Exam 3: Vessels Flashcards
1
Q
Narrowing of vessels can be due to ___, which is gradual, or ___, which is rapid
A
Atherosclerosis
Thromboembolism
2
Q
Weakening of arteries can occur from __ or ___
A
Aneurysm (dilation)
Dissection (rupture)
3
Q
Lumen
A
Interior of vessel
4
Q
Arteriosclerosis
A
Hardening
5
Q
Atherosclerosis
A
Atheromas
6
Q
Aneurysm
A
Dilation of Artery
7
Q
Varicosity
A
Dilation of vein
8
Q
Dissection
A
Blood in vascular wall
9
Q
Thrombus
A
Clot in vessel
10
Q
____ walls are thicker
A
Arterial
11
Q
___ have valves
A
Veins
12
Q
Layers of vessels
A
Tunica intima
Tunica media
Tunica adventitia
13
Q
Tunica intima
A
Endothelial cells
Internal elastic lamina
14
Q
Tunica media
A
Smooth muscles
External elastic lamina
15
Q
Tunica adventitia
A
CT
Nerves
Vessels
16
Q
Blood supply to interior cells occurs via
A
Diffusion
17
Q
Blood supply to exterior cells occurs by
A
Vasa vasorum
18
Q
Most arteriosclerosis is
A
Atherosclerosis
19
Q
1 cause of morbidity / mortality
A
Atherosclerosis
20
Q
MC cause of MI
A
Thrombosis
21
Q
Vascular resistance is regulated at level of
A
Arterioles
22
Q
Site for edema and WBC diapedesis
A
Postcapillary venules
23
Q
Functions of endothelial cells
A
Regulate thrombosis
Vasoreactivity
Regulates smooth muscle cell growth
24
Q
Nitric oxide
A
Vasodilator
25
Endothelin
Vasoconstriction
26
Fibromuscular dysplasia
Local thickening of arterial wall
27
Fibromuscular dysplasia MC in
Young women
| Renal artery
28
Ischemia increases ___ which increases ___
RAAS
| BV
29
Lowest value for stage 1 HTN
130/80
30
Most people with long-term HTN will die from
Heart disease
31
Most likely cause of renovascular HTN
Fibromuscular dysplasia
32
Hypotension
<90/60
33
Hypertension
> 130/80
34
Organs most sensitive to HTN
Heart
Kidney
Eyes
Brain
35
Regulation of BP
Cardiac output
| Peripheral vascular resistance
36
Increase in BP causes stretch and ____ released
ANP
Lowers BP
37
Low BP causes
RAAS activation
Increase BP
38
Silent killer
HTN
39
Essential HTN
90% of all HTN
40
Malignant HTN
> 180/120
1% of all cases
41
Malignant HTN causes
Papilledema
Retinal hemorrhage
Stoke
Renal failure
42
Papilledema
Increase in ICP causes microbleeds in retina
43
Pheochromocytoma
Neuroendocrine tumor
Abnormal chromaffin cells in adrenal medulla
Increase catecholamines secretion
44
Increase in catecholamines causes
SNS stimulation
Episodic spikes in BP
45
Endothelial injury causing thickening of intima is
Irreversible
46
Arteriolosclerosis
Hardening of small arteries due to chronic HTN or diabetes
47
Monckeberg Medial Sclerosis
Ca deposition into media
No stenosis = not significant
48
Atherosclerosis
Atheroma formation causing stenosis
49
Which form of arteriolosclerosis develops due to long-term DM
Hyaline
50
Hyaline arteriolosclerosis is ___ and due to ____ or DM
Pink
Benign HTN
51
Layered arteriolosclerosis is ____ and due to ___
Layered “onion-skin”
Severe HTN
52
Atherosclerosis weakens what layer?
