Vascular disorders

Question 1

Clinical manifestation of the red blood cell extravasation into mucosa or skin, results from various conditions, including rheumatologic, infectious, dermatologic, traumatic, and hematologic disorders.

Answer 1

Purpura

Question 2

Refers to visible hemorrhage into mucous membrane or skin, which corresponds to extravasation of RBC around dermal small vessels and chronic hemosiderin deposition.

Answer 2

Purpura

Question 3

Compromises disorders that result in bruising but are not associated with any specific disease

Answer 3

PRIMARY PURPURA

Question 4

AKA Purpura Simplex or Devil’s pinches
Occurs as a result of skin fragility
Occur in children as they approach puberty

Answer 4

Simple Purpura

Question 5

Occurs as result of sudden increase in capillary pressure and usually manifests as petechiae.
Sneezing, coughing, valsalva maneuvers or seizures may cause this problem.

Answer 5

Mechanical Purpura

Question 6

AKA Purpura Sinelis
Seen in older individuals, or in individuals undergoing corticosteroid therapy
Purpuric lesions on the hand and arms
Easy bruising in older people because their skin is more fragile.

Answer 6

Senile Purpura

Question 7

Caused by self-induced trauma and usually is found on areas of the body that are easily accessible.
Usually caused by pinching, suction or a blow to the skin.

Answer 7

Factitious Purpura

Question 8

AKA Gardner – Diamond Syndrome
Seen in individuals with emotional problems, often after severe trauma or extensive surgery, which may be hypertensive to RBC membrane components or DNA hypersensitivity.
Painful Bruising Syndrome

Answer 8

Psychogenic Purpura

Question 9

Also referred to as Progressive Pigmentary Purpura
Characterize by the development of cayenne pepper petechiae (hallmark) on a background of hyperpigmented brown or orange oval patches often seen in tibial regions bilaterally as a chronic eruptions.

Answer 9

Schamberg’s Purpura

Question 10

Disorders caused by Vascular Abnormalities

Answer 10

SECONDARY PURPURA

Question 11

Result of allergic vasculitis which involves the skin, GIT, kidneys, heart and CNS.
It is considered as an immune complex disease and is characterized by involvement of capillaries with diffuse infiltration of neutrophils, lymphocytes and macrophages.

Answer 11

Henoch–Schonlein Purpura

Question 12

induced by iodides, quinine, procaine, penicillin, and aspirin

Answer 12

Drug – Induced Purpura

Question 13

A wide variety of infections may produce Purpura by means of vascular damage which results from direct endothelial injury by the infectious agents.
E.g. Rickettsia, viruses, cocci

Answer 13

Purpura Associated with Infections

Question 14

It is commonly seen in children; renal dysfunction is common and typically reversible in children.
Classic triad: Arthritis, Abdominal pain, Purpura
Diagnosis: Increased BUN and creatinine; IgA , CRP

Answer 14

Henoch–Schonlein Purpura

Question 15

Ecthyma gangrenosum

May be seen in endocarditis

Answer 15

Septic Emboli to the skin

Question 16

A unique disorder characterized by sudden onset, fever, prostration, symmetric circumscribed ecchymoses and infarcts of the skin and frequently by gangrene of the extremities.

Answer 16

Purpura Fulminans

Question 17

Caused by a deficiency in Vitamin C
affects synthesis of collagen
hydroxylation of lysine and proline

Answer 17

Scurvy

Question 18

Caused by biochemical or hormonal abnormalities

Answer 18

Metabolic Purpura

Question 19

The major initiating factor appears to diffused vascular injury and intravascular coagulation.
The term purpura fulminans applies to any purpura on rapid onset.

Answer 19

Purpura Fulminans

Question 20

Caused by corticosteroid excess results in purpura
Other cutaneous stigmata includes a “moon face”, pigmented abdominal striae, a “buffalo hump” on the lower neck and upper back.

Answer 20

Cushing’s Syndrome

Question 21

A disorder of women that presents with recurrent purpura on the lower extremities and resultant hemosiderin staining of the skin similar to Schamberg’s

Answer 21

Waldenstrom’s Purpura

Question 22

Caused by production of cryoprecipitate serum proteins of protein complexes, results from primary plasma cell dyscrasias or from hepatitis C.

Answer 22

Cryoglobulinemia

Question 23

Results from hypergammaglobulinemia owing to an increase in plasma viscosity.

Answer 23

Hyperviscosity Syndrome

Question 24

deposition of amyloid protein around small blood vessels, resulting in vessel fragility
Low factor X levels from binding of Factor X to amyloid fibrils, hyperfibrinolysis related to excessive urokinase activity and platelet function alterations may enhance bleeding tendencies.

Answer 24

Amyloidosis

Question 25

AKA Osler – Weber – Rendu Syndrome
Vascular malformation involves vessels throughout the body, which is dilated, tortuous and disorganized.
It is characterized by the presence of widespread telangectasia lesions of the skin and mucus membrane.
Lesions develop on the tongue, lips, palate, face, and hands.
IDA is usual

Answer 25

Hereditary Hemorrhagic Telangectasia

Question 26

Disorder involving the blood vessels of GIT
Cutaneous lesion of hereditary hemorrhagic telangectasia is not present.
Has been associated with von Willebrand’s disease.
Hemicolectomy has been used to treat the GIT bleeding.

Answer 26

Angiodysplasia

Question 27

AKA Cutis Hyperelastica
Autosomal dominant disorder characterized by hyper distensible joints and fragile skin
Bleeding is due to abnormalities of collagen in blood vessel walls leading to vascular fragility.

Answer 27

Ehlers–Danlos Syndrome

Question 28

Autosomal dominant genetic disorder due to mutation of the gene for fibrillin resulting in abnormalities of connective tissues and risk for bleeding and bruising.

Answer 28

Marfan Syndrome

Question 29

Autosomal recessive disorder affecting elastic fibers of connective tissue of skin and arteries.

Answer 29

Pseudoxanthoma Elasticum

Question 30

AKA Lobstein Syndrome / Brittle Bone Disease
Rare autosomal dominant disorder caused by mutation of genes which codes for peptides of Type 1 collagen.
Individuals may demonstrate easy bruising, epistaxis, hemoptysis, and intracranial bleeding.

Answer 30

Osteogenesis Imperfecta