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MD3001 > Vascular Disease > Flashcards

Vascular Disease Flashcards

1
Q

Why is it that blood vessel walls may become thicker as age increases?

A

Fibrotic tissue build up leading to higher chance of atherosclerosis

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2
Q

List some complications of atherosclerosis.

A 
Aortic aneurysms
Peripheral vascular disease with intermittent claudication
Myocardial infarction
Carotid atheroma
Cerebral infarction
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3
Q

What is the most common type of aneurysm?

A

Abdominal aortic (normally distal to renal arteries)

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4
Q

What part of the aorta does a syphilitic aneurysm affect?

A

Thoracic aorta

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5
Q

What is a mycotic aorta?

A

Bacteria or fungi related, infection weakens the artery wall, often site of infection is the brain, secondary to embolism

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6
Q

What can result from varicose veins?

A 
Stasis
Congestion
Oedema
Pain
Thrombosis
Haemorrhoids
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7
Q

What is vasculitis?

A

Inflammation and necrosis of blood vessels

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8
Q

Name the 4 most common types of vasculitis.

A 
Giant-cell (temporal) arteritis (>50)
Takayasu arteritis (pulseless disease) (women
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9
Q

Fibrosis of intimate and media, accumulation of ground substance and fragmentation of elastic lamellae are all ……. related vascular changes.

A

Age

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10
Q

What is the difference between atheroma and atherosclerosis?

A

There is no difference

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11
Q

What type of vessel does atherosclerosis target?

A

Medium to large elastic and muscular ARTERIES

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12
Q

What three factors characterise atherosclerosis?

A

Lipid deposition
Fibrosis
Chronic inflammation

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13
Q

List some risk factors of atherosclerosis.

A 
Age
Sex
Hypertension
Hyperlipidaemia (esp. LDL)
Diabetes
Smoking
Obesity
Sedentary lifestyle
Low socio-economic status
Low birth weight
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14
Q

What does an atheromatous plaque consist of?

A

Necrotic centre containing core of lipid
Fibrous cap
Raised 0.3 - 1.5cm into artery

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15
Q

What are some of the effects of peripheral vascular disease?

A 
Intermittent claudication
Pain
Ulcers
Gangrene
Ischaemia of lower limbs
Atheroma of:
- distal aorta
- femoral arteries
- iliac arteries
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16
Q

What are the 6 types of aneurysm?

A 
Atherosclerotic
Dissecting
Berry
Capillary micro-aneurysm
Syphilitic
Mycotic
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17
Q

Which type of person is most likely to develop an atherosclerotic aneurysm?

A

Over 50 year old male who is a smoker

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18
Q

What are the general characteristics of an atherosclerotic aneurysm?

A

Saccular (sac like) or fusiform (spindle like)
15 - 25cm in length
Wall diameter > 50%
Frequently contains mural thrombus (in artery walls)

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19
Q

What are some clinical consequences of an atherosclerotic aneurysm?

A 
Thrombosis
Embolism
Rupture
Obstruction of a branch vessel
Impingement on adjacent structure
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20
Q

Which type of person is most likely to develop an dissecting aneurysm?

A

40 - 60 year old male with hypertension
OR
Younger patients with systemic or localised abnormalities of connective tissue

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21
Q

Where does the initial intimal tear usually originate in a dissecting aneurysm?

A

1 - 2cm from the aortic valve

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22
Q

What the main clinical symptom of dissecting aneurysm?

A

Sudden onset of excruciating pain

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23
Q

Where does pain associated with dissecting aneurysm originate and where does it spread to?

A

Begins in the anterior chest, radiates to the back, between the scapulae and moves inferiorly as dissection progresses

24
Q

What is the pain from dissecting aneurysm commonly confused with?

A

That of MI

25
Q

What is the most common cause of death relating to dissecting aneurysm?

A

Rupture of the dissection outwards into the PERICARDIAL, PERITONEAL or PLEURAL cavities

26
Q

Where do berry aneurysms occur?

