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clinical science > Vascular Disease > Flashcards

Vascular Disease Flashcards

1
Q

Define arteriosclerosis.

A

A broader term for a condition in which the arteries narrow and harden

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2
Q

Define atherosclerosis.

A

A specific kind of arteriosclerosis but it affects the intima of the large and medium sized arteries.

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3
Q

Name the three main forms of Arteriosclerosis

A

Monckenberg medial calcification
Arteriolosclerosis
Atherosclerosis

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4
Q

What is an aneurysm?

A

An abnormal, permanent dilation of a blood vessel

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5
Q

Name the types aneurysms.

A

Fusiform
Saccular
Rupturing/ Dissecting

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6
Q

Most common causes of aneurysms?

A

Atherosclerosis

Systemic hyperstension

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7
Q

What are the consequences of the formation of an embolism?

A 
Rupture into peritoneal cavity or retroperitoneal tissue.
Obstruction of a vessel.
Ischemia .
Embolism from atheroma or thrombus.
Impinge adjacent structures.
Erosion of vertebrae.
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8
Q

Define thrombosis.

A

Formation of a blood clot (thrombus) in a blood vessel, prevents blood from flowing normally.

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9
Q

What is a thrombus?

A

A blood clot that forms in a vessel and remains there.

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10
Q

What is an embolism?

A

A clot that travels form the site where it is formed to another location.

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11
Q

What are the two types of thrombosis?

A

Venous thrombosis

Arterial thrombosis

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12
Q

Characteristics of atherosclerosis?

A

Athermatous/atherosclerotic plaque deposits on the walls causing narrowing of the lumen.

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13
Q

What is atheroma/atheromatous plaque?

A

A localized collection of lipid and cholesterol with a fibrous cap.

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14
Q

How does the collection of atheromatous plaque become complicated?

A

Through rupturing and superadded thrombus.

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15
Q

Consequences of atherosclerosis?

A

Atheromatous plaques cause mechanical obstruction of blood flow and luminal narrowing.
A decreased flow and ischemia follows.
Decrease in tissue perfusion (distal tissues)
If the blood vessels are occluded, there is no blood flow and the result is infarction (coagulative tissue necrosis).

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16
Q

Non-modifiable risk factors of atherosclerosis?

A

Genetic abnormalities (Familial hyperchlesterolaemia)
Family history
Increasing age
Male gender

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17
Q

Modifiable risk factors of atherosclerosis?

A 
Hyperlipidemia
Hypertension
Cigarette smoking & tobacco chewing
Diabetes mellitus
Vasculitis 
Diet
Sedentary life style
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18
Q

Consequences of atherosclerosis?

A

Myocardial ischemia and infarction.
Stroke/CVA.
Peripheral vascular disease, gangrene.
Aneurysms, Gastrointestinal tract ischaemia.

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19
Q

Define Diabetes.

A

An abnormality in glucose metabolism due to either absent or improper utilization of insulin.

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20
Q

The microvascular consequences of retinopathy and nephropathy includes what?

A

Blindness and renal failure.

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21
Q

Which characteristics of diabetes provoke molecular mechanisms that alter the function and structure blood vessels?

A

Metabolic abnormalities->hyperglycaemia, free fatty acids, insulin resistance.

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22
Q

Describe the macrovasular pathology of diabetes.

A 
Accelerated atherosclerosis (earlier onset, more severe, myocardial ischemia and infarction, stroke, peripheral vascular disease)
Systemic hypertension (renal artery stenosis, diabetic nephropathy)
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23
Q

Describe the microvascular pathology of diabetes.

A 
Diabetic nephropathy (nodular glomerulosclerosis, pyelonephritis, papillary necrosis, diffuse mesangial sclerosis)
Peripheral neuropathy (glove and stocking distribution)
Diabetic ocular pathology (cataracts, diabetic retinopathy, glaucoma, retinal detachment)
Autononic neuropathy (delayed gastric enoptying, constipation)
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24
Q

Diabetic neuropathy: example of proprioception loss

A

Charcot joint deformity.

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25
Q

Diabetic neuropathy: motor loss causes…

A

Hammer toes and contracture

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26
Q

Define ischemia

A

Restriction of blood supply to tissue, causing a shortage of oxygen that is needed for cellular metabolism.

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27
Q

Define infarction

A

Tissue death (necrosis) due to inadequate blood supply to the affected areas. The resulting lesion is called an infarct.

28
Q

Define cardiac output.

A

The amount of blood the heart pumps through the circulatory system in a minute.

29
Q

Possible pathology of heart failure.

A

Leaks in the system.
Cardiac muscle weakness and failure.
Valve problems, obstruction or incompetence.
Electrical conduction, irregular rhythm.

30
Q

Name the two pathological setting for myocardial ischaemia and infarction

A

Blockage of coronary artery/arteries (localised region of ischaemia and infarction; results in TRANSMURAL INFARCTION)
Global decrease inn blood flow (shock, results in subendocardial ischaemia and infarction in watershed zone)

31
Q

What is the main risk factor for ischaemic heart disease?

A

Atherosclerosis.

32
Q

Risk factors for myocardial ischaemia and infarction.

