Vascular Path

Question 0

Cherry hemangioma

Answer 0

Benign capillary, geriatrics, don’t regress, risk for them inc. with age

Question 1

Strawberry Hemangioma

Answer 1

Benign capillary, seen in infancy, appears early in life, grow rapid and spontaneously regress by 5-8y/o

Question 2

Lymphangiosarcoma

Answer 2

Malignant, lymphatics, assoc with persistent lymphadenopathy

Question 3

Glomus tumor

Answer 3

Benign, painful, red blue tumor under fingernails, arises from modified smooth muscle cells of Glomus body

Question 4

Bacillary angiomatosis

Answer 4

Benign, capillary, skin papules, seen in AIDS, caused by bartonella henselae infection, mistaken for kaposi sarcoma

Question 5

Kaposi sarcoma

Answer 5

Endothelial malignancy, most commonly in skin but can be seen in mouth, GI, resp tract. Assoc with HHV8, and HIV. Can be mistaken for bacillary angiomatosis

Question 7

Angiosarcoma

Answer 7

Rare, occur in head, neck, breast, assoc with radiation therapy pt.

Question 8

Large vessel vasculaitis

Answer 8

temporal giant cell arteritis, takayasu arteritis

Question 9

temporal giant cell arteritis

Answer 9

granulomatous vasculitis; classically branches of carotid artery; most common form in older adults (>50); affects more females;

Question 10

tempoeral giant cell arteritis presentation

Answer 10

headache (temporal art. involved), visual distrubances (opthalmic artery), jaw claudication, flu like Sx with joint and muscle pain, elevated ESR

Question 11

temporal giant cell arteritis Bx

Answer 11

inflamed vessel wall with giant bodies and intimal fibrosis; segmental lesions so Bx needs to be big enough; negative Bx doesnt exclude disease

Question 12

temporal giant cell arteritis Tx

Answer 12

corticosteroids

Question 13

Takaysau arteritis

Answer 13

granulomatous vasculitis involves aortic branch; adults <50 classically young asian female;

Question 14

takaysau arteritis presentation

Answer 14

visual and neurologic Sx with weak or absent UE pulses; elevated ESR

Question 15

takaysau arteritis Tx

Answer 15

corticosteroids

Question 16

medium vessel vasculitis diseases

Answer 16

polyarteritis nodosa, kawasaki disease, buerger disease

Question 17

PAN

Answer 17

necrotizing vasculitis in multiple organs and the lungs are spared; lesions in varying stages fibrinoid necrosis; string of pearls seen

Question 18

PAN presentation

Answer 18

HTN, abdominal pain with melena, neurologic disturbances, skin lesions; assoc with HBsAg

Question 19

kawasaki disease

Answer 19

classically asian children; Coronary involvement is common

Question 20

kawasaki disease presentation

Answer 20

non specific signs of fever, conunctivitis, eryhematous rash of palms and soles, enlarged cervical nodes

Question 21

kawasaki disease Tx

Answer 21

ASA and IVIg; disease is self limited

Question 22

Buerger disease

Answer 22

necrotizing vasculitis involving digits; hioghly assoc. with heavy smoking

Question 23

Buerger disease presentation

Answer 23

ulceration, gangrene, autoamputation of fingers and toes; raynaud phenom present

Question 24

small vessel vasculitis

Answer 24

wegener granulomatosis, microscopic polyangiitis, churg-strauss syndrome, henoch-schonlein purpura

Question 25

wegener granulomatosis

Answer 25

necrotizing granulomatous vasculitis involving nasopharynx, kidneys, lungs

Question 26

wegener granulomatosis presentation

Answer 26

middle aged man, sinusitis, nasopharyngeal ulceration, hemoptysis with B/L nodular lung infiktrates, hematuria from RPGN; elevated c-ANCA

Question 27

wegener granulomatosis Bx

Answer 27

large necrotizing granulomas with adjacent necrotizing vasculitis

Question 28

wegener granulomatosis Tx

Answer 28

cyclophosphamide and steroids

Question 29

microscopic polyangiiitis

Answer 29

necrotizing vasculitis of multiple organs (lungs kidney); no granulomas; p-ANCA; Tx is steroids and cyclophosphgamide

Question 30

churg strauss syndrome

Answer 30

necrotizing granulomatous inflammation with eosinophils involing multiple organs especially heart and lungs; asthma and peri. eosinophilia is usually present; p-ANCA;

Question 31

Henoch-schonlein purpura

Answer 31

vasculitis due to IgA depostion; most common vasculitis in children;

Question 32

hecnoch-schonlein purpura presentation

Answer 32

palpable purpura on buttocks and legs; GI pain and bleeding; hematuria from IgA nephropathy; usually follows URI; self limited

Question 33

aortic dissection

Answer 33

major risks is HTN or connective tissue disorders

Question 34

thoracic aneurysm

Answer 34

tertiary syphillis, endarteritis; tree bark aorta;

Question 35

abdom aortic anyeursm

Answer 35

between renal and iliac arteries; due to athersclerosis; seen in male smokers >60 with HTN