Blood supply to exterior cells occurs by

A

Vasa vasorum

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18
Q

Most arteriosclerosis is

A

Atherosclerosis

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19
Q

1 cause of morbidity / mortality

A

Atherosclerosis

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20
Q

MC cause of MI

A

Thrombosis

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21
Q

Vascular resistance is regulated at level of

A

Arterioles

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22
Q

Site for edema and WBC diapedesis

A

Postcapillary venules

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23
Q

Functions of endothelial cells

A

Regulate thrombosis
Vasoreactivity
Regulates smooth muscle cell growth

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24
Q

Nitric oxide

A

Vasodilator

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25
Q

Endothelin

A

Vasoconstriction

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26
Q

Fibromuscular dysplasia

A

Local thickening of arterial wall

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27
Q

Fibromuscular dysplasia MC in

A

Young women

Renal artery

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28
Q

Ischemia increases ___ which increases ___

A

RAAS

BV

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29
Q

Lowest value for stage 1 HTN

A

130/80

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30
Q

Most people with long-term HTN will die from

A

Heart disease

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31
Q

Most likely cause of renovascular HTN

A

Fibromuscular dysplasia

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32
Q

Hypotension

A

<90/60

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33
Q

Hypertension

A

> 130/80

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34
Q

Organs most sensitive to HTN

A

Heart
Kidney
Eyes
Brain

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35
Q

Regulation of BP

A

Cardiac output

Peripheral vascular resistance

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36
Q

Increase in BP causes stretch and ____ released

A

ANP

Lowers BP

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37
Q

Low BP causes

A

RAAS activation

Increase BP

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38
Q

Silent killer

A

HTN

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39
Q

Essential HTN

A

90% of all HTN

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40
Q

Malignant HTN

A

> 180/120

1% of all cases

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41
Q

Malignant HTN causes

A

Papilledema
Retinal hemorrhage
Stoke
Renal failure

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42
Q

Papilledema

A

Increase in ICP causes microbleeds in retina

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43
Q

Pheochromocytoma

A

Neuroendocrine tumor

Abnormal chromaffin cells in adrenal medulla

Increase catecholamines secretion

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44
Q

Increase in catecholamines causes

A

SNS stimulation

Episodic spikes in BP

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45
Q

Endothelial injury causing thickening of intima is

A

Irreversible

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46
Q

Arteriolosclerosis

A

Hardening of small arteries due to chronic HTN or diabetes

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47
Q

Monckeberg Medial Sclerosis

A

Ca deposition into media

No stenosis = not significant

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48
Q

Atherosclerosis

A

Atheroma formation causing stenosis

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49
Q

Which form of arteriolosclerosis develops due to long-term DM

A

Hyaline

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50
Q

Hyaline arteriolosclerosis is ___ and due to ____ or DM

A

Pink

Benign HTN

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51
Q

Layered arteriolosclerosis is ____ and due to ___

A

Layered “onion-skin”

Severe HTN

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52
Q

Atherosclerosis weakens what layer?

A

Tunica media

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53
Q

Foam cells

A

Fat laden macrophages

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54
Q

CAD =

A

70% occlusion of coronary arteries

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55
Q

Which is MC to be associated with inflammation

A

Unstable atherosclerotic plaque

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56
Q

Hemodynamic stress occurs at

A

Branch points or areas of turbulence

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57
Q

Claudication

A

Pain in legs due to peripheral vascular disease

Worse with physical activity

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58
Q

3 MI risk factors

A

Hyperlipidemia
HTN
Smoking

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59
Q

Any 2 of the 3 risk factors for MI increases risk

A

4X

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60
Q

All 3 risk factors for MI increases risk

A

7X

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61
Q

Metabolic syndrome aka

A

Syndrome X

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62
Q

Metabolic syndrome diagnosis

A

Any 3 of 5 criteria

Central obesity 
HTN
Insulin resistance 
Dyslipidemia 
Pro-inflammatory state
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63
Q

Localized dilation of artery

A

Aneurysm

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64
Q

True aneurysm

A

All 3 layers affected

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65
Q

False aneurysm

A

Defect in inner wall

Extravascular hematoma

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66
Q

Risk factors for aneurysm

A 
HTN
Trauma
Marfans
Ehlers-Danlos 
Syphilis
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67
Q

Abdominal aortic aneurysm

A

Aorta dilated > 50%

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68
Q

Normal aorta dilated 3 cm, AAA dilated to

A

5 cm

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69
Q

AAA is _____ to adjusting

A

Contraindication

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70
Q

If AAA ruptured, ___ fatal

A

50%

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71
Q

Min criteria for AAA risk of rupture

A

5-6 cm

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72
Q

___ are most susceptible to compression from AAA

A

Ureters

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73
Q

Consequences of aortic dissection

A

Hemorrhage
Vascular occlusion
Pericardial tamponade

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74
Q

Aortic dissection MC in

A

Males, > 50 yo

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75
Q

Most cases of aortic dissection occur in present of

A

HTN

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76
Q

Earlier onset of aortic dissections can be due to

A

Marfan
Ehlers-danlos
Wilson disease

77
Q

“Tearing or stabbing” and anterior chest pain describes

A

Aortic dissection

78
Q

Type A aortic dissection

A

Ascending aorta

MC and most severe

79
Q

Type B aortic dissection

A

Distal to left subclavian A

Less common
Less severe

80
Q

Thoracic aortic dissection can be due to

A

HTN (40-60 years)

