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BLOCK POSTING > Vascular Pathology > Flashcards

Vascular Pathology Flashcards

1
Q

What is vasculitis?

A

Inflammation of the blood vessel wall.

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2
Q

What are the layers of the arterial wall?

A

Endothelial intima smooth muscle media

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3
Q

What are common clinical features of vasculitis?

A

Nonspecific inflammatory symptoms (fever fatigue

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4
Q

How is vasculitis classified by vessel size?

A

Large-vessel (aorta and major branches) medium-vessel (muscular arteries to organs)

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5
Q

What is temporal (giant cell) arteritis?

A

Granulomatous vasculitis involving branches of the carotid artery common in older adults

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6
Q

What are key symptoms of temporal arteritis?

A

Headache (temporal artery) visual disturbances (ophthalmic artery)

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7
Q

How is temporal arteritis diagnosed and treated?

A

Diagnosis requires a biopsy with giant cells and intimal fibrosis; treatment is corticosteroids to prevent blindness.

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8
Q

What is Takayasu arteritis?

A

Granulomatous vasculitis involving the aortic arch at branch points often in young Asian females.

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9
Q

What are the main clinical features of Takayasu arteritis?

A

Visual and neurologic symptoms weak or absent pulse in the upper extremity (“pulseless disease”)

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10
Q

How is Takayasu arteritis treated? .

A

Corticosteroids

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11
Q

What is polyarteritis nodosa?

A

Necrotizing vasculitis involving multiple organs except the lungs common in young adults.

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12
Q

What are key symptoms of polyarteritis nodosa?

A

Hypertension (renal artery) abdominal pain with melena (mesenteric artery)

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13
Q

What does polyarteritis nodosa look like on imaging?

A

“String-of-pearls” appearance due to varying stages of lesions with transmural inflammation and fibrinoid necrosis.

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14
Q

How is polyarteritis nodosa treated?

A

Corticosteroids and cyclophosphamide; fatal if untreated.

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15
Q

What is Kawasaki disease?

A

An acute vasculitis affecting children especially Asian children under 4 years old.

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16
Q

What are clinical features of Kawasaki disease?

A

conjunctivitis Fever

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17
Q

What are the main complications of Kawasaki disease?

A

Coronary artery thrombosis (risk of MI) and aneurysm with rupture.

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18
Q

How is Kawasaki disease treated?

A

Aspirin and IVIG; it is self-limited.

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19
Q

What is Buerger disease?

A

A necrotizing vasculitis affecting the digits often associated with smoking.

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20
Q

What are symptoms of Buerger disease?

A

Ulceration gangrene

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21
Q

How is Buerger disease treated?

A

Smoking cessation.

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22
Q

What is Wegener granulomatosis?

A

Necrotizing granulomatous vasculitis affecting the nasopharynx lungs

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23
Q

What are symptoms of Wegener granulomatosis?

A

Sinusitis or nasopharyngeal ulcers hemoptysis with lung nodules

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24
Q

What lab marker is associated with Wegener granulomatosis?

A

Serum c-ANCA which correlates with disease activity.

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25
Q

How is Wegener granulomatosis diagnosed and treated?

A

Biopsy shows necrotizing granulomas; treatment is cyclophosphamide and steroids though relapses are common.

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26
Q

What is microscopic polyangiitis?

A

Necrotizing vasculitis similar to Wegener’s but without nasopharyngeal involvement or granulomas.

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27
Q

What lab marker is associated with microscopic polyangiitis?

A

Serum p-ANCA which correlates with disease activity.

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28
Q

How is microscopic polyangiitis treated?

A

Corticosteroids and cyclophosphamide; relapses are common.

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29
Q

What is Churg-Strauss syndrome?

A

Necrotizing granulomatous vasculitis with eosinophils affecting multiple organs

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30
Q

What are key features of Churg-Strauss syndrome?

A

Asthma peripheral eosinophilia

31
Q

What is Henoch-Schönlein purpura?

A

IgA-mediated vasculitis the most common vasculitis in children.

32
Q

What are symptoms of Henoch-Schönlein purpura?

A

Palpable purpura on buttocks/legs GI pain/bleeding

33
Q

How is Henoch-Schönlein purpura treated?

A

Usually self-limited; steroids if severe.

34
Q

What is hypertension?

A

Increased blood pressure which can affect the systemic or pulmonary circulation.

35
Q

How is systemic hypertension (HTN) defined?

A

Pressure ≥ 140/90 mm Hg; normal is <120/80 mm Hg.

36
Q

How is HTN classified based on etiology?

