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CPR 1st half > Vascular Pathology > Flashcards

Vascular Pathology Flashcards

1
Q

biopsy of temporal giant cell arteritis will show…

A

inflamed vessel wall with giant cells fibrosis between media and intima BUT negative biopsy doesn’t exclude disease…might not have been in that segment

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1
Q

how to treat takayasu arteritis?

A

corticosteroids

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1
Q

risk factors of essential HTN

A

age, race, obesity, smoking, stress, lack of physical activity, excess salt

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2
Q

micronodular cirrhosis

A

caused by alcoholism

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2
Q

complications of HTN?

A

renal (renal failure) CV (MI) brain (stroke) eye (hypertensive retinopathy)

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2
Q

three pathogenesis that weaken wall and lead to aneurym

A

CT disorders matrix metalloprotease (MMP breaks down elastin) antherosclerosis

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3
Q

igA?

A

henoch schonlein purpura

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4
Q

vasculitis with all lesions same stage? varying stages?

A

same stage = microscopic polyangiitis varying = polyarteritis nodosa

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4
Q

why is henoch schonlein purpura usually after upper respiratory tract infection?

A

because IgA levels are increased to protect mucosal surfaces

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4
Q

what does smoking increase?

A

CRP

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4
Q

what tumor is associated with PVC, arsenic, and thorotrast exposure?

A

angiosarcoma

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5
Q

HSP henoch schonlein purpura

A

small vessel vasculitis due to IgA immune complex deposition; children; palpable purpura on buttocks and legs, GI pain/bleeding, hematuria, post-respiratory tract infection, proteinuria treat w steroid or will self-resolve

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6
Q

complications of atherosclerosis

A

stenosis –> impaired blood flow and ischemia –> peripheral vascular disease, angina (coronary a), and IBD (mesenteric a) rupture –> emboli or thrombosis –> MI, stroke, aneurysm

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7
Q

fatty streak histology =

A

foam cells (macrophages full of lipid) and t lymphocytes

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7
Q

buerger disease

A

medium vessel, necrotizing vasculitis involving DIGITS symptoms - ulcers, gangrene, autoamputation of digits, raynauds phenomenon treat - stop smoking

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8
Q

hemoglobin A1c indicates

A

diabetes mellitus

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8
Q

diagnostic features of polyarteritis nodosa?

A

serum HBsAg (hep B surface antigen) segmental, lesions of varying stage string of pearls = dilatation + fibrous nodes(fibrinoid necrosis

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9
Q

churg strauss syndrome

A

small vessel necrotizing granulomatous vasculitis with eosinophils; multiple organs expecially lungs and heart serum p-ANCA

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9
Q

hyperplastic arteriolosclerosis is caused by

A

malignant HTN

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10
Q

elevated CRP and cholesterol crystals and foam cells indicate

A

atherosclerosis

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11
Q

polyarteritis nodosa

A

medium vessel necrotizing vasculitis involving most organs (LUNGS ARE SPARES) in young adults lesions of varying stages symptoms - HTN (renal a), abdominal symptoms (mesenteric a), neurologic issues, skin lesions

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12
Q

CRP

A

c reactive protein marker of inflammation

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13
Q

calcification of the media

A

monckeberg medial sclerosis

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14
Q

response to endothelium injury

A

injury –> lipid accumulation in intima –> t lymphocytes release interferon –>monocyte/platelet recruitment/adhesion/emigration –> macrophage activation and smooth m recruitment –> lipid/oxidized LDL is engulfed by both –> smooth m proliferation and ecm/collagen deposition + remodeling –> smaller lumen, weakened wall, scarring expansion encroaches on media and adventitia and narrows lumen –> nutrients not reaching full thickness –> necrosis

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15
Q

causes of aortic dissection

A

HTN is most common CT disorder - Marfans (fibrillin) or Ehlers Danlos (collagen)

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16
Q

two types of ANCA

A

cANCA is in cytoplasm periphery = Wegener granulomatosis pANCA is in nucleus periphery = microscopic polyangiitis and churg strauss syndrome

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17
Q

aortic dissection

A

intima tears and blood dissects through media creating false channel sharp radiating chest pain to back, proximal 10 cm of aorta due to preexisting media weakness due to HTN or genetic CT disorder

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18
Q

intimal plaque that obstruct blood flow –> chronic inflammation and progressive accumulation

A

atherosclerosis

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19
Q

ulcers, gangrene, raynauds, autoamputation of digits

A

beurgers disease

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19
Q

hyperplastic arteriolosclerosis

A

thickened vessel wall by hyperplasia of smooth muscle onion skinning appearance BP>20/120, leads to reduced vessel caliber and end organ ischemia, renal failure w flea bitten appearance

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19
Q

where are hemangiomas usually? histology?

A

skin and liver endothelium lined spaces filled with RBC, lobular architecture

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20
Q

(general) inflammation of blood vessel wall

A

vasculitis

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21
Q

takayasu arteritis

A

similar to temporal giant cell arteritis EXCEPT adults

22
Q

thickening of wall in small vessels

A

arteriolosclerosis

23
Q

well circumscribed benign tumor of blood vessels common at birth and regression in childhood

A

hemangioma

24
Q

kid with palms/soles rashes and enlarged cervical lymph nodes

A

Kawasaki disease

25
Q

what indicates high risk of rupture of aneurysm

A

>5 cm elevated MMP

26
Q

essential HTN

A

BP>139/89 unknown etiology 95% of cases increased CO, and increased TPR(peripheral resistance)

27
Q

HHV8?