Marfan (younger)

81
Q

Pericardial tamponade

A

Fluid accumulates in pericardium

82
Q

Pericardial tamponade prevents

A

Ventricular expansion

83
Q

Pericardial tamponade is an

A

Emergency- cardiogenic shock

84
Q

Wilson Disease

A

Abnormal copper transport

85
Q

Excessive copper accumulates in Wilson Disease and damages…

A 
Liver = steatohepatitis 
Brain = psychosis, Parkinsonism 
Eyes= kayser-fleischer rings
86
Q

Warning signs of dissection

A

Sudden, Severe, Sustained

Neck pain (suboccipital)
HA
Vertigo

87
Q

5 Ds and 3 Ds of brainstem ischemia

A 
Diplopia 
Dizziness
Drop attacks
Dysarthria
Dysphagia

Numbness
Nausea
Nystagmus

88
Q

Vessel wall inflammation

A

Vasculitis

89
Q

Infectious vasculitis can be caused by

A

Hep b

Syphilis

90
Q

Immune mediated vasculitis can be due to

A

Lupus

PAN

91
Q

Immune mediated vasculitis is what type hypersensitivity?

A

Type 3

92
Q

Temporal arteritis aka

A

Giant cell arteritis

93
Q

Temporal arteritis (Autoimmune vasculitis) can be due to what 3 vessels?

A

Temporal artery
Ophthalmic artery
Vertebral artery and aorta

94
Q

Temporal arteritis involves

A

Granulomas

95
Q

Temporal arteritis treatment

A

Corticosteroids

96
Q

Symptoms of temporal arteritis

A 
Facial pain 
HA
Diplopia 
Blindness 
Fever
97
Q

Blindness in temporal arteritis is due to what artery

A

Ophthalmic artery

98
Q

Takayasu arteritis aka

A

Pulseless disease

99
Q

Takayasu arteritis is an autoimmune vasculitis that involves what vessels

A

Aortic arch and vessels branching from that

  • radial artery
  • Carotid artery
100
Q

Takayasu arteritis MC in

A

Younger <50 yo

101
Q

Systemic autoimmune vasculitis that occurs in medium sized arteries

A

Polyarteritis nodosa

102
Q

PAN produces what characteristic sign?

A

Rosary Sign

103
Q

2 MC and lethal arteries affected in PAN

A

Renal A

Coronary A

104
Q

PAN spares

A

Pulmonary arteries

105
Q

PAN is ___ and involves fatigue, fever, malaise, weight loss

A

Episodic

106
Q

PAN MC in

A

Young adults

2/3 autoimmune
1/3 post hep B infection

107
Q

PAN treated with

A

Corticosteroids

108
Q

PAN can be __ if untreated

A

Fatal

109
Q

Segmental fibrinoid necrosis and purpura characteristic of

A

PAN

110
Q

Kawasaki Disease

A

Pediatric vasculitis

111
Q

80% of Kawasaki Disease are in what population

A

<4 years

112
Q

___ and ___ are primary concern with Kawasaki Disease

A

CAD and MI

113
Q

Strawberry tongue characteristic of

A

Kawasaki Disease

114
Q

Treatment for Kawasaki disease

A

Aspirin
Corticosteroids
CABG surgery

115
Q

Kawasaki disease is rare and idiopathic, but observed in

A

Asians

Males

116
Q

Kawasaki disease has acute onset and is

A

Self limiting

117
Q

Reye syndrome damages

A

Liver and brain

118
Q

Reye Syndrome can be due to

A 
Viral infection (flu or chickenpox) 
Aspirin
119
Q

Reye syndrome MC ages

A

4-12

120
Q

Reye syndrome is a

A

Medical emergency

May be rapidly fatal

121
Q

Reye syndrome can cause

A

Encephalopathy

Hepatic steatosis

122
Q

Wegener granulomatosis aka

A

Granulomatosis with polyangiitis

123
Q

Kidneys and respiratory tract vasculitis

A

Wegener granulomatosis

124
Q

GPA commonly affects

A

Sinuses
Trachea
Lungs
Kidneys

125
Q

GPA MC in

A

Males

126
Q

If untreated, GPA is ___ lethal in 1 year

A

80%

127
Q

Treatment for GPA

A

Immunosuppression

128
Q

Symptoms of Wegener

A 
Pneumonitis 
Sinusitis 
Kidney damage
Nasopharyngeal inflammation/ulcers 
Fever 
Rash
129
Q