A

Tobacco smoking
Alcohol
Hypertension
Obesity

33
Q

Explanation of why demand increases?

A

Ventricular hypertrophy
Pregnancy
Exercise
High altitude

34
Q

Explanation of low supply?

A

Global ischaemia-cardiac failure, shock

Coronary artery occlusion

35
Q

What is the function of cardiac valves?

A

Prevents retrograde flow of blood.

36
Q

Complications of myocardial infarction?

A 
Death
Arrhythmias
Contractile dysfunction and cardiogenic shock
Myocardial rupture
Vulvar dysfunction
Ventricular aneurysm
Pericarditis
Rupture and tamponade
Progressive heart failure
37
Q

Clinical presentation of myocardial ischaemia and infarction

A

Stable angina pectoris
Unstable angina pectoris
Myocardial infarction

38
Q

Management of myocardial ischaemia

A 
Prevention
Nitroglycerin under tongue
Aspirin
Other drugs
Surgical treatment->stents, angioplasty, arthrectomy bypass
39
Q

What is rheumatic fever?

A

An acute, immunological mediated multisystem inflammatory disease following an infection with Group A B (beta) haemdytic streptococcal infection.

40
Q

What process does rheumatic fever involve?

A

The immunological process of the unmasking of antigens and an antibody-antigen cross reactivity

41
Q

Which bodily structures does rheumatic fever affect?

A

Involves the heart, skin and joints.

42
Q

During phase of rheumatic fever is acute rheumatic carditis a frequent manifestation?

A

The active phase of rheumatic fever.

43
Q

What are the two cardiac manifestation following rheumatic fever?

A

Acute rheumatic pancarditis

Chronic rheumatic heart disease.

44
Q

What are the risk factors involved in Rheumatic heart disease?

A

Low socio-economic status
Overcrowded living conditions
Poor nutrition
Delays in seeking medical attention
High prevalence of Group A B (beta) haemolytic streptococci in the community
Possible predisposing genetic influence in some persons.

45
Q

What is the endocardium?

A

Includes the cadiac valves, chordea tendinae and the lining endocardium.

46
Q

Define infective endocarditis.

A

The colonization/infection of the endocardium by infective organisms.
Results in the formation of bulky, friable vegetations.

47
Q

What type of organism is most responsible for infective endocarditis?

A

Bacterial infections.

48
Q

Origin of infective endocarditis.

A 
Poor dental hygiene
Long term haemodialysis
Systemic sepsis
Recent surgery or non-surgical invasive procedure
Localized suppurative inflammation
IV drug use
49
Q

Cause of Acute bacterial infective endocarditis.

A

Viruluent organisms, like staphylococcus aureus

50
Q

Effect of acute bacterial infective endocarditis on valves.

A

Normal valve or a damaged valve may be involved.

51
Q

Describe the vegetations in acute bacterial infective endocarditis.

A

At lines of valve closure
At edges of defect
Large and Friable
Easily dislodged and embolise

52
Q

What do the vegetations linked to acute bacterial infective endocarditis consist of?

A

Fibrin, proliferating bacteria and suppurative inflammation.

53
Q

Clinical features of acute bacterial infective endocarditis.

A 
Rapid onset
Fever
Rigors
Malaise
Chest pain
Shortness of breath
Rapid fatigue
Rapid death
54
Q

What type of organisms cause subacute bacterial infective endocarditis?

A

Low virulence organisms like streptococcal viridans gorup of bacteria.

55
Q

What is the condition of the valves involved in subacute bacterial infective endocarditis?

A

Damaged valves

E.g. rheumatic valvulitis, or previous infective endocarditis.

56
Q

Can subacute bacterial infective endocarditis involve prosthetic valves?

A

Yes

Can also edges of intracardiac congenital defects or iatrogenic defects

57
Q

Describe the vegetations associated with subacute bacterial infective endocarditis.

A

At lines of valve closure
At edges of defect
Large and friable (smaller than acute)
Easily dislodged and embolise

58
Q

Which cells are associated with the vegetations of subacute bacterial infective endocarditis?

A

Fibrin and bacteria

59
Q

Clinical features of subacute bacterial infective endocarditis.

A 
Slower onset
Fever
Malaise
Fatigue
Loss of weight
Clubbing
Murmers
Low mortality
60
Q

What are the complications of infective endocarditis?

A

Ring abscesses (erodes into underlying myocardium
Systemic embolization (brain abscesses, splenic and renal infarction, septic infarcts)
Right side pulmonary septic infarcts
Valve/chordae rupture
Septicaemia
Immune complex formation

61
Q

Other term for congestion in cardiac terms?

A

Backward failure

62
Q

Other term for reduced output?

A

Forward failure

63
Q

Most common causes of cardiac failure?

A

Ischaemic heart disease
Hypertension
Valvular heart disease
Chronic lung disease

64
Q

Classifications of cardiac failure

A

Right sided failure (right ventricular)
Left sided failure (left ventricular)
Biventricular failure

65
Q

Which circulation system does blood back up into in the case of left sided heart failure?

A

The pulmonary circulation

66
Q

Which circulation system does blood back up into in the case of right sided heart failure?

A

The systemic circulation

clinical science (18 decks)

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