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Principles of Physiopathology > Pathologies of Blood Vessels > Flashcards

Pathologies of Blood Vessels Flashcards

1
Q

What are two non-inflammatory vascular disorders?

A
  • Monkeberg medial sclerosis
  • Raynaud phenomenon
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2
Q

What is Monkeberg medial sclerosis?

A

A degenerative calcification of the tunica media of large and medium sized muscular arteries

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3
Q

What age does Monkeberg medial sclerosis typically present?

A

Older individuals

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4
Q

Where does Monkeberg medial sclerosis most often occur?

A

Arteries of upper and lower extremities (may cause posterior knee pain)

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5
Q

How is Monkeberg medial sclerosis distinct from atherosclerosis?

A

Ordinarily does not lead to a clinical presentation
No luminal narrowing

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6
Q

What is the etiology of Monkeberg medial sclerosis?

A

Etiology unknown

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7
Q

What is Raynaud phenomenon?

A

Paroxysmal pallor or cyanosis of the digits of hand or feet typically due to cold induced vasoconstriction

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8
Q

How do fingers change color with Raynaud phenomenon?

A

White to blue to red

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9
Q

What is the mechanism of Raynaud phenomenon?

A

Reflects an exaggeration of normal central and vasomotor responses to cold or emotion

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10
Q

Is Raynaud phenomenon primary or secondary?

A

Can be either

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11
Q

What is the prognosis for Raynaud phenomenon?

A

Usually benign, however long-standing cases may show signs of atrophy of skin, subcutaneous tissue, and muscles
Ulceration and gangrene are rare

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12
Q

Inflammatory vasculitides refers to…

A

inflammation of the walls of vessels (all sizes and types)

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13
Q

What are possible etiologies of vasculitis?

A
  • Infection
  • Immunologic
  • Unknown
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14
Q

Clinical presentation of vasculitis is often a result of…

A

vessel lumen narrowing/ obliteration/ dilation/ thrombosis

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15
Q

Many vasculitides are responsive to…

A

steroid/immunosuppressive therapy

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16
Q

What is ESR?
What does an elevation of ESR indicate?

A

Erythrocyte sedimentation rate
Non-specific indicator of inflammation when elevated

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17
Q

What is CRP?
What does an elevation of CRP indicate?

A

C-reactive protein
Non-specific indicator of inflammation when elevated

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18
Q

What is RF?
What does RF assess for?

A

Rheumatoid factor
Assesses for inflammatory joint disease

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19
Q

What is ANA?
What condition involves ANA?

A

Antinuclear antibody
Found in lupus

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20
Q

What is ANCA?

A

Antineutrophilic cytoplasmic antibodies

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21
Q

What is the demographic of those most prone to Takayasu arteritis?

A

Females under 40 years of age

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22
Q

Which structure is affected by Takayasu arteritis?

A

Aortic arch, maybe its branches as well

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23
Q

If a patient has a weaking of peripheral pulses and near obliteration of distal portions of aortic branches, what disease is suspected?

A

Takayasu arteritis

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24
Q

What is polyarteritis nodosa?

A

Necrotizing vasculitis of small and medium sized visceral arteries (no lung involvement)

