Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Block 9 Week 1 > Fung > Vascular Path > Flashcards

Fung > Vascular Path Flashcards

1
Q

what is ECM made of?

A

elastin
collagen
glycosaminoglycans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the 3 components of the vasculature?

A

endothelial cells
smooth muscle cells
ECM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the 5 fxns of the endothelial cells?

A 
maintain non-thrombogenic blood-tissue interface
modulate vascular resistance
metabolize hormones
regulate inflammation
regulate cell growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which component of the vasculature proliferates when stimulated?

A

smooth muscle cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what do smooth muscle cells synthesize?

A

collagen
elastin
proteoglycans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what do smooth muscle cells elaborate?

A

growth factors

cytokines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the 3 layers of the vasculature?

A

intima
media
adventitia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the 2 specialized layers in muscular arteries?

A

internal elastic lamina

external elastic lamina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

T/F: arteries have valves

A

false

veins do

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

where do berry aneurysms occur?

A

cerebral vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T/F: the majority of berry aneurysms occur sporadically

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are 4 possible genetic causes of berry aneurysms?

A

AD polycystic kidney disease
Ehlers-Danlos syndrome
NF1
Marfan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are 2 risk factors for developing berry aneurysms?

A

cigarette smoking & HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

are berry aneurysms present at birth?

A

no
they develop over time
(they’re still inexplicably called congenital though)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are atriovenous fistulas?

A

small direct connections btwn arteries & veins that bypass capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

can inflammatory necrosis of adjacent vessels cause AV fistulas?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

can developmental defects cause AV fistulas?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

can penetrating injuries that pierce arteries & veins cause AV fistulas?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

can rupture of an arterial aneurysm into an adjacent vein cause an AV fistula?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

can AV fistulas be iatrogenic?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is fibromuscular dysplasia?

A

focal irregular thickening of the walls of medium & large muscular arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what does fibromuscular dysplasia result in?

A

luminal stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

at what age does fibromuscular dysplasia occur?

A

any

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

in what group is fibromuscular dysplasia most common?

A

young women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is an aneurysm?

A

localized abnormal dilation of a blood vessel or the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

T/F: aneurysms are always acquired

A

false

they can also be congenital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are the 2 types of aneurysms?

A

true

false

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the 2 forms of true aneurysms?

A

saccular

fusiform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is a true aneurysm?

A

involves an intact attenuated arterial wall or thinned ventricular wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what are 4 examples of true aneurysms?

A

atherosclerotic
syphilitic
congenital
ventricular following transmural infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is another name for a false aneurysm?

A

pseudo-aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is a false aneurysm?

A

a defect in the vascular wall leading to an extravascular hematoma that freely communicates w/ the intravascular space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is an example of a false aneurysm?

A

ventricular rupture w/ pericardial adhesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is a saccular true aneurysm?

A

spherical outpouchings involving only a portion of the vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

how big are saccular true aneurysms?

A

5-20 cm diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is a fusiform true aneurysm?

A

diffuse circumferential dilation of a long vascular segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

how big are fusiform true aneurysms?

A

up to 20 cm diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

where can you find fusiform true aneurysms?

A

extensive portions of the aortic arch
abdominal aorta
iliac arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what can cause an aneurysm to form (generally)?

A

any process that causes weakening of the vessel wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what are the 2 main general causes of aneurysms?

A

sporadic
OR
connective tissue disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what is Marfan syndrome?

A

a defect of fibrillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what is Ehlers-Danlos?

A

a defect in the synthesis or structure of fibrillar collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is Vitamin C deficiency?

A

altered collagen cross-linking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is Loeys-Dietz syndrome?

A

a defect in elastin, collagen I, & collagen III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

how can inflammation cause an aneurysm?

A

alters the balance of synthesis & destruction of collagen

increased matrix metalloproteases (MMP) degrade the ECM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what causes a thickening of the intima and cystic medial degeneration?

A

loss of smooth muscle cells
OR
proliferation of non-collagenous/non-elastic ECM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what is the consequence of a thickened intima?

A

decreased diffusion of oxygen and nutrients to the media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what are the 2 most important predisposing factors for aneurysms?

A

HTN & atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what does atherosclerosis cause particularly?

A

AAA

abdominal aortic aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what does HTN cause particularly?

