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MD3001 > vascular disease > Flashcards

vascular disease Flashcards

1
Q

what does atherosclerosis effect?

A

arteries

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2
Q

what does thrombosis effect?

A

veins

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3
Q

what will vasculitis (inflammation) and radiation damage effect?

A

all vessels

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4
Q

age related vascular changes?

A
  • fibrosis of intimate and media
  • accumulation of ground substances
  • fragmentation of elastic lamellae
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5
Q

what can age related changes be mistaken for?

A

aneurysms

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6
Q

atherosclerosis?

A
  • also known as atheroma
  • affects large and medium sized elastic and muscular arteries
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7
Q

characteristics of atherosclerosis?

A

necrotic lipid deposition fibrosis and chronic inflammation

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8
Q

risk factors of atherosclerosis?

A
  • age
  • sex
  • hypertension
  • hyperlipideamia
  • diabetes
  • smoking
  • obesity
  • sedentary life
  • low birth weight
  • low socioeconomic status
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9
Q

what are complications that may arise from atherosclerosis? from head to toe

A
  • cerebral infarction
  • carotid atheroma (emboli)
  • MI
  • aortic aneurysms (rupture causes sudden death)
  • peripheral vascular disease with intermittent claudication (particularly with diabetics)
  • gangrene
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10
Q

morphology of atherosclerosis?

A
  • atheromatous (fibre fatty, fibre lipid) plaque
  • patchy and raised white to yellow
  • core of lipid
  • fibrous cap
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11
Q

what will the fibrous cap of the atheromatous contain?

A
  • smooth muscle cells
  • collagen
  • macrophages
  • foam cells
  • lymphocytes
  • elastin
  • proteoglycans
  • neurovascularised
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12
Q

what will the necrotic centre of the atheromatous contain?

A
  • cell debris
  • cholesterol crystals
  • foam cells
  • calcium
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13
Q

what will peripheral vascular disease cause?

A
  • pain
  • ulcers
  • gangrene
  • intermittent claudication
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14
Q

what does peripheral vascular disease cause?

A

ischaemia of lower limbs

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15
Q

what is peripheral vascular disease?

A

atheroma of distal aorta/ iliac/ femoral arteries

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16
Q

what are aneurysms?

A

localised, permanent, abnormal dilation of blood vessels or the heart

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17
Q

what are the different types of aneurysms?

A
  • atherosclerotic
  • dissecting
  • berry
  • micro aneurysms
  • syphilitic
  • mycotic
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18
Q

describe atherosclerotic aneurysms?

A
  • usually happens in the abdominal aorta, distal to the renal arteries
  • more common in men than women
  • and smokers, aged over 50
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19
Q

morphology of atherosclerotic aneurysms?

A
  • saccular or fusiform
  • 15 to 25cm in length
  • wall diameter > 50%
  • frequently contains mural thrombus
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20
Q

clinical consequences of atherosclerotic aneurysms?

A
  • thrombus
  • embolism
  • rupture
  • obstruction of a branch vessel (ischameic injury)
  • impingement of an adjacent structure
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21
Q

how does atherosclerotic aneurysms present?

A

as an abdominal pulsating mass

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22
Q

who is most prone to dissecting aortic aneurysms?

A
  • men x3 more likely than women aged 40 to 60 with hypertension
  • younger patients with systemic or localised abnormalities of connective tissue
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23
Q

morphology of dissecting aneurysms?

A
  • usually initiates with an intimal tear
  • 1-2cm from aortic valve
  • dissection can extend along the aorta retrograde towards the heart or distally, sometimes into the iliac and femoral arteries
24
Q

where can blood go if the dissecting aortic aneurysms leaks?

A

pericardial sac

25
Q

clinical symptoms of aortic aneurysms?

A
  • the sudden onset of excruciating pain
  • beginning in the anterior chest, radiating to the back between the scapula and moving downwards as the dissection progresses
26
Q

what can the pain of an aortic aneurysm be confused with?

A

MI

27
Q

most common cause of death with dissecting aortic aneurysms?

A

rupture of the dissection outwards into the pericardial, pleural or peritoneal cavities

28
Q

where would a berry aneurysm be found?

