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PATHOLOGY > Vascular > Flashcards

Vascular Flashcards

1
Q
A
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2
Q

Berry aneurysm congenital defect of the

A

tunica intima and tunica media are congenitally absent allowing an outpocketing of the tunica adventitia

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3
Q

Average age of berry aneurysm

A

20-40

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4
Q

Berry aneurysm location

A

Circle of Willis

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5
Q

Arteriovenous fistulas congenital defect

A

abnormal communications between arterial and venous blood vessels

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6
Q

Arteriovenous fistulas may be secondary to

A

to infection, trauma, blood vessel rupture or previous surgical intervention.

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7
Q

Arteriovenous fistulas may contribute to

A

right-sided congestive heart failure by increasing venous return to the heart

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8
Q

Temporal Arteritis definition

A

granulomatous inflammation and breakdown if the internal elastic membrane of branches of carotid artery

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9
Q

Temporal Arteritis Treatment

A

corticosteroids

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10
Q

Takayasu Arteritis definition

A

granulomatous inflammation of aortic arch, young asian female

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11
Q

Takayasu Arteritis symptoms

A

ocular disturbances, weak/absent pulses in UE

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12
Q

Polyarteritis Nodosa

A

young, adult males w/ nodular inflammation of vessels

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13
Q

Polyarteritis Nodosa affects which organs

A

all organs except the LUNG

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14
Q

Polyarteritis Nodosa acute pathology

A

fibrinoid necrosis w/ neutrophils, eosinophils, monocytes

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15
Q

Polyarteritis Nodosa healing lesion pathology

A

fibroblastic proliferation w/ macrophages and plasma cells

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16
Q

Kawasaki Disease symptoms

A

fever, conjunctivitis, erythematous rash of palms and soles, enlarged cervical lymph nodes

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17
Q

Complication of Kawasaki Disease

A

coronary aneurysm

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18
Q

Kawasaki Disease patient population

A

young asian children/infants

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19
Q

Buerger Disease patient population

A

male, heavy smokers,

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20
Q

Buerger Disease Symptoms

A

gangrene, pain mostly in fingers and toes, Raynaud Phenomenon

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21
Q

Treatment for Kawasaki Disease

A

ASA

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22
Q

Treatment for Buerger Disease

A

smoking cessation

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23
Q

Wegener Granulomatosis definition

A

necrotizing granulomatosis of the nasopharynx, lung, kidney

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24
Q

Wegener Granulomatosis Symptoms

A

chronic sinusitis, nasopharynx ulcerations, hemoptysis, pneumonitis, necrotizing glomerulitis

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25
Q

Test for Wegener Granulomatosis

A

C-ANCA

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26
Q

Wegener Granulomatosis patient pop

A

male, 50+

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27
Q

Microscopic Polyangitis definition

A

arterioles, venules, capillaries of the skin, mucus membranes, lung, heart, GIT, kidney, etc

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28
Q

Test for Microscopic Polyangitis

A

P-ANCA

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29
Q

Churg-Strauss Syndrome is associated w/

A

asthma and eosinophilia

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30
Q

Test for Churg-Strauss Syndrome

A

P-ANCA

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31
Q

Infectious vasculitis

A

direct extension of organism into wall or hematogenous embolization

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32
Q

vaso vasora

A

found in the tunica adventitia

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33
Q

Atherosclerosis commonly occurs in the

A

abdominal aorta, coronary arteries, elastic arteries, muscular arteries and cerebral arteries

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34
Q

atherosclerotic plaque is composed what cells

A

smooth muscle cells, macrophages and leukocytes

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35
Q

atherosclerotic plaque is composed what CT

A

collagen, elastic fibers, proteoglycans

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36
Q

Simple atheromatous plaque is composed of

A

composed of a fibrous cap and central lipid core

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37
Q

The fibrous cap is composed of

A

macrophages, foam cells, lymphocytes, collagen, elastin, and proteoglycans

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38
Q

The inner core is a necrotic center composed of

A

lipid, cholesterol, cellular debris, foam cells, and calcium

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39
Q

Simple atheromatous plaques occur b/w

A

tunica intima and tunica media

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40
Q

Complicated atheromatous plaque is associated w/

A

Either: 1.) calcification 2) surface ulceration 3) thrombosis 4) hemorrhage into the plaque causing hematoma. 5) aneurysmal dilation

