Vascular Disease: Overview (Nichols)

Question 1

What is fibromuscular dysplasia?

Answer 1

Focal irregular arterial wall thickening with intimal and medial hyperplasia and fibrosis leading to luminal stenosis, presumptively due to developmental disordered growth (NOT preneoplastic), typically in renal, carotid, splanchnic, or vertebral arteries, most commonly Dx’d in young women.

Question 2

What is hyperplastic arteriolosclerosis?

Answer 2

concentric wall thickening due to smooth muscle cell hyperplasia and hypertrophy, and thickened reduplicated basement membrane (caused by hypertension), causing lumenal narrowing.

Question 3

What is hyaline arteriolosclerosis?

Answer 3

wall thickening due to leakage of plasma protein into wall and increased secretion of matrix by smooth muscle cells (caused by hypertension). Differential Dx: amyloidosis or fibrinoid change/necrosis.

Question 4

What is Fibrinoid change/necrosis?

Answer 4

leakage of plasma protein into wall +/- necrosis (caused by malignant hypertension or vasculitis)

Question 5

What is medial calcific sclerosis?

Answer 5

degenerative calcification of internal elastic lamina, spreading into tunica media, not thought to be clinically significant by itself

Question 6

What demographic tends to present with medial calcific sclerosis?

Answer 6

Old people