A

ascending aortic aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

can infection cause an aneurysm?

A

yes d/t embolization, direct extension, or organism circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

can aneurysms be congenital?

A

yes (developmental berry aneurysms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what is the most common location of atherosclerotic aneurysms?

A

abdominal aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

how do AAAs form?

A

cystic medial degeneration results in thinning & weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what is a major influence for developing AAA?

A

increased MMP (matrix metalloproteases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

T/F: AAAs are always saccular

A

false

they can be saccular or fusiform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what is an inflammatory type AAA?

A

dense periaortic fibrosis containing abundant lymphocytes, plasma cells, & macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what is a mycotic type AAA?

A

d/t circulating microorganisms that destroys the media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what are the 4 clinical consequences of a AAA?

A

rupture w/ potential fatal hemorrhage
obstruction of branch vessel
embolism from atheroma or mural thrombus
impingement on adjacent structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what is a thoracic aneurysm most commonly assoc w?

A

HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

what are the sx of a thoracic aneurysm?

A

bone pain
cough (pressure on recurrent laryngeal nerve)
aortic valve dilation w/ insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

what can a TAA encroach on?

A

mediastinal structures
lungs & airways
esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what is a dissection?

A

blood splays apart the laminar planes of the media to form a blood filled channel w/i the vessel wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

T/F: dissection is always assoc w/ vessel dilation

A

FALSE (may or may not be assoc w/ it)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

who gets dissections?

A

men 40-60 yo w/ HTN

younger pts w/ systemic & localized abnormalities of the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

why don’t you usually see dissection w/ atherosclerosis?

A

bc of medial fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

what is the major risk factor for dissection?

A

HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what is the pathophysiology of dissection?

A

medial hypertrophy of the vasa vasorum w/ degenerative changes of the media
i.e. injury d/t diminished flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

what 3 tissue disorders can lead to dissection?

A

Marfan
Ehlers-danlos
Vitamin C deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

what is the most frequent histologically detectable lesion w/ dissection?

A

cystic medial degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

what is a Type A dissection?

A

a proximal lesion involving either the ascending aorta only or in conjunction w/ the descending aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

what DeBakey types are assoc w/ Type A dissection?

A

I & II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

what is a Type B dissection?

A

distal lesion beginning distal to the subclavian artery & NOT involving the ascending aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

what DeBakey types are assoc w/ Type B dissection?

A

type III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

what is DeBakey type I?

A

involves ascending AND descending aorta

type A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

what is DeBakey type II?

A

involves ascending aorta only

type A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

what is DeBakey type III?

A

involves the descending aorta only (distal to subclavian)

type B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

what is vasculitis?

A

general term for vessel wall inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

what do the clinical features of vasculitis depend on?

A

which vascular bed is affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

T/F: vasculitis affects only small vessels

A

false

affects any vessels of any organ or any size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

what are the 2 most common pathogenic mechanisms of vasculitis?

A

immune-mediated inflammation

direct invasion of vascular walls by infectious pathogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

T/F: infectious pathogens can initiate both infectious AND non-infectious vasculitis

A

true

idk why

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

what vessels does large vessel vasculitis affect?

A

aorta

large branches to extremities/head/neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

what are 2 types of large vessel vasculitis?

A 
Giant cell (temporal) arteritis
Takayasu arteritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

what vessels does medium vessel vasculitis affect?

A

main visceral arteries & their branches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

what are 2 types of medium vessel vasculitis?

A

Polyarteritis nodosa

Kawasaki disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

what vessels does small vessel vasculitis affect?

A

arterioles
venules
capillaries
small arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

what vessels does variable vessel vasculitis affect?

A

no predominant type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

what are 2 types of variable vessel vasculitis?

A

Behcet’s disease

Cogan’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

what is the mechanism for large vessel vasculitis?

A

granulomatous disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

what is the mechanism for medium vessel vasculitis?

A

immune-complex mediated
OR
anti-endothelial cell ab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

what are the mechanisms for small vessel vasculitis?

A

immune complex mediated
OR
paucity of immune complexes (often w/ ANCA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

what are the 4 types of immune-complex mediated small vessel vasculitis?