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41
Q

fatty streaks

A

earliest sign of atherosclerotic plaque

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42
Q

Fatty streaks are characterized by

A

proliferation of smooth muscle with intracytoplasmic lipid accumulation

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43
Q

fatty streaks tend to occur as

A

intimal cushion pads occurring at the bifurcation of arteries

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44
Q

intimal cushion pads HOWEVER are

A

smooth muscle cells with collagen however, they usually lack lipid

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45
Q

atheroma formation is initiated by

A

damage to endothelium lining arterial blood vessels

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46
Q

Damage causes

A

adherence of platelets and monocytes, attraction of SM cells and collagen production, w/ monocyte/macrophage phagocytosis of lipids deposited in the injury site

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47
Q

Monckeberg

A

ring-like calcifications of the tunica media arranged in a concentric fashion throughout the length of an artery - give rise to bone

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48
Q

Monckeberg sites most commonly affected

A

femoral, tibial, radial, ulnar, and arterial supplies of the genital tracts in both sexes

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49
Q

Arteriolosclerosis

A

thickening of arterial walls due to HTN

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50
Q

Hyaline arteriolosclerosis occurs in

A

hypertensive and diabetics

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51
Q

Hyaline arteriolosclerosis appears as

A

accumulation of pink homogenous hyaline material within the blood vessel wall -> narrowing of intima

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52
Q

Benign nephrosclerosis and/or ischemic necrosis and gangrene in the lower extremities of diabetics is due to

A

Hyaline arteriolosclerosis

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53
Q

Hyperplastic arteriolosclerosis

A

malignant hypertensive

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54
Q

Hyperplastic arteriolosclerosis characteristic finding

A

onionskin layering due to an increase of smooth muscle cells within the tunica media

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55
Q

Hyperplastic arteriolosclerosis most commonly affects

A

abdominal and thoracic viscera are very commonly affected

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56
Q

headache, temporal tenderness, visual loss or facial pain.

A

Temporal arteritis

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57
Q

Polyarteritis Nodosa most commonly affects

A

arterial bifurcations

58
Q

Polyarteritis Nodosa Sx

A

fever of unknown origin, weight loss, hematuria, albuminuria, renal failure, hypertension, abdominal pain, melena myalgia and neuritis

59
Q

acute form of Polyarteritis Nodosa

A

fibrinoid necrosis of the blood vessel wall with infiltrates of neutrophils, eosinophils and monocytes

60
Q

Healing form of Polyarteritis Nodosa

A

fibroblastic proliferation with an infiltrate of macrophages and plasma cells

61
Q

Healed form of Polyarteritis Nodosa

A

fibrotic thickening of the blood vessel wall with a loss of the internal elastic membrane.

62
Q

Churg-Strauss Syndrome

A

allergic granulomatosis of Polyarteritis Nodosa

63
Q

Churg-Strauss Syndrome key findings

A

bronchial asthma, marked eosinophilia

64
Q

Wegener granulomatosis

A

necrotizing granulomas, upper airway and lungs, glomerulitis

65
Q

Wegener granulomatosis occurs at age

A

50+

66
Q

Treatment of Wegener granulomatosis

A

if not fatal in 5 mo

67
Q

Buerger Disease patients

A

heavy smokers under the age of 35

68
Q

Buerger Disease Sx

A

Raynaud phenomenon, instep claudication, pain with gangrene

69
Q

mycotic aneurysm

A

weakening of the vessel wall due to infectious vasculitis

70
Q

Raynaud Disease definition

A

intense vasospasm of small arteries and arterioles of

71
Q

Raynaud Disease pathology

A

no identifiable changes in the arterial walls except in the late form in which there may be intimal proliferation

