Vascular Disease Flashcards by Rob Mitchell

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

Fibrotic tissue build up leading to higher chance of atherosclerosis

How well did you know this?

Not at all

Perfectly

List some complications of atherosclerosis.

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

How well did you know this?

Not at all

Perfectly

What is the most common type of aneurysm?

Abdominal aortic (normally distal to renal arteries)

How well did you know this?

Not at all

Perfectly

What part of the aorta does a syphilitic aneurysm affect?

Thoracic aorta

How well did you know this?

Not at all

Perfectly

What is a mycotic aorta?

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

How well did you know this?

Not at all

Perfectly

What can result from varicose veins?

Stasis
Congestion
Oedema
Pain
Thrombosis
Haemorrhoids

How well did you know this?

Not at all

Perfectly

What is vasculitis?

Inflammation and necrosis of blood vessels

How well did you know this?

Not at all

Perfectly

Name the 4 most common types of vasculitis.

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

How well did you know this?

Not at all

Perfectly

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

Age

How well did you know this?

Not at all

Perfectly

What is the difference between atheroma and atherosclerosis?

There is no difference

How well did you know this?

Not at all

Perfectly

What type of vessel does atherosclerosis target?

Medium to large elastic and muscular ARTERIES

How well did you know this?

Not at all

Perfectly

What three factors characterise atherosclerosis?

Lipid deposition
Fibrosis
Chronic inflammation

How well did you know this?

Not at all

Perfectly

List some risk factors of atherosclerosis.

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

How well did you know this?

Not at all

Perfectly

What does an atheromatous plaque consist of?

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

How well did you know this?

Not at all

Perfectly

What are some of the effects of peripheral vascular disease?

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

How well did you know this?

Not at all

Perfectly

What are the 6 types of aneurysm?

Atherosclerotic
Dissecting
Berry
Capillary micro-aneurysm
Syphilitic
Mycotic

How well did you know this?

Not at all

Perfectly

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

Over 50 year old male who is a smoker

How well did you know this?

Not at all

Perfectly

What are the general characteristics of an atherosclerotic aneurysm?

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

How well did you know this?

Not at all

Perfectly

What are some clinical consequences of an atherosclerotic aneurysm?

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

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

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

1 - 2cm from the aortic valve

How well did you know this?

Not at all

Perfectly

What the main clinical symptom of dissecting aneurysm?

Sudden onset of excruciating pain

How well did you know this?

Not at all

Perfectly

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

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

What is the pain from dissecting aneurysm commonly confused with?

That of MI

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

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

Where do berry aneurysms occur?

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

What age group are most frequently affected by berry aneurysms?

Young people

What type of haemorrhage are berry aneurysms commonly associated with?

Sub-arachnoid haemorrhage

What two conditions are capillary micro-aneurysms associated with?

Hypertension | Diabetes mellitus

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

Middle cerebral artery

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

Intra-cerebral haemorrhage

Which vessel is usually affected by syphilitic aneurysms?

Thoracic aorta

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

Secondary to embolism | Forms in the brain

How does a mycotic aneurysm form?

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

Define varicose veins and state how they are produced.

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

What are the 5 risk factors associated with varicose veins?

``` Age Sex Heredity Posture Obesity ```

Where do varicose veins commonly arise?

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

What problems are caused by varicose veins?

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

What is vasculitis?

Inflammation and necrosis of blood vessels

What type of inflammation causes vasculitis?

Immune mediated

List 3 other pathogenesis factors of vasculitis.

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

Name the 4 main types of vasculitis.

``` Giant cell (temporal) arteritis Takayasu arteritis (pulseless disease) Polyarteritis nodosa (PAN) Kawasaki disease ```

What is arteritis?

Inflammation of artery walls

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

Over 50, ideally 70 year old female

Which arteries are affected in temporal arteritis?

Large to small sized arteries - temporal, vertebral and ophthalmic

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

Under 30 years of age female

Which arteries are affected in Takayasu arteritis?

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

Which arteries are affected in PAN?

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

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

Steroids

What symptoms and signs are typical of Kawasaki disease?

High fever | Conjunctival and oral lesions

Which age group is Kawasaki disease most prevalent in?

Children < aged 4

What is the treatment for Takayasu arteritis?

Steroids

What are the two names given to benign vascular tumours?

Angioma | Haemangioma

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

Capillary (ruby spots): skin, spleen, kidneys Juvenile (strawberry): skin Cavernous (port wine stains): skin, spleen, liver, pancreas (known as a lymphangioma) Capillary and Cavernous

What is a malignant vascular tumour known as?

Angiosarcoma

What is Kaposi's sarcoma associated with?

HIV/AIDS (derived from endothelial cells)

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

``` Skin Soft tissue Breast Bone Liver Spleen ```