Vascular Pathology

Question 1

Vasculitis means

Answer 1

Inflammation of the blood vessel wall

Question 2

Temporal (Giant Cell) arteritis involves

Answer 2

Granulomatous vasculitis that involves branches of carotid artery

Question 3

Giant Cell arteritis presents with

Answer 3

1. Headache (temporal artery involvement)
2. Visual disturbance (ophthalmic artery involvement)
3. Polymylagia rheumatica (flu-like symptoms with joint and muscle pain)
4. Elevated ESR

Question 4

Takayasu Arteritis is

Answer 4

Granulomatous vasculitis that classically involves the aortic arch at branch point.

Question 5

Takayasu arteritis presentation

Answer 5

1. Visual and neurologic symptoms with a weak or absent pulse in upper extremities seen in Asian females
2. ESR is elevated

Question 6

Polyarteritis Nodosa is

Answer 6

necrotizing vasculitis that involves multiple organs sparing lungs

Question 7

Polyarteritis Nodosa presentation

Answer 7

1. HT (renal artery involvement)
2. Abdominal pain with melena (mesenteric artery involvement)
3. Neurologic disturbance
4. Skin lesions

Question 8

Polyarteritis Nodosa associated with

Answer 8

Serum HBsAg

Question 9

Polyarteritis Nodosa appearance

Answer 9

String of pearls due to varying stages of presentation:

1. Transumural inflammation with fibrinoid necrosis
2. Healed areas with fibrosis

Question 10

Kawasaki Disease presentation

Answer 10

1. Asian child <4 yr
2. Fever
3. Conjunctivitis
4. Erythematous rash of palms and soles
5. Enlarged cervical lymph nodes

Question 11

Complications of Kawasaki disease

Answer 11

Due to Coronary artery involvement:

1. Thromosis with MI
2. Aneurysm with rupture

Question 12

Beurger disease is

Answer 12

Necrotizing vasculitis involving digits

Question 13

Wegener Granulomatosis is

Answer 13

Necrotizing granulomatous vasculitis involving nasopharynx, lungs, and kidneys

Question 14

Wegener Granulomatosis classic presentation

Answer 14

Middle-aged male with sinusitits or nasopharyngeal ulceration, hemoptysis with bilateral nodular lung infiltrates

Question 15

What is found in serum with Wegener Granulomatosis

Answer 15

c-ANCA

Question 16

Polyangiitis is

Answer 16

Necrotizing vasculitis involving multiple organs, especially lung and kidney

Question 17

Difference between Wegener and Polyangiitis

Answer 17

Polyangiitis doesn’t have nasopharyngeal involvment

Polyangiitis has p-ANCA in serum

Question 18

Churg-Strauss syndrome is

Answer 18

Necrotizing granulomatous inflammation with eosinophils involving multipe organs, especially lungs and heart

Question 19

Churg-Strauss syndrome has what elevated in its serum

Answer 19

p-ANCA

Question 20

Henoch-Schönlein Purpura is

Answer 20

Vasculitis due to IgA immune complex deposition

Question 21

Henoch-Schönlein Purpura presents with

Answer 21

1. Papable purpura on buttocks and legs
2. GI pain and bleeding
3. Hematuria (IgA nephropathy)
4. Occurs after and upper respiratory tract infection

Question 22

Atherosclerosis is defined as

Answer 22

Intimal plaque that obstructs blood flow

Question 23

Arteriolosclerosis defined as

Answer 23

narrowing of small arterioles

divided into hyaline and hyperplastic types

Question 24

Long standing HT or Diabetes leads to

Answer 24

Hyaline arteriolosclerosis

Question 25

Onion-skin appearance of blood vessels seen in

Answer 25

Hyperplastic arteriolosclerosis

Question 26

Malignant HT leads to

Answer 26

Hyperplastic arteriolosclerosis

Question 27

Flea-bitten kidney with ARF seen in

Answer 27

Hyperplastic Arteriolosclerosis