A

Primary (unknown cause 95%) and secondary (identifiable cause

37
Q

What are the risk factors for primary hypertension?

A

Age race (higher in African Americans)

38
Q

What is a common cause of secondary hypertension?

A

Renal artery stenosis known as renovascular hypertension.

39
Q

How does renal artery stenosis lead to HTN?

A

Stenosis reduces glomerular blood flow activating the JGA to secrete renin

40
Q

What causes renal artery stenosis?

A

Atherosclerosis (in elderly males) and fibromuscular dysplasia (in young females).

41
Q

What is fibromuscular dysplasia?

A

A developmental defect causing irregular thickening of large- and medium-sized arteries especially the renal artery.

42
Q

How else can HTN be classified?

A

Benign (most cases slow damage) and malignant (severe HTN > 200/120 mm Hg).

43
Q

What are signs of malignant hypertension?

A

Acute end-organ damage including acute renal failure

44
Q

What is arteriosclerosis?

A

Hardening of the arteries due to thickening of the vessel wall.

45
Q

What are the three types of arteriosclerosis?

A

Atherosclerosis arteriolosclerosis

46
Q

What is atherosclerosis?

A

Intimal plaque formation in large- and medium-sized arteries often with a necrotic core and fibromuscular cap.

47
Q

What are common sites of atherosclerosis?

A

Abdominal aorta coronary artery

48
Q

What are modifiable risk factors for atherosclerosis?

A

Hypertension high LDL cholesterol

49
Q

What are non-modifiable risk factors for atherosclerosis?

A

Age gender (higher in males and postmenopausal females)

50
Q

What initiates the formation of atherosclerosis?

A

Endothelial damage allowing lipids to enter the intima.

51
Q

What forms foam cells in atherosclerosis?

A

Macrophages consume oxidized lipids becoming foam cells.

52
Q

What are the stages of atherosclerosis development?

A

Starts as fatty streaks (lipid-laden macrophages) progressing to atherosclerotic plaque.

53
Q

What are complications of atherosclerosis?

A

Stenosis plaque rupture with thrombosis

54
Q

What does stenosis of medium-sized vessels cause?

A

Impaired blood flow leading to peripheral vascular disease angina

55
Q

What is the consequence of plaque rupture with thrombosis?

A

Thrombosis can cause myocardial infarction (MI) in coronary arteries or stroke in cerebral arteries.

56
Q

What does plaque rupture with embolization cause?

A

Atherosclerotic emboli often containing cholesterol crystals.

57
Q

What happens when atherosclerosis weakens the vessel wall?

A

Can lead to aneurysm formation such as abdominal aortic aneurysm.

58
Q

What is arteriolosclerosis?

A

Narrowing of small arterioles divided into hyaline and hyperplastic types.

59
Q

What causes hyaline arteriolosclerosis?

A

Protein leakage into the vessel wall often due to benign HTN or diabetes.

60
Q

What is hyperplastic arteriolosclerosis?

A

Thickening of vessel walls due to smooth muscle hyperplasia giving an “onion-skin” appearance

61
Q

What is Monckeberg medial calcific sclerosis?

A

Calcification of the media in muscular arteries which is non-obstructive and clinically insignificant.

62
Q

What is aortic dissection?

A

Intimal tear with blood dissecting through the aortic media typically in the proximal aorta.

63
Q

What causes aortic dissection?

A

Most commonly HTN; also connective tissue disorders like Marfan syndrome or Ehlers-Danlos syndrome.

64
Q

What are symptoms and complications of aortic dissection?

A

Sharp tearing chest pain radiating to the back; complications include pericardial tamponade

65
Q

What is thoracic aneurysm and its classic cause?

A

Dilation of the thoracic aorta often due to tertiary syphilis

66
Q

What are complications of thoracic aneurysm?

A

Aortic valve insufficiency compression of nearby structures

67
Q

What is abdominal aortic aneurysm and its classic cause?

A

Dilation of the abdominal aorta often due to atherosclerosis

68
Q

What is a major complication of abdominal aortic aneurysm?

A

Rupture particularly when >5 cm

69
Q

What is hemangioma?

A

A benign tumor of blood vessels commonly seen at birth

70
Q

What is angiosarcoma?

A

A highly aggressive malignant proliferation of endothelial cells commonly in skin

71
Q

What exposures are associated with liver angiosarcoma?

A

Polyvinyl chloride arsenic

72
Q

What is Kaposi sarcoma?

A

A low-grade malignant proliferation of endothelial cells associated with HHV-8 infection.

73
Q

What are the types of Kaposi sarcoma?

A

Older Eastern European males (localized) AIDS patients (disseminated)

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