Robbins Vessels

Question 1

1. Thinning of the media not necessarily associated with

Answer 1

acute coronary syndrome

Question 2

8. Something like AAA can be closely associated with

Answer 2

poorly controlled diabetes mellitus (strongest risk factor listed here)

Question 3

12. Thrombophlebitis a common problem resulting from

Answer 3

venous stasis (compared to varicose veins that are superficial and can thrombose, BUT NOT RELATED TO BED REST)

Question 4

13. Key components of essential HTN

Answer 4

Renal retention of excess Na:

1. increased intravascular fluid volume
2. increase in CO
3. peripheral vasoconstriction

Question 5

16. Venous stasis results in

Answer 5

hemosiderin deposition and dermal fibrosis, with brownish discoloration and skin roughening (can see some focal ulceration and only the superficial set of veins involved in this case)

Question 6

26. Deletion of what can help with atherosclerosis?

Answer 6

T-cell receptor genes: lose these, prevent T cell development and T cells cannot adhere to VCAM-1 on activated endothelial cells to migrate into vessel wall. They can then secrete various proinflamm molecules to recruit and activate monocytes and smooth muscle cells and perpetuate chronic inflamm of the vessel wall

Question 7

32. If a premenopausal woman or a young man has severe coronary atherosclerosis,

Answer 7

diabetes must be suspected as a predisposing factor (softer risk factors are obesity, stress, lack of physical activity/exercise)

Question 8

33. Skin lesions in upper chest with central pulsatile cores are

Answer 8

spider telangiectasias, a consequence of micronodular cirrhosis, typically as a consequence of chronic alcoholism; think of hyperestrogenism that results from hepatic damage

Question 9

37. Angiosarcoma can appear as

Answer 9

an irregular, infiltrative, soft reddish mass, with pleomorphic spindle cells positive for CD31;
look for POLYVINYL CHLORIDE association!!!

Question 10

38. CRP is an acute phase reactant that

Answer 10

increases in response to inflamm; causes endothelial cell activation, promotes thrombosis, and increases leukocyte adhesiveness in developing atheromas;
it is an independent predictor of cardiovascular risk