A

Circle of Willis (anastomosis that supplies blood to the brain and surrounding structures)

27
Q

What age group are most frequently affected by berry aneurysms?

A

Young people

28
Q

What type of haemorrhage are berry aneurysms commonly associated with?

A

Sub-arachnoid haemorrhage

29
Q

What two conditions are capillary micro-aneurysms associated with?

A

Hypertension

Diabetes mellitus

30
Q

In the branches of which artery do capillary micro-aneurysms occur?

A

Middle cerebral artery

31
Q

What type of haemorrhage are capillary micro-aneurysms commonly associated with?

A

Intra-cerebral haemorrhage

32
Q

Which vessel is usually affected by syphilitic aneurysms?

A

Thoracic aorta

33
Q

What is a mycotic aneurysm normally secondary to and where does it commonly form?

A

Secondary to embolism

Forms in the brain

34
Q

How does a mycotic aneurysm form?

A

Wall of artery weakened by infection, allowing infiltration of bacteria and/or fungi

35
Q

Define varicose veins and state how they are produced.

A

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

36
Q

What are the 5 risk factors associated with varicose veins?

A 
Age
Sex
Heredity
Posture
Obesity
37
Q

Where do varicose veins commonly arise?

A

Saphenous system in the lower limbs
Oesophageal varices
Haemorrhoids (anus)
Varicocele (spermatic cord)

38
Q

What problems are caused by varicose veins?

A

Cosmetic problems
Aching in legs
Stasis dermatitis (skin inflammation)
Skin ulceration and bleeding

39
Q

What is vasculitis?

A

Inflammation and necrosis of blood vessels

40
Q

What type of inflammation causes vasculitis?

A

Immune mediated

41
Q

List 3 other pathogenesis factors of vasculitis.

A

Deposition of immune complexes
Direct attack by circulating antibodies
Direct invasion of vascular walls by infectious pathogens

42
Q

Name the 4 main types of vasculitis.

A 
Giant cell (temporal) arteritis
Takayasu arteritis (pulseless disease)
Polyarteritis nodosa (PAN)
Kawasaki disease
43
Q

What is arteritis?

A

Inflammation of artery walls

44
Q

What type of person is most likely to develop temporal/giant cell arteritis?

A

Over 50, ideally 70 year old female

45
Q

Which arteries are affected in temporal arteritis?

A

Large to small sized arteries - temporal, vertebral and ophthalmic

46
Q

What type of person is most likely to develop Takayasu arteritis?

A

Under 30 years of age female

47
Q

Which arteries are affected in Takayasu arteritis?

A

Medium to large sized arteries - those of the upper limb and the arch of aorta

48
Q

Which arteries are affected in PAN?

A

Medium to small size muscular arteries of the kidneys, heart, liver and gastrointestinal tract

49
Q

Fibrinoid necrosis is potentially fatal without the correct treatment. What must be administered to reduce the risk of mortality?

A

Steroids

50
Q

What symptoms and signs are typical of Kawasaki disease?

A

High fever

Conjunctival and oral lesions

51
Q

Which age group is Kawasaki disease most prevalent in?

A

Children < aged 4

52
Q

What is the treatment for Takayasu arteritis?

A

Steroids

53
Q

What are the two names given to benign vascular tumours?

A

Angioma

Haemangioma

54
Q

What are the 4 best know benign vascular tumours and which region of the vasculature does each affect?

A

Capillary (ruby spots):
skin, spleen, kidneys

Juvenile (strawberry):
skin

Cavernous (port wine stains):
skin, spleen, liver, pancreas
(known as a lymphangioma)

Capillary and Cavernous

55
Q

What is a malignant vascular tumour known as?

A

Angiosarcoma

56
Q

What is Kaposi’s sarcoma associated with?

A

HIV/AIDS (derived from endothelial cells)

57
Q

Which regions of the vasculature is it possible for an angiosarcoma to arise?

A 
Skin
Soft tissue
Breast
Bone
Liver
Spleen

MD3001 (63 decks)

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