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Pathoma > Vascular Pathology > Flashcards

Vascular Pathology Flashcards

1
Q

What is the innermost layer of the blood vessel?

A

tunica intima

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2
Q

What is the middle layer of the blood vessel?

A

tunica media

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3
Q

What is the outermost layer of the blood vessel?

A

tunica adventitia

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4
Q

What vessel(s) does large vessel vasculitis involve?

A

aorta and branches

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5
Q

What vessel(s) does medium vessel vasculitis involve?

A

muscular arteries

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6
Q

What vessel(s) does small vessel vasculitis involve?

A

arterioles/venules/capillaries

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7
Q

What are the two forms of Large Vessel Vasculitis?

A

Temporal Arteritis

Takayasu

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8
Q

What is another name for Temporal Arteritis?

A

Giant Cell Artiritis

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9
Q

What type of immune cell invades during temporal artiritis?

A

granuloma

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10
Q

Giant cell artiritis most often involves what artery?

A

branches of the carotid

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11
Q

What are the three presentations of Giant Cell Artiritis?

A

headache

visual disturbances

jaw claudication

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12
Q

What is the histological finding of Giant Cell Artiritis?

A

intimal fibrosis

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13
Q

What characteristic do the lesions ave during Temporal Artiritis? What does this mean?

A

segmental lesions

have to remove and examine long section of vessel

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14
Q

What is the Tx for Temporal Artiritis? What is the major risk in avoiding treatment?

A

corticosteoroids

blindness

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15
Q

Without treatment, temporal cell artiritis carries a high risk of what?

A

blindness

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16
Q

Takayasu Artiritis commonly involves what specifc point of the vessel?

A

aortic arch at branch points

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17
Q

What age and population is the classic presentation of Takayasu Artiritis?

A

young asian female

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18
Q

What are three major presenting symptoms of Takayasu Arteritis?

A

weak or absent pulse on upper extremity

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19
Q

What is the Tx for takayasu artiritis?

A

Corticosteroids

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20
Q

What are the three Medium vessel size vasculitis?

A

Polyartiritis Nodasa

Kawasaki Disease

Buerger Disease

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21
Q

What type of immune reaction takes place during Polyartiritis Nodosa?

A

Necrotizing

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22
Q

Which organ is spared during Polyarteritis Nodosa?

A

lungs

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23
Q

What marker is associated with Polyartiritis Nodsa?

A

serum HBsAg

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24
Q

What type of necrosis takes place during Polyarteritis Nodosa?

A

Fibrinoid

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25
Q

During Polyarteritis Nodosa forms after the fibrinoid necrosis heals? What is the sign for this?

A

fibrosis

String of Pearls

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26
Q

What two drugs are used to treat polyarteritis nodosa?

A

Corticosteroids and cyclophosphamide

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27
Q

What ethnicity is most often stricken with Kawasaki Disease?

A

Asian

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28
Q

What age is most often affected by Kawasaki Disease?

A

under age of 4

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29
Q

What are three the most obvious presentations of a child with Kawasaki Disease?

A

rash on palms and feet

conjuctivitis

enlarged cervical lymph nodes

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30
Q

What are the two risks involved with Kawasaki Disease if it effects the coronary arteries?

A

thrombosis with MI

Aneurysm with rupture

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31
Q

What are the two treatments of Kawasaki Disease?

A

Aspirin and IVIG

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32
Q

What type of inflammatory process takes place during Buerger Disease?

A

necrotizing

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33
Q

What body part is commonly affected during Buerger Syndrome?

A

fingers and toes

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34
Q

What disease is often also present during Buerger Syndrome?

A

Raynaud Phenomenom

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35
Q

What is the Tx for Buerger?

A

stop smoking

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36
Q

Wegener Granulomatosis often involves which three organs?

A

nasopharynx, lungs and kidneys

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37
Q

What age and sex is most often associated with Wegener Granulomatosis?

A

middle aged male

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38
Q

What nasal symptom does a person with Wegener Granulomatosis present with?

A

sinusitis or nasopharyngeal ulceration

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39
Q

What lung symptom does a person with Wegener Granulomatosis present with?

A

Hemoptysis

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40
Q

What renal symptom does a person with Wegener Granulomatosis present with?

A

necrotizing glomerulonephritis

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41
Q

Why does a patient with Wegener Granulomatosis present with Hematuria?

A

rapidly progressin glomerulonephritis

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42
Q

What vasculitis can present with serum c-ANCA? What is this used for?

