Vascular Disease Pathology I

Question 1

How to avoid blood clotting?

Answer 1

Laminar flow

Question 2

What causes thrombosis?

Answer 2

Change in vessel wall
Change in bloodflow
Change in blood constituents

Question 3

Causes of ischaemic heart disease?

Answer 3

Atherosclerosis
Myocardial hypertrophy
Small vessel disease

Question 4

What is atherosclerosis?

Answer 4

Plaque builds up in arteries

Question 5

Risk factors of atherosclerosis?

Answer 5

Cigarette smoking
Hypertension
Diabetes (poorly controlled)
Hyperlipidaemia
Men

Question 6

Why is left ventricular hypertrophy a problem?

Answer 6

Part of heart is enlarged but same amount of blood reaches it = not enough blood

Question 7

Where do small vessel changes occur?

What does this cause?

Answer 7

At arteriolar level
Inappropriate vasoconstriction:
- Reduced production of nitric oxide
- Increased destruction of nitric oxide

Question 8

What does ischaemic heart disease look like?

Answer 8

Regional transmural MI
Subendocardial MI
Chronic ischaemia

Question 9

What is regional transmural MI? What does it cause?

Answer 9

Patch of dead heart muscle in one area of the heart as one coronary artery is blocked
Crushing chest pain

Question 10

What is subendocardial MI?

Answer 10

Severe coronary artery atherosclerosis in all 3 main coronary arteries
Some sudden reduction in blood flow e.g. hypotension during an operative procedure

Question 11

Chronic ischaemia

Answer 11

Fixed atherosclerotic lesion
Angina
Myocardial fibrosis
Hibernating myocardium
Stunned myocardium

Question 12

Complications of MI?

Answer 12

Death
Arrhythmias
Mitral incompetence
Cardiac failure
Pericarditis
Cardiac rupture
Mural thrombosis
Ventricular aneurysm
Pulmonary emboli

Question 13

What is cardiac failure?

Answer 13

Arrhythmias

Loss of myocardium and so reduced pump function

Question 14

Mitral incompetence?

Answer 14

Rupture or necrosis of papillary muscles

Pan systolic murmur

Question 15

Cardiac rupture?

Answer 15

Weakening of wall due to muscle necrosis and acute inflam
3-7 days after infarction
Rupture into pericardial sac and interventricular septum

Question 16

Mural thrombosis?

Answer 16

Thrombosis on the abnormal endothelial surface following infarction
7-14 days after infarction
Embolisation to any arterial site

Question 17

Clinical importance of hypertension?

Answer 17

Commonest cause of heart failure
Major risk factor for atherosclerosis
Major risk factor for cerebral haemorrhage

Question 18

Classification of hypertension?

Answer 18

Primary - no identified cause

Secondary - identifiable cause

Question 19

Primary hypertension - what can cause it?

Answer 19

Adrenaline
Sodium control
Renin angiotensin aldosterone

Question 20

Secondary hypertension causes?

Answer 20

Renal 
- Renin dependent 
- Salt and water overload
Endocrine
- Cushing's 
Coarctation of aorta
Drug therapy
- Corticosteroids, NSAIDs

Question 21

Clinicopathological classification of hypertension?

Answer 21

Benign
- Long asymptomatic period
- Increased freq of complications later
Malignant
- Markedly raised diastolic pressure
- Symtomatic
- Rapidly fatal if untreated

Question 22

Effects of hypertension?

Answer 22

Accelerated atherosclerosis
Sclerosis of smaller vessels
Micro-aneurysms and haemorrhages
Heart and kidney failure
Cerebral haemorrhages = strokes