Vascular Disease Flashcards
What are the risk factors for atherosclerosis?
- Age
- Sex
- Hypertension
- Hyperlipidaemia (particularly LDL)
- Diabetes
- Smoking
- Obesity
- Sedentary lifestyle
- Low socio-economic status
- Low birth-weight
What is an aneurysm?
Localised, permanent, abnormal dilation of blood vessel or the heart
Where do berry aneurysms occur?
The circle of Willis
What kind of aneurysm is common in young people?
Berry aneurysms
Where do syphilitic aneurysms usually occur?
The thoracic aorta
What are varicose veins?
Abnormally dilated, tortuous veins produced by prolonged, increased intraluminal pressure and loss of vessel wall support
What is vasculitis?
Inflammation and necrosis of blood vessels
What are the risk factors for varicose veins?
- Age (female, multiple pregnancies)
- Sex
- Heredity
- Posture
- Obesity
What is the pathogenesis of vasculitis?
- Cell immune-mediated inflammation
- Deposition of immune complexes
- Direct attack by circulating antibodies
- Direct invasion of vascular walls by infectious pathogens
- Often part of multi-system disease
What is an aneurysm called that is one sided?
Saccular
What is an aneurysm called that has a buldge on both sides of the vessel?
Fusiform
What kind of haemorrhage is a berry aneurysm associated with?
A sub-arachnoid haemorrhage
How much more likely are men with hypertension aged 40 to 60 to get a dissecting aortic aneurysm?
x3
Where does the intimal tear usually take place in an aortic aneurysm?
1-2 cm from the aortic valve
What kind of aneurysm takes place in the branches of the middle cerebral artery?
Capillary micro-aneurysm
What kind of aneurysm is associated with intra-cerebral haemorrhage?
Capillary micro-aneurysm
What are the different types of vasculitis?
- Giant-cell (temporal) arteritis
- Takayasu arteritis (pulseless disease)
- Polyarteritis nodosa (PAN)
- Kawasaki disease (children <4)
Describe Giant-cell (temporal) arteritis?
- Granulomatous inflammation of large to small-sized arteries (temporal, vertebral and opthalamic).
- Cord-like nodular thickening
- Throbbing headaches
- Malaise
- Fever
Describe the morphology of an atheromatous plaque
- Patchy and raised white to yellow
- Core of lipid
- Fibrous cap
What are the effects of atheroma of distal aorta / illiac / femoral arteries?
- Intermittent claudication
- Pain
- Ulcers
- Gangrene
What is the difference between a true and false aneurysm?
A true aneurysm occurs within the vessel walls, a false aneurysm involves blood leaking out through the endothelium creating a haematoma
What is a dissecting aneurysm?
A tear in the intimal layer and blood escapes from the lumen into the intimal layer
How big are atherosclerotic aneurysms?
15 to 25 cm in length
What is usually causes a mycotic aneurysm?
Bacteria or fungi
What veins are usually varicose?
The saphenous veins
Describe takayasu arteritis (pulseless disease)
- Granulomatous vasculitis of medium and larger arteries of upper limbs (+ arch of aorta)
- Radial or brachial pulses cannot be felt or are very weak
- Asymmetric BP
- Dysponea
What demographic does takayasu arteritis usually affect?
Women aged < 30
Describe Polyarterits nodosa (PAN)
- Medium small size muscular arteries of the kidneys, heart, liver and GI tract are involved
Describe kawasaki disease
- High fever, conjunctival and oral lesions
- Self-limited
Who is mainly affected by Kawasaki disease?
Children < aged 4
What is claudication?
Cramping pain in the leg induced by exercise, typically caused by obstruction of the arteries.
What is used to treat Takayasu Arteritis?
Steroids
What is the name given to a benign vascular tumour?
Angioma
What is the name given to a benign tumour of the arteries?
Haemangioma
What is the colloquial term for Juvenile angiomas?
Strawberry (affecting skin)
What is the colloquial term for capillary angiomas?
Ruby spots (affecting skin, spleen, kidneys)
What is the colloquial term for caverous angiomas?
Port wine stains (affecting skin, spleen, liver and pancreas)
What type of tumours are lymphangiomas?
Capillary or Cavernous
What is the term given to malignant vascular tumours?
Angiosarcomas
Where can angiosarcomas appear?
Almost anywhere (skin, soft tissue, breat, bone, liver and spleen)
What is Kaposi’s sarcoma assciated with?
HIV / Aids
Where type of cells do Kaposi’s sarcomas derive from?
angioproliferative tumour derived from endothelial cells
