Vascular Diseases Flashcards
1
Q
What is nephrosclerosis?
A
- Renal pathology associated with sclerosis of renal arterioles and small arteries
- Strongly associated with HTN
2
Q
What is seen in nephrosclerosis?
A
- Associated with advanced age
- More frequent in blacks than in whites
- Hypertension and diabetes increase the incidence and severity of the lesions
3
Q
What do the kidneys look like in nephrosclerosis?
A
- Either normal or moderately reduced in size
- Cortical surfaces have a fine, even granularity that resembles grain leather
4
Q
What causes hypertension secondary to renal artery stenosis?
A
- Increased production of renin from the ischemic kidney
5
Q
What is fibromuscular dysplasia?
A
- Focal irregular thickening in medium and large muscular arteries including renal, carotid, splanchnic, and vertebral vessels
6
Q
What does fibromuscular dysplasia look like?
A
- Segments of the vessel wall are focally thickened by a combination of medial and intimal hyperplasia and fibrosis, resulting in luminal stenosis
7
Q
What syndromes are encompassed under thrombotic microangiopathies?
A
- Thrombotic thrombocytopenic purpura (TTP)
- Hemolytic-uremic syndrome (HUS)
8
Q
What is the most likely cause of typical HUS?
A
- Intestinal infection with with strains of E. coli that produce shiga like toxins
9
Q
Who does typical HUS affect?
A
- Can occur at any age, but children and older adults at higher risk
10
Q
What is seen in typical HUS?
A
- Following a prodrome of influenza like or diarrheal symptoms
- Sudden onset of bleeding manifestations
- Severe oliguria
- Hematuria, associated with microangiopathic hemolytic anemia, thrombocytopenia, and prominent neurologic changes
- HTN
11
Q
What are some causes of atypical HUS?
A
- Autoantibodies against complement regulatory proteins
- Antiphospholipid syndrome (either primary or secondary to SLE)
- Complications of pregnancy or the postpartum period
- Vascular diseases affecting the kidney
- Chemotherapeutic and immunosuppressive drugs
- Irradiation of the kidney
12
Q
Who is affected with TTP?
A
- Adults younger than 40
13
Q
What is the pentad of TTP?
A
- Fever
- Neurologic symptoms
- Microangiopathic hemolytic anemia
- Thrombocytopenia
- Renal failure
14
Q
What is the initiating event of TTP?
A
- Platelet aggregation induced by very large multimers of vWF, which accumulate due to a deficiency of ADAMTS13
15
Q
What is the treatment for TTP?
A
- Plasma exchange, which removes autoantibodies and provides functional ADAMTS13