A

SLE
IgA
Cryoglobin
OTHER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

what are the 3 types of “paucity of immune complexes” small vessel vasculitis?

A

vasculitis w/o asthma or granulomas
granulomas, no asthma
eosinophils, asthma, & granulomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

what are the 8 types of small vessel vasculitis?

A 
SLE vasculitis
IgA vasculitis
cryoglobinemic vasculitis
Wegener granulomatosis
Churg-Strauss syndrome
Microscopic polyantitis
anti-GBM disease
hypocomplementemic urticarial vasculitis
96
Q

what are 3 other types of vasculitis?

A

single organ
vasculitis assoc w/ systemic disease
vasculitis assoc w/ probable etiology

97
Q

does non-infectious vasculitis predispose you to vasculitis?

A

yes

Kawasaki disease

98
Q

what 3 things happen in non-infectious vasculitis?

A

immune complex deposition
anti-neutrophil cytoplasmic ab
anti-endothelial cell ab

99
Q

what are 3 examples of immune-complex associated vasculitis?

A

SLE
polyarteritis nodosa
drug hypersensitivity vasculitis

100
Q

what 3 things are detected in immune complex assoc vasculitis?

A

ab
complement
ag-ab complexes

101
Q

what does ANCA stand for?

A

antineutrophil cytoplasmic antibodies

102
Q

what is ANCA?

A

circulating abs react w/ neutrophil cytoplasmic ag

103
Q

what are the abs directed against in ANCA?

A 
they're heterogeneous
directed against:
neutrophil primary granules
monocyte lysosomes
endothelial cells
104
Q

what are the 2 types of antineutrophil cytoplasmic antibodies?

A

anti-myeloperoxidase (MPO-ANCA)
&
anti-proteinase-3 (PR3-ANCA)

105
Q

what is MPO?

A

a lysosomal granule constituent

106
Q

what conditions is MPO-ANCA seen in?

A

therapeutic agents (propylthiouracil)
microscopic polyangitis
Churg-Strauss syndrome

107
Q

what is p-ANCA?

A

perinuclear

108
Q

what is c-ANCA?

A

cytoplasmic

109
Q

what is PR3?

A

a neutrophil azurophilic granule constituent

110
Q

what does PR3 share homology with?

A

microbial peptides

111
Q

when do you see PR3-ANCA?

A

in Wegener granulomatosis

112
Q

what are the 2 mechanisms for vasculitis with ANCA?

A

drugs or cross-reactive microbe (ag) induce ANCA formation
OR
neutrophils release MPO/PR3 & cause ANCA formation in a susceptible host

113
Q

what happens when the host releases cytokines?

A

causes expression of MPO/PR3 on neutrophils or other cell types

114
Q

what happens when ANCA reacts?

A

directly induces endothelial injury OR activates other neutrophils

115
Q

what do ANCA-activated neutrophils do?

A

degranulate, release ROS > further injure endothelial cells

116
Q

what is the process for vasculitis with ANCA (4 steps)?

A
  1. induced ANCA formation via drugs (or ag) OR neutrophil release of MPO/PR3
  2. cytokine release > MPO/PR3 expression on neutrophils
  3. ANCA react > endothelial injury or activation of neutrophils
  4. ANCA-activated neutrophils degranulate > ROS > injure endothelial cells
117
Q

what is the most common vasculitis among elderly pts over 50 yo?

A

giant cell arteritis

118
Q

what is giant cell arteritis?

A

chronic granulomatous inflammation of large to small-sized arteries

119
Q

what does giant cell arteritis affect?

A

arteries of the head: temporal artery, vertebral artery, ophthalmic artery, aorta

120
Q

is giant cell arteritis a medical emergency?

A

YES

ophthalmic artery involvement can cause blindness

121
Q

what is the mechanism of giant cell arteritis?

A

T cell lymphocytic immune response to an unknown ag

122
Q

what 2 things may also contribute to giant cell arteritis?

A

TNF & anti-endothelial cell humoral immune responses

123
Q

what is the histology of giant cell arteritis?

A

discontinuous involvement of the vessel
intimal thickening
medial granulomatous inflammation with giant cells
elastic lamina fragmentation

124
Q

what is the clinical consequence of having discontinuous involvement of the vessel?

A

multiple biopsies

125
Q

what is takayasu arteritis?

