Vascular Disease

Question 1

Atherosclerotic plaques form most commonly at the ______.

Answer 1

ICA bifurcation and distal basilar artery

Question 2

The formation of an atherosclerotic plaque is usually initiated by _____ leading to increase in ____.

Answer 2

subtle intimal injury permeability of lipoproteins

Question 3

What percent of the population has a complete circle of willis?

Answer 3

20%

Question 4

What is the most common cause of TIA?

Answer 4

platelet–fibrin embolus from an ulcerative atherosclerotic plaque

Question 5

What is the most cause of death in stroke patients?

Answer 5

MI

Question 6

What are Gitter cells?

Answer 6

lipid laden macrophages seen on day 5-7 following ischemic stroke

Question 7

What is pseudolaminar cortical necrosis?

Answer 7

caused by generalized hypoxia; middle cortical layers are affected (layers 3, 5, and 6)

Question 8

Lacunar strokes count for ______ percent of strokes.

Answer 8

20

Question 9

Moyamoya in children usually presents with _____ and in adults with _____.

Answer 9

ischemia/transient weakness hemorrhage

Question 10

Which NF is associated with multi-vascular abnormalities?

Answer 10

NF 1

Question 11

Klippel Traneuy Weber is associated with what vascular abnormality?

Answer 11

spinal AVMs and carotid aplasia

Question 12

What is seen on angiogram in fibromuscular dysplasia?

Answer 12

string of beads appearance

Question 13

FMD most commonly affects which vessels?

Answer 13

cervical ICA (75%), vertebral artery (25%), and renal arteries

Question 14

What does CADASIL stand for?

Answer 14

Cerebral autosomal dominant inherited arteriopathy with subcortical infarcts and leukoencephalopathy

Question 15

What mutation is associated with CADASIL?

Answer 15

notch 3 gene on Ch 19

Question 16

Where is the most common place for carotid dissection?

Answer 16

2 cm above the carotid bulb

Question 17

What is the most common place for vertebral artery dissection?

Answer 17

between C2 and occiput

Question 18

What is Raeder’s syndrome?

Answer 18

Unilateral headache and face pain of the V1 and V2 distributions and Horner’s syndrome ICA may be narrowed by sinusitis, arteritis, or dissection

Question 19

What is the most common necrotic vasculitis with CNS lesions?

Answer 19

polyarteritis nodosa

Question 20

What is polyarteritis nodosa?

Answer 20

necrotic vasculitis; affects small and medium sized arteries causes polyneuropathy by obliteration of vaso nervosum, microaneurysms (70%), skin purpura, renal dysfunction

Question 21

What is seen on pathology for temporal arteritis?

Answer 21

mononuclear cell inflammation of all three layers with multinucleated giant cells and resorption of the internal elastic lamina

Question 22

Steroids in temporal arteritis has what outcome?

Answer 22

decreases risk of blindness

Question 23

What is takayasu arteritis?

Answer 23

occlusive thromboaortopathy with giant cell arteritis affecting the aortaand its branches and the pulmonary arteries causing stenosis and aneurysms decreased peripheral pulses (pulseless disease)

Question 24

How do you treat Wegner’s granulomatosus?

Answer 24

cyclophosphamide

Question 25

Which vasculitis is closely linked with smoking?

Answer 25

Buerger disease

Question 26

What is Behcet disease?

Answer 26

recurrent inflammatory disease with male predominance that affects arteries and veins characterized by oral and genital ulcers, UC, aneurysm thrombophlebitis, erythema nodosum, polyarthritis

Question 27

What is the triad of TTP? Pentad?

Answer 27

severe thrombocytopenia, microangiopathic hemolytic anemia, and neurologic dysfunction fever and renal dysfunction

Question 28

What causes TTP?

Answer 28

deficiency in ADAMTS13, von-Willibrand factor protease

Question 29

What are Charcot Bouchard aneurysms?

Answer 29

form on the lenticulostriate arteries dilated perivascular spaces, état lacunaire (in the centrum semiovale), and état criblé (in the basal ganglia), which form lacunae with gliosis but no symptoms can cause hypertensive ICH

Question 30

What is Binswanger disease?

Answer 30

form on the lenticulostriate arteries. There are dilated perivascular spaces, état lacunaire (in the centrum semiovale), and état criblé (in the basal ganglia), which form lacunae with gliosis but no symptoms

Question 31

How does blood apear on MRI in the different stages?

Answer 31

Question 32

What are the five most common areas for hypertensive hemorrhages?

Answer 32

putamen (60%), thalamus (20%), pons (10%), cerebellum (near the dentate, 5%), and subcortical white matter (2%)

Question 33

Amyloid is ______ on birefringence when stained with \_\_\_\_\_.

Answer 33

yellow-green congo red dye

Question 34

What is seen on pathology for amyloid angiopathy?

Answer 34

Blood vessels become dilated with thick walls containing pink amorphous material

Question 35

What percent of MI patients treated with thrombolytics develop intracranial hemorrhage? What's the mortality?

Answer 35

1% 60% mortality

Question 36

Why does the germinal matrix hemorrhage in premature infactns?

Answer 36

involutes by week 36 usually,. hemorrhage from hypoxia/ischemia of the deep border zone that supplies the germinal matrix

Question 37

What is the grading for germinal matrix hemorrhages?

Answer 37

Grade 1: limited to the germinal matrix. Grade 2: blood in the ventricles, but no increase in ventricular size. Grade 3: blood in the ventricles with hydrocephalus. Grade 4: intraparenchymal extension of the hemorrhage

Question 38

What is seen on pathology with capillary telangiectasias?

Answer 38

multiple normal sized thin vascular spaces, without muscle in the wall, with normal brain in between

Question 39

In HHT, the mucocutaenous lesions are ______ and the brain lesions are \_\_\_\_\_.

Answer 39

telangiectasia AVM

Question 40

What is the most common vasculature malformation?

Answer 40

venous malformations

Question 41

What is the most common location for a venous malformation?

Answer 41

at the angle of the ventricle

Question 42

Multiple vascular malformations are associated with what syndrome?

Answer 42

blue rubber nevus syndrome

Question 43

Venous varixes are associated with \_\_\_\_\_.

Answer 43

AVMs

Question 44

What is a sinus pericranii?

Answer 44

A large communication between intracranial and extracranial veins; congenital or traumatic soft mass that changes with head position