Vascular Disease Basics Flashcards
What are advanced glycation end products (AGEs) ?
Process when glycated products are produced when an oxidative step is involved (ROS accelerates process) leading to glycated proteins, lipids, or nucleic acids (e.g. hemoglobin A1c)
What do AGEs do?
- can induce cross linking of collagen which can cause vascular stiffening and entrapment of low-density lipoprotein particles (LDL) in artery walls
- can glycate LDL which promotes its oxidation
- can bind to RAGE and cause oxidative stress as well as activation of inflammatory pathways in vascular endothelial cells
How will someone with a ruptured Berry aneurysm present?
with pounding headache
Where are Berry aneurysms common?
at branch points because there is more turbulence
What layer of the vessel is thought to be the cause of a Berry aneurysm?
the media
What are the two forms of aneurysm?
Saccular and Fusiform
What are AV fistulas?
abnormal connections of artery and vein without capillary bed
Fibromuscular dysplasia is common in what population?
younger women
What vessel layer is thought to be the source of fibromuscular dysplasia?
media (75%)
What happens in fibromuscular dysplasia?
a ‘string of beads’ look caused by alternating thickening of the media affecting the distal 2/3 of the main renal artery
can lead to HTN (however, it is noninflammatory and nonathersclerotic)
What are some cell wall markers?
CD31, CD34, D2-40
What is an ectasia?
a generic term for local dilatation of a structure
What is a telangiectasia?
permanent dilatation of preexisting small vessels (usually in skin or mucous membranes)
What are some types of vascular estasias?
- nevus flammeus
- spider telangectasias
- Hereditary hemorrhagic telangectasia
can be congenital or acquired- not a true neoplasm
Describe nevus flammeus.
They are usually large flat patches of purple/red skin with well-defined borders. At birth the surface is flat but in time it becomes bumpy and often more unsightly
T or F. Nevus flammeus shrink by themselves and often disappear
F.
Describe salmon patches.
common lesions that appear often at the nape of the neck (stork bite) or forehead between the eyebrows (aka angel’s kiss) that become more common when crying and often spontaneously disappear within the first year of life
What is Sturge Weber syndrome?
port wine ectasia that distributes along the trigeminal nerve
Why would imaging be appropriate with Sturge Weber syndrome?
because they often develop venous angiomas in the cortical leptomeninges
What is Sturge Webber syndrome associated with physically?
- mental retardation
- seizures
- hemiplegia
What is the most common symptom of Hereditary hemorrhagic telangiectasia?
recurring nose bleeds
Describe hemangiomas.
- very common
- composed of blood filled vessels
- benign and malignant transformation is rare
What are some types of hemangiomas (benign)?
- Capillary hemangioma
- Juvenile hemangioma
- Pyogenic granulomas
- Cavernous hemangioma
Where are capillary hemangiomas common?
- skin and subq
- mucus membranes
- liver, spleen and kidney
What are juvenile hemangiomas?
a form of capillary hemangioma that usually presents in newborns and grow rapidly for a few months then fade by 1-3 yrs. Gone by 7 y/o completely
Describe the histology of Juvenile hemangiomas.
- mitotic figures may be present
- mast cells are present
What are pyogenic granulomas?
capillary hemangiomas that grow rapidly in areas of trauma (often on skin, gingiva, oral mucosa) that typically bleed and ulcerate easily
When are pyogenic granulomas particularly common?
pregnancy
What hemangioma is associated with Von Hippel Lindau syndrome?
cavernous granulomas
Cavernous lymphangiomas are associated with what?
Turner syndrome
What are glomus tumors?
Benign, painful tumors commonly found under the nail bed that are proliferations of specialized smooth muscle cells of glomus body (thermoregulation)
What does Kaposi sarcoma result in?
disruption of normal cell division (prevents apoptosis)
What are the stages of Kaposi sarcoma?
- patches- pink, red or purple typically on distal leg
- plaque- larger, raised
- nodular- more overtly neoplastic
What things can cause angiosarcomas in the liver?
- arsenical pesticides
- Thorotrast (radioactive contrast agent)
- Polyvinyl chloride
long latency period
What things can cause angiosarcomas in lymphedema?
radiation- common in upper extremity after a radical mastectomy
