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MD3001 Cardiology > Vascular Disease > Flashcards

Vascular Disease Flashcards

1
Q

What structures are affected by vascular disease?

A
  • arteries: causing
  • arteriosclerosis
  • atherosclerosis
  • veins: causing thrombosis and formation of varicosities
  • all vessels:
  • vasculitis
  • radiation damage
  • tumours
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2
Q

What happens to the vascular system as you get older?

A
  • intima and media fibrose
  • ground substance accumulates loosening arteries and making them bigger
  • fragmentation of elastic lamellae (less elastic)
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3
Q

What characterises atherosclerosis?

A
  • lipid deposition
  • fibrosis
  • chronic inflammation
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4
Q

What are the components of atherosclerosis?

A
  • central nephrotic core
  • lipid core
  • fibrous cap on the surface
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5
Q

What are the risk factors for atherosclerosis?

A
  • age: older
  • sex: men > women
  • hypertension
  • hyperlipidaemia: in paricular LDL
  • diabetes: more type 1
  • smoking
  • obesity
  • non-active lifestyle
  • low socio-economic status
  • low birth weight
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6
Q

What are the possible complications of atherosclerosis?

A
  • cerebral infarction which can cause stroke
  • carotid atheroma can cause TIA/ cerebral infarct
  • aortic aneurysms
  • MI
  • peripheral vascular disease
  • gangrene
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7
Q

What is peripheral vascular disease?

A
  • atheroma of distal aorta/iliac/femoral arteries

- causes ischaemia of lower limbs

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8
Q

What are the effects of peripheral vascular disease?

A
  • intermittent claudication
  • pain
  • ulcers
  • gangrene
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9
Q

What are aneurysms?

A

localised, permanent, abnormal dilatation of a blood vessel or the heart

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10
Q

What are true aneurysms?

A
  • when it affects and occurs in the walls of the vessel
  • saccular: bulging on one side
  • fusiform: bulging on both sides
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11
Q

What are false aneurysms?

A

not affecting the entire wall, possible rupture in endothelia and blood clot buldging out towards adventitia

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12
Q

What vessel is most commonly affected by atherosclerotic aneurysms?

A

abdominal aorta distal to renal arteries

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13
Q

What is the morphology of atherosclerotic aneuryms?

A
  • saccular/fusiform
  • 15-25cm length
  • wall diameter >50%
  • commonly has mural thrombus contained
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14
Q

What are the clinical consequences of atherosclerotic aneurysms?

A
  • thrombosis
  • embolism
  • rupture
  • obstruction of a branch vessel resulting in ischemic injury
  • impingement on adjacent structure
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15
Q

How do atherosclerotic aneurysms present themselves?

A

abdominal pulsating mass

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16
Q

What are risk factors specific to dissecting aortic aneurysms?

A
  • men 40-60 with hypertension

- younger patients with systemic/localised abnormalities in connective tissue

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17
Q

What are risk factors specific to atherosclerotic aneurysms?

A
  • men more than women

- smokers over 50

18
Q

What is the morphology of dissecting aortic aneurysms?

A
  • initiated with intimal tear and blood escaping from lumen into intimal layer
  • most common in thoracic aorta and can spread upwards towards heart or downwards towards iliac/femoral arteries
19
Q

What are the clinical symptoms of dissecting aortic aneurysms?

A
  • sudden onset of excruciating pain

- begins anterior chest, radiates to back between scapulae, moving downward as dissection progresses

20
Q

How do dissecting aortic aneurysms cause death?

A

rupture of dissection outward into pericardial, pleural or peritoneal cavities

21
Q

What are berry aneurysms?

A

aneurysms in the circle of Willis

22
Q

What do rupture of berry aneurysms cause?

A

sub-arachnoid haemorrhage

23
Q

What are the risk factors specific to berry aneurysms?

A
  • young people

- hypertensive

24
Q

What are the risk factors specific to capillary micro-aneurysms?

A
  • hypertension

- diabetes mellitus

25
Q

What are capillary microaneurysms?

A

small aneurysms of the branches of the middle cerebral artery

26
Q

What vessel do syphilitic aneurysms affect?

A

thoracic aorta

27
Q

What are mycotic aneurysms?

A
  • when the wall of an artery is weakened by bacterial/fungal infection
  • in the brain, secondary to embolism
28
Q

What are varicose veins?

A

abnormally dilated, tortuous (twists and turns) veins produced by prolonged increased transluminal pressure and loss of vessel wall support

29
Q

What are the risk factors for varicose veins?

A
  • age
  • sex
  • hereditary
  • posture
  • obesity
30
Q

Explain the progression of varicose veins

A
  • venous valves incompetent

- leads to stasis, congestion, oedema, pain and thrombosis

31
Q

What are the clinical consequences of varicose veins?

A
  • cosmetic problems
  • aching in legs
  • stasis dermatitis
  • skin ulceration and bleeding
32
Q

What is vasculitis?

A

inflammation and necrosis of blood vessels

33
Q

What are the different pathogeneses of vasculitis?

A
  • 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
34
Q

What are the different types of vasculitis?

A
  • giant cell (temporal) arteritis
  • takayasu arteritis (pulseless dsease)
  • polyarteritis nodosa
  • kawasaki disease
35
Q

Giant cell arteritis

A
  • granulomatous inflammation of large to small arteries
  • temporal/vertebral/opthalmic
  • cord like nodular thickening
  • older age women
  • throbbing temporal pain/fever/malaise
36
Q

Takayasu arteritis

A
  • granulomatous inflammation of medium and larger arteries
  • upper limbs
  • younger women
  • dizziness/visual disturbance/dyspnoea/intermittent claudication of upper limbs
37
Q

Polyarteritis nodosa

A
  • medium to small size muscular arteries
  • kidneys, heart, liver, GI tract
  • fibrinoid necrosis can be fatal without steroid treatment
38
Q

Kawasaki disease

A
  • high fever
  • conjunctival and oral lesions
  • very young children
39
Q

Benign vascular tumours

A

hemiangioma:

  • juvenile : strawberry, affects skin
  • capillary: ruby spots, affects skin/spleen/kidneys
  • cavernous: port wine stains, affects skin/spleen/liver/pancreas
  • lymphangioma: capillary and cavernous
40
Q

Malignant vascular tumours

A
  • angiosarcoma
  • affects skin/soft tissue/breast/bone/liver/spleen
  • Kaposi’s sarcome: associated with HIV?AIDS
  • angioproliferative tumour derived from endothelial cells

MD3001 Cardiology (56 decks)

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