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NYCC Physiopathology > final pt 5 draft > Flashcards

final pt 5 draft Flashcards

1
Q

what are 2 non-inflammatory vascular disorders?

A
  • Monkeberg Medial Sclerosis
  • Raynaud phenomenon
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2
Q

what are the inflammatory vascular disorders?

A
  • takayasu arteritis
  • polarteritis nodosa
  • Allergic Granulomatous and angitis (Churg-Strauss)
  • Temporal Arteritis
  • Kawasaki disease
  • Wegeners Granulomatosis
  • Thromoangitis Obliterans (Buergers)
  • Behcet
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3
Q

what refers to a degenerative calcification of the tunica media of large and medium sized muscular arteries?

A

Monkeberg medial sclerosis

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4
Q

what age is monkeburg usually seen in?

A

older individual

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5
Q

Mokeberg medial sclerosis usually occurs in what arteries?

A

arteries of the upper and lower extremities (may cause post. knee pain)

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6
Q

T/F: Monkeberg medial sclerosis is very similar to atherosclerosis

A

F
it is distinct from atherosclerosis
-ordinarily does NOT lead to a clinical presentation per se
atherosclerosis is of the tunica intima where monkeberg is of the tunica media

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7
Q

T/F: there is major luminal narrowing in Monkeberg medial sclerosis

A

F: there is none

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8
Q

what is the etiology of Monkeberg?

A

unknown

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9
Q

is Monkeberg inflammatory or non?

A

non inflammatory

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10
Q

what is paroxysmal pallor or cyanosis of the digits of the hands or feet?

A

Raynaud phenomenon

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11
Q

what is Raynauds usually caused by?

A

due to cold induced vasoconstriction

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12
Q

what is the color change sequence in Raynauds?

A

white- blue- Red

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13
Q

T/F: Raynauds reflects an exaggeration of normal central and vasomotor responses to cold or emotion

A

T

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14
Q

what is the prognosis of RP?

A
  • usually benign
  • long-standing cases may show signs of atrophy of skin, subcutaneous tissue and muscles
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15
Q

T/F: ulcerations and gangrene are rare for RP

A

T

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16
Q

what is the difference between primary and secondary Raynaud Phenomenon?

A
  • primary = you just have it
    secondary = some primary disease triggers RP
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17
Q

what refers to the inflammation of walls of vessels (all sizes and types)?

A

inflammatory vasculitides

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18
Q

how can we classify inflammatory Vasculitis?

A

based on pathogenesis or etiology

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19
Q

what are different ways you get vasculitis?

A

infection
immunologic
unknown

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20
Q

what is the clinical presentation of vasculitis?

A

often a result of vessel lumen narrowing/ obliteration/ dilation / thrombosis

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21
Q

what therapy is usually used to treat vasculitis?

A

Responsive to steroid/immunosuppressive-therapy

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22
Q

what kind of tests will suspected Vasculitis patients have performed?

A

inflammatory/ autoimmune panel

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23
Q

what is tested in an inflammatory/autoimmune panel?

A

ESR
CRP
RF
ANA
ANCA
Specific Ig’s

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24
Q

what does ESR stand for an what is it?

A
  • Erythrocyte sedimentation rate
  • non specific indication of inflammation when elevated
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25
Q

what does CRP stand for and what is it?

A

C- reactive protein
Non specific indicator of inflammation when elevated

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26
Q

what does RF stand for and what is it?

A

Rheumatoid factor
assess for inflammatory joint disease

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27
Q

what does ANA stand for and what is it seen in?

A

Anti nuclear antibody
seen in LUPIS

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28
Q

what does ANCA stand for what is it predictive for if elevated?

A

Anti- neutrophilic cytoplasmic antibodies
will have some type of inflammatory vascular disease if elevated

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29
Q

what are 2 other things that may be tested on an inflammatory panel?

A

anti glomerular basement membrane antibody
Anti thyroglobulin antibody

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30
Q

what disease is seen in females under 40 and a common sign is there BP is different by over 10 mmHG in either arm?

A

Takayasu arteritis

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31
Q

Takayasu arteritis classically involves ____ and its branches, and is characterized by what?

A

aortic arch
characterized by principally weakening of peripheral pulses

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32
Q

what would examination of a person with Takayasu arteritis show?

A

thickening of the aorta particularly the aortic arch and its branches
near obliteration of distal portions of aortic branches

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33
Q

what is necrotizing vasculitis of small and medium sized visceral arteries with no lung involvement?

A

polyarteritis nodosa

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34
Q

presentation of polyarteritis nodosa is common in which organs and which sex and age?