A

granulomatous arteritis of medium or large arteries

126
Q

what characterizes takayasu arteritis?

A

ocular disturbances

marked weakening of pulses in upper extremities (pulseless disease)

127
Q

what happens to the aorta in takayasu arteritis?

A

fibrous thickening of the aortic arch & great vessels

128
Q

what does takayasu arteritis share features with?

A

giant cell arteritis

BUT W/ TAKAYASU THE PTS ARE LESS THAN 50 YO!!!!!

129
Q

what is polyarteritis nodosa?

A

systemic vasculitis of small or medium-sized muscular arteries

130
Q

what arteries does polyarteritis nodosa affect?

A 
renal vessels 
visceral vessels (heart, liver, GI tract)
131
Q

what arteries does polyarteritis nodosa NOT affect?

A

pulmonary circulation

arterioles, capillaries, venules

132
Q

what disease is polyarteritis nodosa assoc w/?

A

chronic hep B

133
Q

what complexes in vessels w/ hep B & polyarteritis nodosa?

A

HBsAg-HBsAb

immune complex mediated

134
Q

what is the cause of polyarteritis nodosa?

A

unknown in most cases

135
Q

what is polyartertitis nodosa?

A

segmental transmural necrotizing inflammation (neutrophils, eosinophils, & lymphocytes)

136
Q

how does polyarteritis nodosa affect the vessel?

A

circumferentially

137
Q

what region does polyarteritis nodosa prefer?

A

vessel branch points

138
Q

what are some complications of polyarteritis nodosa?

A

weakened vessels

aneurysms

139
Q

what replaces the acute inflammatory infiltrate in polyarteritis nodosa?

A

fibrous thickening of the vessel wall

140
Q

what are the lesions like in polyarteritis nodosa?

A

coexist in different stages > recurrent & ongoing insults

141
Q

what is kawasaki disease?

A

acute febrile self-limited illness of infancy/childhood

142
Q

what vessels does kawasaki affect?

A

large to medium to small vessels

143
Q

what kind of syndrome is kawasaki?

A

mucocutaneous lymph node syndrome

144
Q

what are the sx of kawasaki?

A 
conjunctival & oral erythema & erosion
edema of hands & feet
erythema of palms & soles
desquamative rash
cervical lymph node enlargement
145
Q

why is kawasaki clinically significant?

A

coronary artery involvement

146
Q

what can cause MI in kawasaki?

A

aneurysms that rupture & thrombose

147
Q

why is there vasculitis in kawasaki?

A

from delayed hypersensitivity rxn of T cells to uncharacterized ag (possibly infectious agents)

148
Q

what is the auto-ab process in kawasaki?

A

cytokines produced
B cell activation
auto-ab produced against endothelial & smooth muscle cells

149
Q

what part of the vessel do kawasaki inflammatory lesions affect?

A

entire thickness of the vessel wall

150
Q

does kawasaki have more or less fibrinoid necrosis than polyarteritis nodosa?

A

less

151
Q

what happens w/ healed lesions in kawasaki?

A

may have obstructive intimal thickening

152
Q

what is microscopic polyangitis?

A

segmental fibrinoid necrotizing vasculitis

153
Q

what vessels does microscopic polyangitis affect?

A

capillaries, arterioles, and venules

154
Q

what disease does microscopic polyangitis resemble?

A

polyarteritis nodosa

but microscopic polyangitis affects SMALLER VESSELS

155
Q

T/F: all lesions in microscopic polyangitis are at the same stage at the same time

A

TRUE

156
Q

which ANCA is microscopic polyangitis assoc w/?

A

MPO-ANCA

157
Q

what is another name for microscopic polyangitis?

A

leukocytoclastic vasculitis

158
Q

what does microscopic polyangitis affect?

A 
skin > palpable cutaneous purpura
mucous membranes
lungs > hemoptysis
brain
heart
GI tract > bowel pain & bleeding
kidney > hematuria, proteinuria
muscle > pain, weakness
159
Q

what can microscopic polyangitis occur w/?

A

henoch-schonlein purpura
essential mixed cryoglobinemia
vasculitis assoc w/ CT disorders

160
Q

what is Churg-Strauss syndrome?

A

small vessel necrotizing vasculitis

161
Q

what is churg-strauss assoc w/?

