Vascular diseasae Flashcards
describe the Temporal giant cell arteritis
- Over age of 50
- Arteries of the head (esp. temporal artery and vertebral)
- Ophthalamic arterial involvement (visual disorders)
- Nodular thickenings of vessel with reduction of lumen (very patchy, skippy in the way it presents)
- Granulomatous inflammation (HLA-DR associated)
- T-Cell mediated
describe the symptoms of Temporal arteritis
- Vague symptoms: fever, fatigue, weight loss
- Headache (along superficial temporal artery), sometimes pain on palpation, facial pain
- Vision problems if opthalmic artery is involved
Describe Takayasu arteritis (pulseless disease)
- Granulomatous vasculitis of medium and large arteries (aortic arch and branches also pulmonary coronary and renal arteries)
- destruction of media by mononuclear cells and giant cells
- Characterized by OCULAR DISTURBANCES and WEAKING of PULSES in upper extremities
- predominantly females under age 40
Polyarteritis Nodosa (PAN)
- Systemic necrotizing vasculitis of small and medium sized arteries
–> produce infarcts (beaded appearence in renal artery)
- Type II immune injury involving immune complexes (associated with hepatitis B and C)
- Patients (typically YOUNG ADULTS) have multitude of systemic symptoms and cutaneous manifestations (HYPERTENSION and MELENA = black stool)
–> lots of ischemia that can develop into necrosis
–> rashes can develop where areas aren’t getting enough blood
Kawasaki disease
- Often afflicting Asian infants, necrotizing arteritis of coronary arteries
- fibrinoid necrosis in the smaller and medium vessels
- young children under 2 years of age
- Affects the coronary arteries
–> skin rashes and peaking
–> erythremia
- symptoms: pink eye, oral mucosal change (strawberry tongue), enlarged lymph nodes, patchy rash, peeling skin
descrie the diagnosis criteria for kawasaki disease
- C = Conjunctivitis (non-exudative)
- R = rash (polymorphous non-vesicular)
- E = edema (or erythema of hands or feet)
- A = adenopathy (cervical, often unilateral)
- M = mucosal involvement (erythema or fissures or crusting)
Granulomatosis and polyangitis (wegener)
- Triad of:
–> necrotizing granulomas of upper respiratory tract (results in saddle nose)
–>Granulomatous vasculitis of medium and small vessels
–> Necrotizing, often crescentic glomerulonephritis (renal disease)
- possible HYPERSENSITIVITY to infectious or environmental agent
describe the clinical manifestations of Granulomatosis with polyangitis (wegner)
- Pulmonary (cough, hemoptysis, dyspnea, chest pain)
- Upper airway (epistaxis sinusitis, rhinorrhea, otitis hearing impairment)
- Musculoskeletal (arthralgias, myalgias, arthritis
- Renal/glomerulonephritis
- cutaneous (purpura, ulcers, vesicles, or nodules)
Churg-strauss syndrome
- Small vessel necrotizing vasculitis
- Characteristic is Asthma, allergic rhinitis, lung infiltrates
- Peripheral hypereosinophilia
- extravascular necrotizing granulomata
- MPO-ANCA positive (50% of cases)
Mech of Action:
–> immune system activates T4 cells –> activate both arms of immune system (plasma cells produce ANCA producing vasculitis)
–> eosinophils cause lots of tissue damage when they degranulate
describe the clinical manifestations of Churg-strauss syndrome
- Asthma (reversible if not severe - related to eosinophils)
- Nervous system (mononeuritis multiplex, CNS, Cerebral hemorrhage)
–> pain in their nerves in some spots
- Cutaneous (purpure, urticaria, subcutaneous nodules)
- sinusitis
- Inflammation in small arteries
–> loads of eosinophils
Buerger’s disease (thromboangiitis obliterans)
- Vascular insufficiency of tibial and radial arteries due to thrombosing acute and chronic inflammation
- Hypersensitivity to tobacco (typically in YOUNG ADULTS)
- can cause ischemia and necrotizing
what are some immune complex-mediated vasculitides
- Systemic lupus erythematosus
- rheumatoid arthritis
- henoch-Schonlein purpura
- Cryoglobulinemia
define aneurysms
- Localized abnormal dilation of any vessel
- Vessel most affected is the aorta
describe the types of aneurysms
- True aneurysms
- retains all three layers of vessel wall at affected site
–> saccular aneurysms (like a balloon coming off artery)
–> fusiform aneurysms (overall swelling around the vessel)
- False aneurysms
- intima and media damaged, only adventitia remains
- development of a hematoma
describe the various etiologies of aneurysms
- Atherosclerotic aneurysms = typically between renal arteries and bifurcation
- Syphilitic aneurysm = manifestation of teritiary syphilis in thoracic aorta and arch)
- Infective aneurysms (mycotic aneurysm) = false aneurysm from inflammatory damage
- Berry aneurysm = congential (occurs in the circle of willis) (hypertension important risk factor for rupture)