A

common in kidney and liver in young males

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35
Q

what would a patient with polyarteritis nodosa present with?

A

necrotizing of the vessel wall (fibroid necrosis)

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36
Q

what are the three phases that polyarteritis nodosa may present itself?

A

acute, healing, scarred (may co-present)

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37
Q

what are some complications that can happen in polyarteritis nodosa and is it corticosteroid responsive?

A

aneurysm
thrombosis
infarct
and yes

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38
Q

what is systemic vasculitis in young individuals with asthma?

A

allergic granulomatous and angitis (churg-strauss)

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39
Q

2/3 of patients with Churg-Strauss will have what?

A

C or P-ANCA (anti-neutrophilic cytoplasmic antibodies)

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40
Q

does C-ANCA clump or no?

A

doesn’t clump

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41
Q

where would you seen allergic granulomatosis and angitis?

A

small and medium sized arteries and arterioles of the lungs, spleen, kidney, heart, CNS and others

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42
Q

what WBC would be seen intensely in Churg-Strauss?

A

Eosinophils

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43
Q

what is the most common systemic form of vasculitis in patients over 50?

A

temporal arteritis (giant cell arteritis)

44
Q

is temporal arteritis chronic or acute?

A

both chronic and acute in form

45
Q

what arteries does giant cell arteritis affect?

A

large and small arteries particularly in the head
especially the temporal arteries- also vertebral and ophthalmic

46
Q

if the ophthalmic artery is affect by temporal arteritis what could happen?

A

may lead to sudden permanent blindness

47
Q

T/F: the pathogenesis suggests that immune reaction is generated towards components of the vascular wall- still putative; granulomatous nature suggests T-cell mediated mechanism and antigen driven injury

A

T

48
Q

what are the clinical features of Giant cell arteritis?

A

facial pain, intense upon palpation
ocular symptoms- mild to severe
may lead to permanent blindness

49
Q

what do you treat temporal arteritis with?

A

anti inflammatory

50
Q

50% of patients with temporal arteritis also have ____, where patients present with pain and stiffness in neck, shoulders and hips with extreme exhaustion

A

Polymyalgia Rheumatica (PMR)

51
Q

what do the WBC attack in polymyalgia Rheumatica?

A

the joints of the body

52
Q

what disease is of the coronary arteries affecting young children less than 4?

A

kawasaki disease

53
Q

what is the etiology of Kawasaki disease?

A

unknown

54
Q

what syndrome is Kawasaki disease associated with?

A

mucocutaneous lymph node syndrome
- acute self limiting fever, rash, erythema, desquamation, and lymphadenopathy

55
Q

20% of kids with Kawasaki disease develop what?

A

cardiac sequellae… aneurysmal formation

56
Q

what are the clinical consequences of Kawasaki disease?

A

asymtomatic vasculitis
coronary artery ectasia
coronary artery aneurysm
thrombosis
MI
sudden death

57
Q

what is the treatment of Kawasaki disease?

A

aspirin and intravenous gammaglobulin

58
Q

what is necrotizing vasculitis that is dangerous and happens quickly?

A

Wegeners granulomatous

59
Q

what is the triad of Wegner’s granulomatous?

A

acute necrotizing granulomas of upper respiratory tract
necrotizing granulomatosis of small to medium sized vessels
renal disease in the form of focal glomerulitis

60
Q

the pathogenesis of Wegner’s granulomatous suggests some type of _______________ reaction?

A

hypersensitivity

61
Q

what from the blood panel do people with Wegners granulomatous present with?

A

ANCA

62
Q

what do you treat Wegners granulomatous with and what happens if you dont treat it?

A

cyclophosphamide and rapidly fatal if you dont treat

63
Q

what is a distincitve disease leading to vascular insufficiency in distal arteries; it is characterized by segmental acute and chronic thrombosing of small and medium arteries?