A

Kaposi sarcoma

28
Q

fatty streak can begin to develop in

A

adolescence

30
Q

thrombophlebitis

A

vein inflammation due to venous stasis (bed rest)

31
Q

necrotizing vasculitis involving many organs, especially lungs and kidneys serum pANCA similar to wegeners but no nasopharyngeal invovlement

A

microscopic polyangiitis

33
Q

which vasculitis has palpable purpura in children buttock and legs?

A

Henoch schonlein purpura

34
Q

renal artery stenosis

A

increased plasma renin (angiotensin 1–>2)–> aldosterone release –> increase reabsorption of Na –> increase BP unilateral atrophy of one kidney

36
Q

three catergories of vasculitis

A

large vessel - aorta or major branches medium vessel - muscular arteries that supply organs small vessel - venules, capillaries, or arterioles

37
Q

which vasculitis associated with asthma?

A

churg strauss

39
Q

what can cause vaso vasorum of aorta and what can that lead to?

A

syphilis; vasculitis

40
Q

hyaline arteriolosclerosis

A

proteins leak into vessel wall creating thick walls w hyaline due to longstanding HTN or diabetes

42
Q

2 types of large vessel vasculitis

A

temporal giant cell arteritis AND takayasu arteritis

44
Q

temporal giant cell arteritis

A

large vessel arteritis in older adults (>50) affects branches of carotid a (temporal, ophthalmic) granulomatous vasculitis with intimal fibrosis treat with corticosteroids

46
Q

ANCA indicates

A

noninfectious vasculitis

47
Q

HBsAg

A

polyarteritis nodosa

48
Q

3 types of medium vessel vasculitis

A

polyarteritis nodosa Kawasaki disease buerger disease

48
Q

thoracic aneurysm

A

dilation of thoracic aorta; seen in tertiary syphilis treebark appearance of aorta

50
Q

scavenger receptor

A

receptor on macrophages that detects and picks up oxidized LDL –> creates a foam cell

51
Q

how to treat beurger disease?

A

cessation of smoking

53
Q

thickening of the intima of medium and large vessels

A

atherosclerosis

54
Q

what large vessel vasculitis occurs at branch points of aortic arch?

A

takayasu arteritis

56
Q

lymphedema vs lymphangitis

A

lymphedema is blockage, lymphangitis is infection

57
Q

Kawasaki disease

A

Asian kids could cause coronary aneurysm so IMPORTANT to treat asap with aspirin

58
Q

microscopic polyangiitis

A

small vessel necritizing vasculitis similar to wegeners BUT no nasopharyngeal involvement and no granulomas ALL lesions are SAME AGE serum p-ANCA treat w corticosteroids and cyclophosphamide

59
Q

why give a kid with Kawasaki disease aspirin?

A

this isn’t a viral illness aspirin will inhibit COX and prevent a thrombus in the coronary artery

60
Q

dissection types I II III

A

A = I(ascending and descending) and II (ascending) B= III(descending) - best prognosis

61
Q

three populations at risk for Kaposi sarcoma?

A

HIV/AIDS, older eastern European males, transplant recipients

63
Q

what does a weak or absent upper extremity pulse point to?

A

takayasu arteritis

64
Q

how to treat polyarteritis nodosa?

A

fatal if not treated use corticosteroids or cyclophosphamide

65
Q

aneurysm

A

dilated area of vessel frequent in male smokers over 50 with HTN

66
Q

Kaposi sarcoma

A

low grade malignant proliferation of endothelial cells purple patches, plaques, or nodules, does not blanch if you press since no vessels, just blood IN skin associated with HHV8 and HIV/AIDS; elevated CD31,

68
Q

benign vs malignant HTN

A

benign - mild elevation in BP, clinically silent, progressive malig - severe (>200/120), may be secondary or de novo, signs of end organ ischemia, acute renal failure = medical emergency

69
Q

4 types of small vessel vasculitis

A

Wegener granulomatosis microscopic polyangiitis churg-strauss syndrome Henoch Schonlein Purpura (HSP)

70
Q

monckeberg medial calcific stenosis

A

calcification of media of muscular arteries not clinically significant, nonobstructive

71
Q

abdominal aortic aneurysm

A

dilated abdominal aorta; usually below renal arteries but above bifurcation pulsatile, progressive abdominal mass, presents with triad: hypotension, pulsatile abdominal mass, and flank pain

73
Q

which medium vessel vasculitis spares the lungs?

A

polyarteritis nodosa

74
Q

angiosarcoma

A

malignant aggressive proliferation of endothelium cells; common in breast, skin, and liver pleomorphism and hyperchromasia (vary shape size and color)

75
Q

three ways churg strauss is different from microscopic polyangiitis?

A

it is granulomatous, has peripheral eosinophilia, and associated with asthma.

76
Q

tumor that blanches? that doesn’t?

A

hemangioma blanches; Kaposi sarcoma doesnt

77
Q

importance of treating temporal giant cell arteritis

A

treat with corticosteroids ASAP –high risk of blindness due to thrombosis of ophthalmic a cutting off supply to eye

78
Q

Wegener granulomatosis

A

small vessel vasculitis, necrotizing granulomatosis involving nasopharynx, lungs, and kidneys (c curve) serum c-ANCA treat: cyclophosphamide “weCener”

79
Q

syphilis causes

A

vaso vasorum of the aorta

80
Q

symptoms of temporal giant cell vasculitis

A

headache(temporal a), visual issues (ophthalmic a), jaw claudication, flu, joint/muscle pain, elevated ESR

81
Q

strawberry tongue with red fissured lips

A

Kawasaki disease

82
Q

histology of HTN

A

thickened arteriolar wall (hyaline/protein deposition), narrowed lumen onion skinning (hyperplastic arteriolosclerosis) = malignant

CPR 1st half (11 decks)

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