72
Q

Raynaud phenomenon definition

A

arterial insufficiency from a direct underlying cause

73
Q

Underlying causes of Raynaud phenomenon

A

SLE, scleroderma, atherosclerosis, Buerger

74
Q

The most common cause of aortic aneurysms is

A

atherosclerosis

75
Q

Aneurysm pathogenesis

A

cystic medial necrosis with degeneration of the tunica media and subsequent weakening of the wall

76
Q

Atherosclerotic aneurysms pt pop

A

hypertensive males, abdominal aorta, may rupture

77
Q

Complications of Atherosclerotic aneurysms

A

mural thrombi/emboli, rupture into peritoneum

78
Q

Syphilitic (luetic) aneurysms common site

A

ascending thoracic aorta and arch

79
Q

Syphilitic (luetic) aneurysms characteristic shape

A

fusiform

80
Q

Syphilitic (luetic) aneurysms appearance of vessel

A

endothelium undergoes “tree-barking”, caused by linear destruction and inflammation of the tunica intima

81
Q

Syphilitic (luetic) aneurysms pathology

A

lymphocytes and plasma cells, medial necrosis and destruction

82
Q

Aortic Dissection

A

tear of the tunica intima into the tunica media with separation and dissection along the tunica media

83
Q

Aortic Dissection fate

A

spontaneously reenter the aortic lumen or may end as a blind pouch

84
Q

Aortic Dissection pathology

A

cystic medial necrosis with fragmentation of the elastic membrane

85
Q

Aortic Dissection Type A1

A

begins in the ascending aorta and extends over the arch and down along the entire descending aorta

86
Q

Aortic Dissection Type A2

A

begins at and involves only ascending aorta

87
Q

Aortic Dissection Type B

A

distal to the aortic arch and involves the entire descending aorta

88
Q

Venous varicosities are caused by

A

destruction of venous valves with subsequent venous insufficiency

89
Q

Venous varicosities Sx

A

progression of marked dilation and tortuosity of veins

90
Q

Venous varicosities pt pop

A

genetic predisposition, non-mobile upright occupations

91
Q

Venous varicosities of the Lower extremities

A

superficial veins, dilated tortuousities, prone to thrombi

92
Q

Venous varicosities - Hemorrhoids caused by

A

increased abdominal pressure (obesity, tumor, scarring secondary to previous surgery or trauma, pregnancy)

93
Q

Venous varicosities - Esophageal varices

A

lower plexus of the esophagus, cirrhosis, chronic alcoholics and prone to rupture

94
Q

Venous varicosities - Varicocele

A

pampiniform plexus of the spermatic cord, “bag of worms”

95
Q

Phlebothrombosis and Thrombophlebitis

A

inflammation with thrombosis - inflammatory processes of the veins associated with the formation of venous thrombi

96
Q

Causes for Phlebothrombosis

A

cardiac failure, neoplasia, pregnancy, obesity, post operative state, infection, prolonged bed rest or immobilization and hypercoagulable states

97
Q

Trousseau sign

A

paraneoplastic syndrome of malignany is migratory thrombophlebitis

98
Q

Phlebothrombosis locations

A

DVT, periprostatic venous plexus, large veins of the skull

99
Q

first manifestation of Phlebothrombosis may be

A

PE

100
Q

Lymphangitis causes

A

bacterial - group A beta hemolytic streptococci

101
Q

Lymphangitis pathogenesis

A

dilated and filled with acute inflammatory exudate -> break through causing cellulitis and abscess

102
Q

Clinically lymphangitis is diagnosed by

A

development of streaks along extremities spreading towards the trunk from the distal area proximally

103
Q

The most common causes of lymph edema include

A
  1. metastasis + obstruction in the lymphatic vessels 2) surgery 3) radiation 4) filariasis 5) post inflammatory thrombosis with scarring of lymphatic channels.
104
Q

chylous ascites, chylothorax or chylopericardium

A

Lymph edema in the abdominal and thoracic cavities

105
Q

Capillary hemangioma

A

small, benign, neoplasm of capillaries in the skin, mucus membrane, viscera

106
Q

strawberry hemangioma

A

large capillary hemangioma on the skin of infants

107
Q

strawberry hemangioma fate

A

usually fade at approximately 3 years of, regress by 5

108
Q

Cavernous hemangiomas

A

small, benign, neoplasm of dilated vascular spaces of the head and neck, mucus membranes, viscera, brain