A

Thromboangitis Obliterans (Buerger’s)

64
Q

T/F you will have micro abscesses and granulomatous inflammation in Buergers disease

A

T

65
Q

what arteries does buergers disease usually affect and what is a huge risk factor for this disease

A

principally in tibial and radial arteries
seen in heavy cigarette smoking men that are overweight

66
Q

what are some other symptoms of Buergers disease

A

symptoms of claudication
may present with cold intolerance/ Raynauds

67
Q

what is another name for Buergers disease

A

Thromboangitis Obliterans (Buerger’s)

68
Q

what disease involves the mucous membranes and is characterized by oral apthous ulers, genital ulceration, ocular inflammation, and lesions in the CNS, cardiovascular, and GI

A

Behcet

69
Q

what is the cause of Behcet

A

unknown cause however immune basis

70
Q

what are enlarged tortuous blood vessels

A

varicose veins

71
Q

what are varicose veins caused by

A

increased intraluminal pressure

72
Q

what are some risk factors for varicose veins

A

being a women
familial predispositions
obesity

73
Q

T/F: in varicose veins the vessel walls may be thinned due to dilation or thickened due to hypertrophy

A

T

74
Q

T/F: you might also have stasis dermatitis and secondary ulceration

A

T

75
Q

what are the other locations where you might have varicosities

A

rectum and anus
esophagus
scrotum

76
Q

what is the most common type of varices

A

esphageal varices

77
Q

what side are varicoceles’ more common on

A

left

78
Q

what is a painful, red, swollen vein thrombosis

A

thrombophlebitis

79
Q

what is a vein thrombosis that is not painful

A

phlebothrombosis

80
Q

what are some major risk factors for DEEP VEIN THROMBOSIS

A
  • prolonged bed rest
  • reduced cardiac output
  • surgery (major threat to life sudden death following post-op ambulation)
81
Q

what is the cause of death in a deep vein thrombosis

A

pulmonary embolus

82
Q

what does the pulmonary embolus result in

A

cor pulmonale - cant get blood to lungs

83
Q

T/F: half of people with DVT have no symptoms

A

T

84
Q

what are some of the symptoms of DVT

A

a general swelling of the calf, ankle, foot, or thigh
increased warmth of leg
redness
pain in the leg
night leg cramps
blueish discoloration of the skin on the leg or toes

85
Q

what is the treatment for DVT

A

Cava filter treatment

86
Q

what are 2 different vascular neoplasias

A

benign hemangiomas
capillary hemangiomas

87
Q

what are common congenital vascular lesions; -most common on the skin but are also found on mucosal surfaces and visceral organs

A

benign Hemangiomas

88
Q

T/F: benign hemangiomas are present at birth and grow, but remain limited in size

A

T

89
Q

what kind of hemangiomas occur on skin (strawberry hemangioma) subcutaneous tissue and mucous membranes of mouth and lips

A

capillary hemangiomas

90
Q

T/F: in capillary hemangiomas the vascular channels have the size and structure of normal capillaries

A

T

91
Q

T/F: strawberry hemangiomas usually need to get removed with surgery

A

F: they usually fade at 1-3 years

92
Q

what are lesions that consist of large vascular channels and the skin looks like port wine stains

A

cavernous hemangiomas

93
Q

T/F: cavernous hemangiomas have raised spongy masses which do not regress spontaneously; they may undergo thrombosis, fibrosis, hemorrhage

A

T

94
Q

in which disease is cavernous hemangiomas clinically significant in

A

Hippel Lindau disease

95
Q

what is Hippel lindau disease

A

a rare, inherited genetic disorder that causes tumors and cysts to grow in various parts of the body.

96
Q

what are the different kinds of malignant neoplasias

A

Angiosarcoma
Kaposi’s sarcoma

97
Q

what is a rare highly malignant (50%) mortality rate and consists of neoplastic endothelial cells

A

angiosarcoma

98
Q

what are the different locations of angiosarcoma and what is the most common location

A

MC: liver
skin
soft tissue
breast
bone
spleen

99
Q

what is the liver involvement of angiosarcoma associated with

A

carcinogens (vinyl chloride, arsenic, thorotrast)

100
Q

what is Kaposi’s sarcoma derived from

A

neoplastic endothelial and stromal cells

101
Q

what disease is Kaposis sarcoma associated with

A

AIDS (1/3 of patients)

102
Q

what is the appearance of someone with Kaposi’s sarcoma

A

painful purple/brown nodules/ plaques on hands, feet and face
histological appearance may vary
rarely the primary cause of death

103
Q

in coronary artery bypass what are the grafts subject to

A

thrombosis, intimal thickening, atherosclerosis

104
Q

what is thrombolysis

A

treatment to lyse thrombi and emboli
plasminogen activators used

105
Q

what are the problems with thrombolysis

A

failure to lyse, reocclusion due to the persistence of original disorder

106
Q

what is balloon angioplasty

A

luminal expansion of atherosclerotic arteries
atherosclerotic plaques become unstable

107
Q

what are the complications of balloon angioplasty

A

plaque rupture
medial dissection
stretching of the media
proliferative restenosis

NYCC Physiopathology (27 decks)

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