A

Wegener

correlate disease activity

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43
Q

What is the treatment for Wegener Granulomatosis?

A

cyclophosphamide and steroids

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44
Q

What two organs are involved with Microscopic Polyangitis?

A

lungs and kidneys

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45
Q

Lack of what two symptoms separate Wegener Granulomatosis from Microscopic Polyangitis ?

A

nasopharyngeal involvement

no necrotizing granulomatous formation

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46
Q

What antibody is present during Microscopic Polyangitis ?

A

p-ANCA

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47
Q

What is the Tx for microscopic polyangitis?

A

cyclophosphamide and corticosteroids

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48
Q

What type of inflammation is present during Churg Strauss?

A

necrotizing, granulomatous

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49
Q

What is notable about the inflammation of Churg Strauss?

A

presence of eosinophils

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50
Q

What two organs are most effected by Churg-Strauss?

A

heart and lungs

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51
Q

What antibody is found during Churg-Strauss?

A

p-ANCA

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52
Q

What is the disease of Henoch-Schonlein Purpura?

A

vasculitis

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53
Q

What causes Henoch-Schonlein Purpura?

A

IgA immune complex deposition

54
Q

What is the most common vasculitis in children?

A

Henoch-Schonlein Purpura

55
Q

What is notable about the physical examination of patient with Henoch Schonlein Purpura?

A

palpable purpura on buttocks and legs

56
Q

What two locations does a patient commonly bleed from during Henoch-Schonlein Purpura?

A

GI tract

kidneys

57
Q

What causes the hematuria during Henoch-Schonlein Purpura?

A

IgA nephropathy

58
Q

What type of infection often preceedes Henoch-Schonlein Purpura?

A

upper respiratory tract infection

59
Q

How is Henoch-Schonlein Purpura treated?

60
Q

What two diseases cause renal artery stenosis? What patient populations?

A

Fibromuscular Dysplasia = young women

atherosclerosis = old men

61
Q

What causes Hyaline Arteriosclerosis?

A

proteins leaking into vessel wall

62
Q

What are the two causes of Hyaline Arteriosclerosis?

A

benign HTN and diabetes

63
Q

What does long-term Hyaline Arteriosclerosis produce to the glomerulus? Leading to?

A

glomerular scarring

renal failure

64
Q

What causes hyperplastic arteriosclerosis?

A

malignant HTN

65
Q

What structure is produced during hyperplastic arteriosclerosis?

A

onion skin

66
Q

What type of necrosis can hyerplastic arteriosclerosis lead to? Clasically causing? What structure?

A

fibrinoid necrosis

acute renal failure

flea bitten

67
Q

What tears during an Aortic Dissection?

A

tunica intima

68
Q

What layer of the vessel does blood go into during aortic dissection?

A

tunica media

69
Q

Destruction of what structure can lead to an aortic dissection?

A

vaso vasorum

70
Q

What two genetic diseases can lead to aortic dissection?

A

Marfan and Ehlers-Danlos

71
Q

What two diseases can have cystic medial necrosis of vells?

A

Ehlers-Danlos and Marfan

72
Q

Where does the pain of an aortic dissection radiate?

73
Q

What is the most common cause of death during aortic dissection?

A

pericardial tamponade

74
Q

What is the mechanism by which tertiary syphillis can produce a thoracic aneurysm?

A

endarteritis of vaso vasorum

75
Q

What are the two major complications of tertiary syphillis on the heart?

A

dilation of aortic valve root

aortic regurg.

76
Q

Greater than how large does a AAA increase in its chance of rupture? What measure?

A

5 cm

diameter

77
Q

An angiosarcoma is a malignant proliferation of what cell type?

A

endothelial cells

78
Q

What are the three primary causes of an angiosarcoma?

A

arsenic, vinyl chloride and thorotrast

79
Q

Kaposi sarcoma is a malignant proliferation of what cell?

A

endothelial

80
Q

Which virus is known to cause Kaposis Sarcoma?

81
Q

What geographical region is Kaposis Sarcoma clasically present in?

A

older, eastern european males

82
Q

What two immunosuppressed populations can Kaposi’s Sarcoma be present in?

A

HIV

transplant patients

83
Q

What is the ESR over during Temporal Cell arteritis?

84
Q

What is a common presentation for a patient with Polyarteritis Nodosa?

A

young patient with HTN

85
Q

What artery is most often affected during Kawasaki Disease?