Thromboangiitis obliterans aka

A

Buerger Disease

130
Q

Buerger disease components

A

Raynaud
Vascular claudication
Ulceration
Gangrene

131
Q

Tobacco smoke causes

A

Buerger disease

132
Q

Vascular insufficiency common in ___ and ___ in Buerger Disease

A

Tibial artery

Radial artery

133
Q

Buerger MC in

A

Males 3X

Age 20-40

134
Q

Symptoms of buerger disease

A

Cold, cyanotic extremities

Vascular claudication

135
Q

Raynaud phenomenon

A

Exaggerated arterioles vasoconstriction

136
Q

Primary raynaud

A

Idiopathic

Cold or strong emotions

137
Q

Secondary raynaud

A

Atherosclerosis
SLE
Buerger disease
Systemic sclerosis

138
Q

Obliterative vasculitis

A

Buerger disease

139
Q

Raynaud MC in

A

11% females
8% males

Adolescent or young adults

140
Q

Takotsubo cardiomyopathy aka

A

Broken heart syndrome

Stress-induced cardiomyopathy

141
Q

Extreme psychological stress causing catecholamine release

A

Takotsubo cardiomyopathy

142
Q

Phlebothrombosis

A

Venous thrombosis

Absence of inflammation

143
Q

Thrombophlebitis

A

Venous thrombosis

Inflammation

144
Q

Varicose veins

A

Superficial veins are dilated and tortuous

MC in legs

145
Q

Phlebitis

A

Venous inflammation

146
Q

Risk for varicose veins

A

Obesity
Genetics
Pregnancy
High heels

147
Q

Regarding varicose veins, increase in pressure causes ____ which causes ____

A

Vasodilation

Incompetent valves

148
Q

Insufficient venous return causing discoloration, thinning of skin, and edema

A

Stasis dermatitis

Venous eczema

149
Q

Most cases of thrombophlebitis

A

DVT

150
Q

SVC syndrome

A

SVC compressed or invaded

151
Q

Common “invaders” in SVC syndrome

A

Lung CA

Mediastinal lymphoma

152
Q

Congested UE veins

A

SVC syndrome

153
Q

IVC Syndrome

A

IVC compressed or invaded

154
Q

IVC syndrome can be due to

A

Liver Ca
Renal Ca
Pregnancy

155
Q

Congested LE veins

A

IVC Syndrome

156
Q

Lymphedema

A

Lymphatic obstruction

-intestinal fluid accumulates

157
Q

Lymphedema MC from

A

Infection or inflammation

158
Q

Primary lymphedema

A

Congenital malformation

-Milroy disease

159
Q

Milroy Disease

A

Inherited hypoplasia/agenesis of lymph vessels

160
Q

Secondary lymphedema

A

Destruction of previously normal vessel

-tumors, infection (filariasis), surgery (mastectomy)

161
Q

Signs of lymphedema

A

Peau D’orange

Brawny Induration

162
Q

Peau d’orange

A

Skin of orange

Skin tethered by sweat ducts

163
Q

Brawny induration

A

Hardening of skin due to chronic lymphedema

164
Q

Lymphangitis

A

Acute inflammation of lymphatic channel

165
Q

Lymphangitis can be due to

A

Bacterial infection

Painful red streaks

166
Q

Vascular tumors are often from transformed

A

Endothelial cells
CT
Vessel walls

167
Q

MC vascular tumor

A

Hemangioma

168
Q

Occasionally, vascular tumors can be fairly aggressive and be called

A

Kaposi sarcoma

169
Q

Rare highly malignant vascular tumor sarcoma

A

Angiosarcoma

170
Q

Hemangioma

A

Benign tumor of capillary endothelial

  • well differentiated
  • well localized
171
Q

In Hemangiomas, malignant transformation is ____ and usually self resolve by age ___

A

VERY RARE

Age 7

172
Q

AIDS defining disease

A

Kaposi sarcoma

173
Q

Kaposi sarcoma caused by

A

Kaposi sarcoma herpesvirus (KSHV)

174
Q

KSHV transmission

A

Sex or oral secretions

175
Q

MC HIV related malignancy

A

Kaposi sarcoma

176
Q

Signs of kaposi sarcoma

A

Macules (purpura)
MC LE
Eventually back, face, mouth, genitals, GI, lungs

177
Q

Malignancy of vascular endothelial

A

Angiosarcoma

178
Q

angiosarcoma MC in

A

Older adults

179
Q

Anaplastic angiosarcomas spread widely via

A

Lymph nodes

180
Q

MC location of angiosarcoma

A

Skin
Breast
Liver
Soft tissues

181
Q

Malignancy of lymphatic endothelial

A

Kaposi sarcoma

182
Q

Early angiosarcoma

A

Small

Red

183
Q

Late angiosarcoma

A

Large

Red-tan

184
Q

Endovascular stenting

A

Preserves luminal patency

  • holds down flaps
  • limits vasospasm
185
Q

Common treatment for CAD

A

Endovascular stenting

186
Q

Grafts

A

Replace or bypass arteries

187
Q

Synthetic graft

A

Increase risk of thrombosis

188
Q

Autologous graft

A

Great saphenous vein (50% at 10 years)

Internal mammary artery (90% at 10 years)

189
Q

Risk for angiosarcoma

A

PVC industry

Systems Path 1 (12 decks)

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