Tunica media
53
Foam cells
Fat laden macrophages
54
CAD =
70% occlusion of coronary arteries
55
Which is MC to be associated with inflammation
Unstable atherosclerotic plaque
56
Hemodynamic stress occurs at
Branch points or areas of turbulence
57
Claudication
Pain in legs due to peripheral vascular disease
Worse with physical activity
58
3 MI risk factors
Hyperlipidemia
HTN
Smoking
59
Any 2 of the 3 risk factors for MI increases risk
4X
60
All 3 risk factors for MI increases risk
7X
61
Metabolic syndrome aka
Syndrome X
62
Metabolic syndrome diagnosis
Any 3 of 5 criteria
```
Central obesity
HTN
Insulin resistance
Dyslipidemia
Pro-inflammatory state
```
63
Localized dilation of artery
Aneurysm
64
True aneurysm
All 3 layers affected
65
False aneurysm
Defect in inner wall
Extravascular hematoma
66
Risk factors for aneurysm
```
HTN
Trauma
Marfans
Ehlers-Danlos
Syphilis
```
67
Abdominal aortic aneurysm
Aorta dilated > 50%
68
Normal aorta dilated 3 cm, AAA dilated to
5 cm
69
AAA is _____ to adjusting
Contraindication
70
If AAA ruptured, ___ fatal
50%
71
Min criteria for AAA risk of rupture
5-6 cm
72
___ are most susceptible to compression from AAA
Ureters
73
Consequences of aortic dissection
Hemorrhage
Vascular occlusion
Pericardial tamponade
74
Aortic dissection MC in
Males, > 50 yo
75
Most cases of aortic dissection occur in present of
HTN
76
Earlier onset of aortic dissections can be due to
Marfan
Ehlers-danlos
Wilson disease
77
“Tearing or stabbing” and anterior chest pain describes
Aortic dissection
78
Type A aortic dissection
Ascending aorta
MC and most severe
79
Type B aortic dissection
Distal to left subclavian A
Less common
Less severe
80
Thoracic aortic dissection can be due to
HTN (40-60 years)
Marfan (younger)
81
Pericardial tamponade
Fluid accumulates in pericardium
82
Pericardial tamponade prevents
Ventricular expansion
83
Pericardial tamponade is an
Emergency- cardiogenic shock
84
Wilson Disease
Abnormal copper transport
85
Excessive copper accumulates in Wilson Disease and damages...
```
Liver = steatohepatitis
Brain = psychosis, Parkinsonism
Eyes= kayser-fleischer rings
```
86
Warning signs of dissection
Sudden, Severe, Sustained
Neck pain (suboccipital)
HA
Vertigo
87
5 Ds and 3 Ds of brainstem ischemia
```
Diplopia
Dizziness
Drop attacks
Dysarthria
Dysphagia
```
Numbness
Nausea
Nystagmus
88
Vessel wall inflammation
Vasculitis
89
Infectious vasculitis can be caused by
Hep b
| Syphilis
90
Immune mediated vasculitis can be due to
Lupus
| PAN
91
Immune mediated vasculitis is what type hypersensitivity?
Type 3
92
Temporal arteritis aka
Giant cell arteritis
93
Temporal arteritis (Autoimmune vasculitis) can be due to what 3 vessels?
Temporal artery
Ophthalmic artery
Vertebral artery and aorta
94
Temporal arteritis involves
Granulomas
95
Temporal arteritis treatment
Corticosteroids
96
Symptoms of temporal arteritis
```
Facial pain
HA
Diplopia
Blindness
Fever
```
97
Blindness in temporal arteritis is due to what artery
Ophthalmic artery
98
Takayasu arteritis aka
Pulseless disease
99
Takayasu arteritis is an autoimmune vasculitis that involves what vessels
Aortic arch and vessels branching from that
- radial artery
- Carotid artery
100
Takayasu arteritis MC in
Younger <50 yo
101
Systemic autoimmune vasculitis that occurs in medium sized arteries
Polyarteritis nodosa
102
PAN produces what characteristic sign?
Rosary Sign
103
2 MC and lethal arteries affected in PAN
Renal A
| Coronary A
104
PAN spares
Pulmonary arteries
105
PAN is ___ and involves fatigue, fever, malaise, weight loss
Episodic
106
PAN MC in
Young adults
2/3 autoimmune
1/3 post hep B infection
107
PAN treated with
Corticosteroids
108
PAN can be __ if untreated
Fatal
109
Segmental fibrinoid necrosis and purpura characteristic of
PAN
110
Kawasaki Disease
Pediatric vasculitis
111
80% of Kawasaki Disease are in what population
<4 years
112
___ and ___ are primary concern with Kawasaki Disease
CAD and MI
113
Strawberry tongue characteristic of
Kawasaki Disease
114
Treatment for Kawasaki disease
Aspirin
Corticosteroids
CABG surgery
115
Kawasaki disease is rare and idiopathic, but observed in
Asians
| Males
116
Kawasaki disease has acute onset and is
Self limiting
117
Reye syndrome damages
Liver and brain
118
Reye Syndrome can be due to
```
Viral infection (flu or chickenpox)
Aspirin
```
119
Reye syndrome MC ages
4-12
120
Reye syndrome is a
