Vascular Patho Flashcards
when will you hear murmur, friction rub, indistinct sounds
murmur- turbulence of blood flow thru stenotic or incompetent valves
Friction rub- Pericarditis
Indistinct sounds- Pericardial effusion
When will you see raised jugular venous pressure
increased central venous pressure due to right or congestive cardiac failure
When will u get edem
if due to vascular disease, attributable to raised venous pressure exceeding plasma oncotic pressure
when will you have raised troponin or creatine phosphokinase
due to myocardial infarction
mechanisms of vasculitis
Disordered immunity or direct injury induced by infectious agents
what will most pts with vasculitis have in their blood
increased lvls of circulating immune complexes and the complement concentrations may be lw
autoantibodies are present in some pts
tx for vasculidis
Anti inflammatory and cytotoxic drugs may induce clinical remissions in 75% of pts
Important complication of vasculiditis
Thrombosis of the inflamed vessel segments resulting in ischemia or infarction of affected organ
What is polyarteritis nodosa
Systemic vasculitus (except ling) in young adults (M>F)
symptoms varied and depend on system
low grade fever
weight loss
malaise
lab findings in polyarteritis nodosa
Hepatitis B antigen- pos in 30% of cases
Perinuclear antineutrophil cytoplasmic autoantibodies (P-ANCA)
what is churg strauss syndrome and main pathology of it
variant of PAN: rare syndrome that affects small to medium sized arteries, associated w bronchial asthma
Pathology- granulomas and eosinophilia
What is weaner granulomatosis, aetiology
rare multisystem autoimmune disease
M>F 40-60s
hallmark feature include necrotizing granulomatous inflammation and immune vasculitis in small and med sized blood vessels
clinical pathology and pres of wegener granulomatosis
- necrotizing vasculitis w granulomas
- classically involves the nose, sinuses, lungs, kidney
Signs- saddle nose deformity (mc signs)
Lab findings in wagerers granulomatosis
Cytoplasmic antineutraphil cytoplasic antibodies (C-ANCA)
–antibodies against proteinase 3
temporal arteritis epidemiology and what marker is it associated w
mc form of vasculitis
elderly F>M
Associated w HLA DR4
Why does GCA not cause widespread vasculisis
Because intracranial arteries lack an internal elastic laminaa
What arteries does GCA usually target
Common, external and internal carotid artery (extracranially)
post ciliary and ophthalmic (intracranially)
Clinical features of GCA
- throbing HA
- Tender, firm temporal aa
- amaurosis fugal- non perm loss of vision in one eye due to temporary lack of blood flow to retina
- facial pain
Pathology of temporal arteritis
Segmental granulomatous vasculitis
–multinucleated giant cells and fragmentation of int elastic lamina
What is takayasu arteritis, epidemiology
Asian women <50
inflammatory disease of large and medium sized arteries with predilection for aorta and branches
What is pathology of takayasu arterities
- Granulomatous vasculitis w extensive intimal fibrosis
- irrecular fibrosis thickening of wall of aortic arch
- loss of pulse in upper ex*
What is buerger disease highly correlated to
tabaco use
features of buerger disease
- Absence or minimal presence of atheromas
- segmental vascular inflammation
- vasooccusiove phenominem
Younge males <40
pathology of buerger disease
- Recurrent neutrophilic vasculitis w micro abscesses
- segmental thrombosis leading to vascular insufficiency and vascular occlusion
- Organized thrombus and fibrosis are found in blood vessels in end stage