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25
Where is presentation of polyarteritis nodosa most common?
Kidney, liver
26
What is the demographic of those most prone to polyarteritis nodosa?
Young males
27
If a patient presents with necrotizing of the vessel wall (fibrinoid necrosis), what disease is suspected?
Polyarteritis nodosa
28
What are the three phases of polyarteritis nodosa?
Acute, healing, scarred (may copresent)
29
What are complications of polyarteritis nodosa?
Aneurysm, thrombosis, infarct
30
Polyarteritis nodosa is ___ responsive
corticosteroid
31
What is the demographic of those most prone to allergic granulomatosis and angitis (Churg-Strauss)?
Young individuals with asthma
32
Two-thirds of patients with allergic granulomatosis and angitis (Churg-Strauss) have...
C-ANCA or P-ANCA
33
What structures are affected by allergic granulomatosis and angitis (Churg-Strauss)?
Small and medium-sized arteries and arterioles of the lungs, spleen, kidney, heart, CNS, and others
34
What is the morphology of a typical lesion demonstrating a pattern of fibrinoid necrosis caused by allergic granulomatosis and angitis (Churg-Strauss)?
Intense eosinophilic infiltrate
35
What is the demographic of those most prone to giant cell arteritis (temporal arteritis)?
Patients over 50 years of age
36
Giant cell arteritis (temporal arteritis) is a ___ form of vasculitis in adults
MC systemic form
37
Is giant cell arteritis (temporal arteritis) chronic or acute in form?
Both acute and chronic
38
What structures are affected by giant cell arteritis (temporal arteritis)?
Large and small arteries, particularly in the head Especially temporal arteries but also vertebral and ophthalmic
39
What is a possible consequence of ophthalmic artery involvement in giant cell arteritis (temporal arteritis)?
Sudden permanent blindess
40
Pathogenesis of giant cell arteritis (temporal arteritis) suggests that ___ is generated towards components of the vascular wall
immune reaction
41
___ nature of giant cell arteritis (temporal arteritis) suggests T-cell mediated mechanism and antigen driven injury
Granulomatous
42
Granulomatous nature of giant cell arteritis (temporal arteritis) suggests...
T-cell mediated mechanism and antigen driven injury
43
What are clinical features of giant cell arteritis (temporal arteritis)?
* Facial pain, intense upon palpation * Ocular symptoms mild to severe * May lead to permanent blindness
44
Giant cell arteritis (temporal arteritis) is treated with...
anti-inflammatory
45
If a patient presents with pain and stiffness in neck, shoulder, and hip with extreme exhaustion, what is suspected?
Polymyalgia rheumatica
46
50% of patients with polymyalgia rheumatica also have...
temporal arteritis (giant cell arteritis)
47
What occurs systemically with polymyalgia rheumatica?
WBCs attack joints of the body
48
What is the etiology of Kawasaki disease?
Unknown etiology
49
What is Kawasaki disease?
Disease of the coronary arteries affecting young children under 4 years of age
50
Kawasaki disease is associated with...
mucocutaneous lymph node syndrome (acute self-limiting fever, rash, erythema, desquamation, and lymphadenopathy)
51
About 20% of children with Kawasaki disease develop...
cardiac sequellae leading to aneurysmal formation
52
What are the clinical consequences of Kawasaki disease in order of increasing severity?
* Asymptomatic vasculitis * Coronary artery ectasia * Coronary artery aneurysm * Thrombosis * Myocardial infarction * Sudden death
53
What is the treatment for Kawasaki disease?
Aspirin and intravenous gammaglobulin (decrease immune response)
54
Wegener's granulomatosis is a necrotizing vasculitis characterized by:
1. Acute necrotizing granulomas of upper respiratory tract 2. Necrotizing granulomatosis of small to medium sized vessels 3. Renal disease in the form of focal glomerulitis
55
90% of those with Wegener's granulomatosis present with ___ 75% is ___
90% ANCA 75% C-ANCA
56
Pathogenesis of Wegener's granulomatosis suggests...
hypersensitivity reaction
57
What is the result of Wegener's granulomatosis if not treated?
Rapidly fatal
58
What is the treatment for Wegener's granulomatosis?
Cyclophosphamide (chemotherapy)
59
Thromboangitis obliterans (Buerger's disease) is a distinctive disease leading to...
vascular insufficiency
60
What characterizes thromboangitis obliterans (Buerger's disease)?
Segmental acute and chronic thrombosing of small and medium arteries
61
Where does thromboangitis obliterans (Buerger's disease) principally present?
Tibial and radial arteries
62
Thromboangitis obliterans (Buerger's disease) previously occurred almost exclusively in...
heavy cigarette smoking men
63
What type of inflammation is found in thromboangitis obliterans (Buerger's disease)?
Microabscesses/ granulomatous inflammation
64
What are some symptoms of thromboangitis obliterans (Buerger's disease)?
Claudication; maybe cold intolerance/ Raynaud's
65
Behcet mainly involves...
mucous membranes
66
If a patient presents with oral apthous ulcers, genital ulceration, ocular inflammation, and lesions in CNS, cardiovascular, and GI, what is suspected?
Behcet
67
What is the cause of Behcet?
Unknown, however immune basis
68
What are varicose veins?
Enlarged tortuous blood vessels
69
What is the etiology of varicose veins?
Increased intraluminal pressure
70
What are some risk factors for varicose veins?
Female sex, familial predisposition, obesity
71
Describe the vessel walls of varicose veins?
May be thinned due to dilation or thickened due to hypertrophy
72
What are some results of varicose veins?
Stasis dermatitis and secondary ulceration
73
What is the term for varicosity of rectum and anus?
Hemorrhoids
74
What is the term for varicosity of esophagus?
Esophageal varices
75
What is the term for varicosity of scrotum?
Varicocele
76
What is thrombophlebitis?
Blood clot blocking one or more veins with inflammation, often in legs
77
What is phlebothrombosis?
Blood clot in a vein without inflammation
78
Deep vein thrombosis is associated with...
prolonged bed rest, reduced cardiac output, surgery
79
Deep vein thrombosis is a major threat to life; there can be sudden death following...
post-op ambulation
80
What is the cause of death associated with deep vein thrombosis?
Pulmonary embolus resulting in cor pulmonale
81
What is cor pulmonale?
Enlarged right ventricle due to lung condition (ie. pulmonary embolus)
82
If a patient presents with a general swelling in the calf, ankle, foot, or thigh, increased warmth of the leg, redness, leg pain, night leg cramps, and bluish discoloration of skin on leg or toes, what is suspected?
Deep vein thrombosis

Principles of Physiopathology (36 decks)

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