A

Coronary arteries

86
Q

What two type of vasculitis are found during Wegener?

A

necrotizing, granulomatous

87
Q

Other than peripheral eosinophilia, what is another presenting symtpom of Churg-Strauss?

88
Q

What is the most common age to develop Henoch-Schonlein Purpura?

89
Q

Henoch-Schonlein Purpura usually follows what other disease?

A

upper respiratory tract infection

90
Q

What is fibromuscular dysplasia?

A

developmental defect that results in thickening of blood vessel wall

91
Q

What artery is especially affected by FIbromuscular Dysplasia?

92
Q

What patient group is especially affected by fibromuscular dysplasia?

A

young females

93
Q

What type of necrosis takes place during malignant HTN?

94
Q

What part of the vessel thickens during atherosclerosis?

95
Q

What is the plaque of atherosclerosis composed up?

A

necrotic lipid core

96
Q

What is the cap of atherosclerosis composed of?

A

fibromuscular cap

97
Q

What is the necrotic lipid core composed of?

A

cholesterol

98
Q

What process does an atherosclerotic cap undergo?

A

dystrophic calcification

99
Q

What four arteries are most susceptible to atherosclerosis?

A

abdominal aorta>coronary>popliteal>internal carotid

100
Q

What are the four modifiable risk factors for the development of atherosclerosis?

A

HTN, hypercholesterolemia, diabetes and smoking

101
Q

Stenosis greater than what percent is necessary for atherosclerosis to beging manifesting as symptoms?

102
Q

What are the two types of arteriolosclerosis?

A

hyaline and hyperplastic

103
Q

Why does benign HTN produce hyaline arteriolosclerosis?

A

pressure forces proteins into wall

104
Q

Why does diabetes produce hyaline arteriolosclerosis?

A

glycosylation of basement membrane makes it leaky to proteins

105
Q

Does hyaline arteriosclerosis cause the afferent or efferent arteriole to scar?

106
Q

Why does malignant HTN produce hyperplastic arteriolosclerosis?

A

smooth muscle hypertrophies to contain pressure

107
Q

What is fibrinoid necrosis?

A

death of vessel wall

108
Q

What is Mockeberg Disease? Clinically significant?

A

calcification of tunica media

no

109
Q

What are the two requirements for an aortic dissection to occur?

A

high stress

pre-existing weakness

110
Q

What is the most common cause of an aortic dissection?

111
Q

What specific protein of Marfan syndrome is defective?

112
Q

Other than tamponade, how can an aortic dissection produce end organ damage?

A

obstruction of branching arteries

113
Q

Why does a AAA become weak?

A

atherosclerosis

114
Q

What are the three classic presentations of a ruptured AAA?

A

hypotension

pulsatile mass

flank pain

115
Q

What structure can an aortic dissection compress?

116
Q

What are the two most common locations of a hemangioma?

A

skin and liver

117
Q

Is an angiosarcoma benign or malignant?

A

very malignant

118
Q

Is Kaposi’s Sarcoma benign or malignant?

A

low-grade malignant

119
Q

What are the two locations Kaposi’s Sarcoma may arise?

A

skin and visceral organs

120
Q

What is the Tx of an eastern european man with Kaposi’s Sarcoma?

A

surgical resection

121
Q

How is Kaposi’s treated in an AIDS patient?

A

antiretrovirals

122
Q

How is Kaposi’s treated in a transplant patient?

A

decrease immunosuppression

123
Q

What type of inflammation is present during Takayasu Arteritis?

A

necrotizing granulomatous

124
Q

What two vessels does Polyarteritis Nodosa primarily effect?

A

Renal and Visceral vessels

125
Q

What lymph nodes are enlarged during Kawasaki Disease?

126
Q

What are three differnces between Wegeners and Microscopic Polyangiitis?

A

Wegener = c-ANCA

Microscopic = no nasopharyngeal

microscopic = no granuloma

127
Q

What two vessels are most effected during Fibromuscular Dysplasia?

A

Carotid and Renal

128
Q

What layer of the vessel is affected during Monckenberg? What process?

A

media

calcification

129
Q

What specific process caused by HTN can result in aortic dissection?

A

hyaline arteriolosclerosis of vasa vasorum

130
Q

What happens to the kidney during Renal Artery Stenosis?

131
Q

Are the lesions in Polyarteritis Nodosa or varying stages of the same stage?

132
Q

What is the key histological finding of an embolus?

A

cholesterol clefts

Pathoma (19 decks)

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