A 
asthma
allergic rhinitis
lung infiltrates
peripheral hypereosinophilia
extravascular necrotizing granulomas
162
Q

what is churg-strauss also called?

A

allergic granulomatosis

163
Q

what does churg-strauss histologically resemble?

A

PAN or microscopic polyangitis

BUT churg-strauss has granulomas & eosinophils

164
Q

what ANCA is present sometimes w/ Churg-Strauss?

A

MPO-ANCA

165
Q

what are the clinical manifestations of churg-strauss?

A

palpable purpura
GI tract bleeding
focal & segmental glomerulosclerosis

166
Q

what 3 things characterize the necrotizing vasculitis assoc w/ Wegener granulomatosis?

A

acute necrotizing granulomas in upper &/or lower respiratory tract
necrotizing granulomatous vasculitis affecting small-med sized vessels
focal necrotizing crescentic glomerulonephritis

167
Q

what does Wegener granulomatosis resemble?

A

polyarteritis nodosa

BUT Wegener has respiratory involvement

168
Q

what is Wegener granulomatosis?

A

a T-cell mediated hypersensitivity rxn to an inhaled infectious agent

169
Q

what ab it present in 95% of wegener pts?

A

anti-PR3 c-ANCA

170
Q

what is another name from thromboangiitis obliterans?

A

buerger disease

171
Q

what is thromboangiitis obliterans?

A

segmental thrombosing acute & chronic inflammation of medium & small arteries

172
Q

what does thromboangiitis obliterans lead to?

A

vascular insufficiency principally in the tibial & radial arteries (sometimes veins & nerves)

173
Q

who gets thromboangiitis obliterans?

A

almost exclusively seen in heavy smokers before 35 yo

174
Q

why do cigarettes cause vascular damage?

A

directly toxic to endothelial cells
OR
an immune response to cigarettes

175
Q

what are the clinical features of thromboangiitis obliterans?

A

superficial nodular phlebitis
Raynaud-type cold sensitivity
instep claudication
severe pain at rest in extremities

176
Q

what is infectious vasculitis?

A

direct invasion of infectious agents (bacteria or fungus)

177
Q

how can infectious vasculitis spread hematogenously?

A

seeding during sepsis or embolization

178
Q

what can infectious vasculitis lead to?

A

mycotic aneurysms

179
Q

what is Raynaud phenomenon a result of?

A

exaggerated vasoconstriction of digital arteries & arterioles

180
Q

what are the sx of Raynaud phenomenon?

A

paroxysmal pallor

cyanosis of digits of hands & feet

181
Q

what is primary raynaud phenomenon?

A

exaggeration of central & local vasomotor responses to cold or emotional stress

182
Q

what is secondary raynaud phenomenon?

A 
vascular insufficiency of the extremities secondary to arterial disease caused by...
SLE
Scleroderma
Buerger disease
Atherosclerosis
183
Q

what are varicose veins?

A

abnormally dilated tortuous veins

184
Q

how are varicose veins produced?

A

prolonged increased intraluminal pressure & loss of vessel support

185
Q

where can you get varicose veins?

A

superficial veins of upper & lower leg
esophageal varices
hemorrhoids

186
Q

how can varicose veins cause esophageal varices?

A

d/t portal vein HTN

187
Q

what can esophageal varices do?

A

rupture > fatal hemorrhage

188
Q

what are thrombophlebitis & phlebothrombosis?

A

interchangeable names for venous thrombosis & inflammation

189
Q

where do you get thrombophlebitis?

A 
deep leg veins
periprostatic venous plexus
pelvic venous plexus
large skull veins
dural sinuses
190
Q

where does MOST thrombophlebitis occur?

A

deep leg veins

90%

191
Q

why do pts get thrombophlebitis in their deep leg veins?

A

prolonged immobilization predisposes you

192
Q

what can deep leg vein thrombophlebitis lead to?

A

PE

193
Q

what predisposes you to thrombophlebitis?

A

systemic hypercoagulability

194
Q

when can you get migratory thrombophlebitis?

A

paraneoplastic syndromes

195
Q

what causes SVC syndrome?

A

neoplasms that compress or invade the SVC (bronchogenic ca or mediastinal lymphoma)

196
Q

what are the complications of SVC syndrome?