Medical emergency
| May be rapidly fatal
121
Reye syndrome can cause
Encephalopathy
| Hepatic steatosis
122
Wegener granulomatosis aka
Granulomatosis with polyangiitis
123
Kidneys and respiratory tract vasculitis
Wegener granulomatosis
124
GPA commonly affects
Sinuses
Trachea
Lungs
Kidneys
125
GPA MC in
Males
126
If untreated, GPA is ___ lethal in 1 year
80%
127
Treatment for GPA
Immunosuppression
128
Symptoms of Wegener
```
Pneumonitis
Sinusitis
Kidney damage
Nasopharyngeal inflammation/ulcers
Fever
Rash
```
129
Thromboangiitis obliterans aka
Buerger Disease
130
Buerger disease components
Raynaud
Vascular claudication
Ulceration
Gangrene
131
Tobacco smoke causes
Buerger disease
132
Vascular insufficiency common in ___ and ___ in Buerger Disease
Tibial artery
| Radial artery
133
Buerger MC in
Males 3X
| Age 20-40
134
Symptoms of buerger disease
Cold, cyanotic extremities
| Vascular claudication
135
Raynaud phenomenon
Exaggerated arterioles vasoconstriction
136
Primary raynaud
Idiopathic
| Cold or strong emotions
137
Secondary raynaud
Atherosclerosis
SLE
Buerger disease
Systemic sclerosis
138
Obliterative vasculitis
Buerger disease
139
Raynaud MC in
11% females
8% males
Adolescent or young adults
140
Takotsubo cardiomyopathy aka
Broken heart syndrome
| Stress-induced cardiomyopathy
141
Extreme psychological stress causing catecholamine release
Takotsubo cardiomyopathy
142
Phlebothrombosis
Venous thrombosis
| Absence of inflammation
143
Thrombophlebitis
Venous thrombosis
| Inflammation
144
Varicose veins
Superficial veins are dilated and tortuous
MC in legs
145
Phlebitis
Venous inflammation
146
Risk for varicose veins
Obesity
Genetics
Pregnancy
High heels
147
Regarding varicose veins, increase in pressure causes ____ which causes ____
Vasodilation
Incompetent valves
148
Insufficient venous return causing discoloration, thinning of skin, and edema
Stasis dermatitis
| Venous eczema
149
Most cases of thrombophlebitis
DVT
150
SVC syndrome
SVC compressed or invaded
151
Common “invaders” in SVC syndrome
Lung CA
| Mediastinal lymphoma
152
Congested UE veins
SVC syndrome
153
IVC Syndrome
IVC compressed or invaded
154
IVC syndrome can be due to
Liver Ca
Renal Ca
Pregnancy
155
Congested LE veins
IVC Syndrome
156
Lymphedema
Lymphatic obstruction
| -intestinal fluid accumulates
157
Lymphedema MC from
Infection or inflammation
158
Primary lymphedema
Congenital malformation
| -Milroy disease
159
Milroy Disease
Inherited hypoplasia/agenesis of lymph vessels
160
Secondary lymphedema
Destruction of previously normal vessel
-tumors, infection (filariasis), surgery (mastectomy)
161
Signs of lymphedema
Peau D’orange
| Brawny Induration
162
Peau d’orange
Skin of orange
| Skin tethered by sweat ducts
163
Brawny induration
Hardening of skin due to chronic lymphedema
164
Lymphangitis
Acute inflammation of lymphatic channel
165
Lymphangitis can be due to
Bacterial infection
| Painful red streaks
166
Vascular tumors are often from transformed
Endothelial cells
CT
Vessel walls
167
MC vascular tumor
Hemangioma
168
Occasionally, vascular tumors can be fairly aggressive and be called
Kaposi sarcoma
169
Rare highly malignant vascular tumor sarcoma
Angiosarcoma
170
Hemangioma
Benign tumor of capillary endothelial
- well differentiated
- well localized
171
In Hemangiomas, malignant transformation is ____ and usually self resolve by age ___
VERY RARE
Age 7
172
AIDS defining disease
Kaposi sarcoma
173
Kaposi sarcoma caused by
Kaposi sarcoma herpesvirus (KSHV)
174
KSHV transmission
Sex or oral secretions
175
MC HIV related malignancy
Kaposi sarcoma
176
Signs of kaposi sarcoma
Macules (purpura)
MC LE
Eventually back, face, mouth, genitals, GI, lungs
177
Malignancy of vascular endothelial
Angiosarcoma
178
angiosarcoma MC in
Older adults
179
Anaplastic angiosarcomas spread widely via
Lymph nodes
180
MC location of angiosarcoma
Skin
Breast
Liver
Soft tissues
181
Malignancy of lymphatic endothelial
Kaposi sarcoma
182
Early angiosarcoma
Small
| Red
183
Late angiosarcoma
Large
| Red-tan
184
Endovascular stenting
Preserves luminal patency
- holds down flaps
- limits vasospasm
185
Common treatment for CAD
Endovascular stenting
186
Grafts
Replace or bypass arteries
187
Synthetic graft
Increase risk of thrombosis
188
Autologous graft
Great saphenous vein (50% at 10 years)
Internal mammary artery (90% at 10 years)
189
Risk for angiosarcoma
PVC industry