109
Q

von Hippel-Lindau

A

condition in which cavernous hemangiomas occur in the cerebellum or brain stem and eye grounds, pancreas, liver, etc

110
Q

Granuloma Pyogenicum

A

polypoid form of hemangioma, with surface inflammation and ulceration or the skin, gingiva, and oral mucosa

111
Q

Granuloma Pyogenicum pathology

A

distinct collarette at base w/ granulation-looking stroma

112
Q

33% of Granuloma Pyogenicum are due to

A

trauma

113
Q

granuloma gravidarum

A

tumor on the gingiva and spontaneously regresses after delivery

114
Q

Glomus Tumor definition

A

benign, painful tumor of the nerve receptor sensitive to temperature variation and regulating arterial flow

115
Q

Glomus Tumor commonly found

A

distal extremities, especially beneath the nails

116
Q

Pathology of Glomus Tumor

A

Vascular channels split by CT Aggregated nests of gloms cells

117
Q

Vascular Ectasias

A

Nevus flammeus, Spider telangiectasis, Hereditary hemorrhagic telangiectasia

118
Q

Hemangioendothelioma

A

endothelial cells growing in vascular lumina

119
Q

Hemangioendothelioma is intermediate b/w

A

hemangioma and angiosarcoma

120
Q

Hemangioendothelioma is most common in the

A

skin but also the spleen and liver

121
Q

Hemangioendothelioma pathology

A

spindle shaped cells with occasional mitotic figures and pleomorphism

122
Q

Angiosarcoma

A

anaplastic endothelial cells with frequent mitotic figures

123
Q

Angiosarcoma is most common in the

A

skin, breast, soft tissue and liver

124
Q

Angiosarcoma symptoms

A

small red well-demarcated masses -> bulky and fleshy with central areas of hemorrhage and poorly defined borders

125
Q

Hepativ variants of Angiosarcoma involve exposure to

A

arsenic, Thorotrast and PVC

126
Q

Hemangiopericytoma

A

lower extremities and retroperitoneum, these rare tumors arise from pericytes

127
Q

Hemangiopericytoma pahtology

A

spindle-shaped cells

128
Q

Hemangiopericytoma risk of metastatsis

A

50% may metastasize to the lungs, bone and liver.

129
Q

Classic Kaposi Sarcoma pt pop

A

older men of Eastern European and Mediterranean,

130
Q

Classic Kaposi Sarcoma Sx

A

multiple purple red skin plaques or nodules usually arising on the lower extremities and spreading proximally

131
Q

African Kaposi Sarcoma pt pop

A

children and younger men

132
Q

African Kaposi Sarcoma accounts for 10% of

A

All tumors in Africa, regional lymph node involvement

133
Q

Transplant Associated Kaposi pt pop

A

transplant recipients + immunosuppressants

134
Q

Transplant Associated Kaposi Sx

A

localized or metastasized, regresses w/ discontinuation of immunosuppressants

135
Q

AIDS-associated Kaposi pt pop

A

33% of all AIDS pts

136
Q

AIDS-associated Kaposi Sx

A

wide dissemination, skin, membranes, viscera and typically develop another malignancy

137
Q

Appearance of all kaposi lesions

A

red to blue coalescing plaques and nodules composed of spindle cells around angulated blood filled vascular spaces with occasional mitoses

138
Q

Lymphangioma

A

benign, subcutaneous tissues of the head, neck and axilla

139
Q

Lymphangioma pathology

A

identical to capillary hemangioma but absence of blood from the vascular spaces

140
Q

Lymphangiosarcoma

A

malignant, after prolonged lymph obstruction w/ lymphedema

141
Q

Lymphangiosarcoma is most common in

A

mastectomy pt

142
Q

Lymphangiosarcoma Sx

A

small subcutaneous nodules, which later coalesce to form a large mass

PATHOLOGY (18 decks)

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