A

circle of willis
- most commonly seen in the anterior cerebral artery

29
Q

who is most at risk of berry aneurysms?

A

young people with hypertension

30
Q

what are berry aneurysms often associated with?

A

subarachnoid haemorrhage

31
Q

what are capillary micro aneurysms associated with?

A
  • hypertension
  • diabetes mellitus
32
Q

what are capillary micro aneurysms associated with?

A

intra cerebral haemorrhage

33
Q

where will you most commonly see a capillary micro aneurysm?

A

small aneurysms of branches of middle cerebral artery

34
Q

syphilitic aneurysms?

A

usually effects the thoracic aorta

35
Q

mycotic aneurysms?

A
  • wall of artery weakened by infection
  • caused by bacteria or fungus
  • often in brain or secondary to embolism
36
Q

varicose veins?

A

abnormally dilated, tortuous veins produced by prolonged, increased intraluminal pressure and loss of vessel wall support

37
Q

risk factors of varicose veins?

A

age
sex
heredity
posture
obesity

38
Q

what can varicose veins cause?

A
  • cosmetic problems
  • aching in legs
  • stasis dermatitis
  • skin ulceration and bleeding
39
Q

what is vasculitis?

A

inflammation and necrosis of blood vessels

40
Q

pathogenesis of vasculitis?

A
  • cell immune-mediated inflammation
  • deposition of immune complexes
  • direct attack by circulating antibodies
  • invasion of vascular walls by infectious pathogens
  • often part of a multi system disease
41
Q

what happens to the venous valve in varicose veins?

A

it becomes incompetent and leads to stasis, congestion, oedema, pain and thrombosis.

42
Q

what can varicose veins lead to?

A
  • oesophageal varices (in patients with portal hypertension)
  • haemorrhoids
  • varicocele (plaque around testes in men , can cause infertility)
43
Q

what are the 4 different types of vasculitis?

A

1- giant cell (temporal) arteritis
2- takayasu arteritis (pulseless disease)
3- polyarteritis nodosa (PAN)
4- Kawasaki disease (children < age 4)

44
Q

what are the 3 different types of haemangioma?

A

1- juvenile (strawberry) - effects skin
2- capillary (ruby spots) - effects skin, spleen, kidneys
3-cavernous (port wine stains) - effects skin, spleen, liver, pancreas

45
Q

what are the different types of vascular tumours?

A

angioma
heamangioma
lympahngioma

46
Q

what are the 2 different malignant vascular tumours?

A

angiosarcoma
Kaposi’s sarcoma

47
Q

kaposi’s sarcoma?

A
  • associated with HIV/AIDS
  • this is an angioproliferative tumour derived from endothelial cells of blood vessels (it will look brown/purple on the skin)
48
Q

where will angiosarcomas effect?

A

skin
soft tissue
breast
bone
liver
spleen

49
Q

who will giant cell (temporal) arteritis effect?

A

> age 50, average onset is age 70 and women are more prone than men.

50
Q

who will takayasu arteritis (pulseless disease) effect?

A

when <30

51
Q

what is giant cell arteritis?

A

granulomatous inflammation of large to small sized arteries (in the temporal, vertebral and ophthalmic arteries)
- it is cord like nodular thicking
- patchy lesion
- throbbing temporal pain
- malaise
- fever

52
Q

what is Takaysu arteritis?

A

granulomatous vasculitis of medium and large arteries of upper limbs and aortic arch.
- very rarely you’ll feel the pulse in the limbs because of the narrowing of the vessels coming out of the aortic arch especially the subclavian

53
Q

signs of takayasu arteritis?

how to treat?

A
  • dizziness
  • visual disturbances
  • dyspnea
  • intermittent claudication upper limbs
  • asymmetric BP
  • give steroid treatment
54
Q

what is polyarteritis nodosa (PAN)?

A

MEDIUM SMALL SIZE MUSCULAR ARTERIES OF THE KIDEYS, HEART, LIVER AND GI TRACT ARE INVOLVED.
- FIBRINOID NECROSIS COULD BE FATAL WITHOUT steroid TREATMENT

55
Q

what would you see Kawasaki disease?

A
  • a higher fever, conjunctival and oral lesions.
  • self limiting.

MD3001 (56 decks)

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