A

dilation of the veins of the head

neck & arm cyanosis

197
Q

what causes IVC syndrome?

A

neoplasms that invade or compress the IVC (HCC, RCC)
OR
thrombus from hepatic, renal, or LE veins

198
Q

what is lymphangitis?

A

acute inflammation d/t bacteria

199
Q

which bacteria cause lymphangitis?

A

group A beta-hemolytic streptococci

200
Q

what causes primary lymphedema?

A

congenital defects
OR
familial agenesis or hypoplasia

201
Q

what causes secondary lymphedema?

A 
tumors
lymph node dissection
post-irradiation fibrosis
filariasis
post-inflammatory thrombosis & scarring
202
Q

T/F: primary tumors of large vessels are common

A

FALSE

they’re rare!

203
Q

what is the neoplasm you get in the vessels?

A

soft tissue sarcoma

204
Q

from what can vessel neoplasms be derived?

A

endothelium
OR
cells that support blood vessels

205
Q

what do benign vessel tumors produce?

A

well-formed vascular channels lined by normal endothelium

206
Q

what do malignant vessel tumors look like?

A 
NO well-formed vascular channels
cytologic atypia (duh)
207
Q

what are hemangiomas/pyogenic granulomas?

A

common tumors w/ increased #s of BVs filled w/ blood

208
Q

what is a capillary hemangioma?

A

closely packed thin walled capillaries

209
Q

what is a cavernous hemangioma?

A

large dilated vascular channels

210
Q

what is a pyogenic granuloma a form of?

A

capillary hemangioma

211
Q

what is lymphangioma?

A

benign lymphatic analogues of BV hemangioma

212
Q

what is simple capillary lymphangioma?

A

small lymphatic channels

213
Q

what is cavernous lymphangioma?

A

massively dilated lymphatic channels w/ lymphocytes in the CT

214
Q

what is another name for cavernous lymphangioma?

A

cystic hygroma

215
Q

what is the cause of Kaposi sarcoma?

A

HHV-8

216
Q

who gets chronic Kaposi sarcoma?

A

older Eastern European/Mediterranean men

217
Q

how does Kaposi sarcoma present?

A

skin lesions

218
Q

who gets lymphadenopathic KS?

A

people in areas of Africa

219
Q

how does lymphadenopathic KS present?

A

lymphadenopathy (duh)

220
Q

what is transplant associated KS?

A

occurs in organ transplant & immunosuppressed setting

221
Q

how does transplant associated KS present?

A

nodal, mucosal, visceral involvement

v aggressive

222
Q

who gets AIDS-assoc KS?

A

pts w/ AIDS

223
Q

what is the most prevalent malignancy in AIDS pts?

A

AIDS assoc KS

224
Q

how does AIDS assoc KS present?

A

lymph node & visceral involvement

225
Q

what is angiosarcoma?

A

malignant endothelial neoplasms that range from well-differentiated to anaplastic

226
Q

what settings give you hepatic angiosarcoma?

A

arsenic, thorotrast, polyvinyl chloride, lymphedema, post-radiation

227
Q

what is a glomus tumor?

A

benign tumor arising from modified smooth muscle cells of the glomus body

228
Q

what is the glomus body involved w/?

A

thermoregulation

229
Q

what is vascular ectasia?

A

common lesions but NOT true neoplasms

local dilation of pre-existing vessels

230
Q

what are the types of vascular ectasia?

A

nevus flammeus
spider telangiectasia
hereditary hemorrhagic telangiectasia

231
Q

what are some examples of nevus flammeus?

A

birthmarks
port-wine stain
Sturge-Weber syndrome

232
Q

what is another name for hereditary hemorrhagic telangiectasia?

A

Osler-Weber-Rendu disease

233
Q

what is bacillary angiomatosis?

A

vascular proliferation arising from an opportunistic infection in immunocompromised pts

234
Q

what bacteria causes bacillary angiomatosis?

A

Bartonella

235
Q

what is hemangioendothelioma?

A

intermediate neoplasm eg epithelioid hemangioendothelioma

236
Q

what is hemangiopericytoma?

A

rare tumors derived from pericytes

237
Q

i am so sorry this is a fucking million cards

A

at least it’s over! :)

Block 9 Week 1 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions