Vascular Pathology

Question 1

Mechanism of organ ischemia in vasculitis

Answer 1

Endothelial destruction - thrombosis or fibrosis occluding vessels

Question 2

Most common form of vasculitis in older adults > 50, usually females

Answer 2

Temporal (Giant Cell) Arteritis

Question 3

Symptoms of Giant Cell Arteritis

Answer 3

Headache
Visual disturbance
Jaw Claudication

• Temporal artery

Question 4

Flu-like symptoms with joint and muscle pain in giant cell arteritis

Answer 4

Polymyalgia Rheumatica

Question 5

Morphology of Giant Cell Arteritis

Answer 5

Imflamed vessel wall with giant cell (granulomatous)(multinucleaed) and fibrosis

Question 6

Granulomatous vasculitis presenting in patients less than 50 yrs old, usually involves aortic arch

Answer 6

Takayasu Arteritis

Question 7

Vasculitis which presents with weak or absent pulse in an upper extremity

Answer 7

Takayasu Arteritis

Question 8

Medium vessel vasculitis involves what arteries?

Answer 8

Muscular Arteries

Question 9

Necrotizing medium sized vasculitis which involves most organs

Answer 9

Polyarteritis Nodosa

Question 10

Organ unaffected by Polyarteritis Nodosa

Answer 10

Lung

Question 11

Polyarteritis Nodosa is associated with what antigen

Answer 11

HbsAg

Question 12

String-of-pearls appearance on imaging from fibrinoid necrosis of vessels is associated with

Answer 12

Polyarteritis Nodosa

• “Nodes” of small aneurysms between fibrosed tissue are the “pearls”

Question 13

Vasculitis presenting with fever, conjunctivitis, erythematous rash of palms and soles, and lymphadenopathy

Answer 13

Kawasaki Disease

Question 14

Necrotizing vasculitis involving the digits, presenting with ulceration, gangrene, raynaud phenomenon

Answer 14

Buerger Disease

Question 15

Small Vessel Vasculitis involve

Answer 15

arterioles, capillaries, venules

Question 16

Necrotizing granulomatous vasculitis involving nasopharynx, lungs, kidneys

Answer 16

Wegener Granulomatosis

Question 17

Serum marker increased in Wegener Granulomatosis which correlate with disease activity

Answer 17

C-ANCA

anti-neutrophil cytoplasmic antibody

Question 18

Treatment for Wegeners Granulomatosis

Answer 18

Cyclophosphamide

Question 19

Necrotizing vasculitis involving multiple organs, especially lung and kidney, with no granuloma formation

Answer 19

Microscopic Polyangiitis

Question 20

Serum marker increased in Microscopic polyangitis

Answer 20

P-ANCA

Question 21

Necrotizing granulomatous vasculitis with eosinophils involving multiple organs especially lungs and heart

Answer 21

Churg-Strauss Syndrome

Question 22

Vasculitis associated with Asthma

Answer 22

Churg-Strauss Syndrome

Question 23

Serum marker elevated in Churg-Strauss Syndrome

Answer 23

P-ANCA

Question 24

Vasculitis due to IgA complex deposition

Answer 24

Henoch-Schonlein Purpura

Question 25

Most common Vasculitis in children

Answer 25

Henoch-Schonlein Purpura

Question 26

Two major causes of renal artery stenosis

Answer 26

``` Atherosclerosis Fibromuscular Dysplasia (young) ```

Question 27

Vessel layer involved in atherosclerosis

Answer 27

Intima of medium and large sized vessels

Question 28

Contents of atherosclerotic plaque

Answer 28

Necrotic Lipid Core | Fibrous Cap

Question 29

Fatty Streak is

Answer 29

Macrophage capturing oxidized lipids deposited in intima

Question 30

Amount of stenosis required to produce ischemic symptoms

Answer 30

> 70%

Question 31

Cholesterol clefts is a hallmark of

Answer 31

Atherosclerotic embolus

Question 32

Arteriolosclerosis caused by leaking proteins in long standing hypertension and diabetes

Answer 32

Hyaline arteriolosclerosis mechanism of HTNKD and DMKD

Question 33

Onion-skin appearance of vessels is associated with

Answer 33

Hyperplastic arteriolosclerosis

Question 34

Flea-bitten appearance in a kidney causing AKI is caused by what vessel pathology

Answer 34

Hyperplastic arteriolosclerosis

Question 35

Calcification of the tunica media, non-obstructive and not clinically significant, usually incidentally seen in mammography

Answer 35

Monckeberg medial calcific stenosis

Question 36

Intimal tear in blood vessel, allowing blood to access the media

Answer 36

Aortic Dissection

Question 37

Common site of aortic dissection

Answer 37

Proximal 10 cm of aorta

Question 38

Requirements for dissection

Answer 38

Pre-existing media weakness (connective tissue defect, hypertension)

Question 39

How does hypertension cause aortic dissection?

Answer 39

Sclerosis of vasa vasorum leads to poor perfusion of adventitia and media

Question 40

Most common cause of death in aortic dissection

Answer 40

Pericardial tamponade

Question 41

Requirements for aneurysm

Answer 41

Weakness in the aortic wall

Question 42

Tree-bark appearance of the aorta is associated with

Answer 42

Aneurysm

Question 43

Complication of thoracic aneurysm due to dilatation of aortic root

Answer 43

Aortic insufficiency

Question 44

Location of AAA

Answer 44

Below renal artery, above bifurcation

Question 45

Size of AAA prone to rupture

Answer 45

> 5 cm

Question 46

Triad of symptoms in AAA rupture

Answer 46

hypotension, pulsatile abdominal mass, flank pain

Question 47

Benign tumor comprised of blood vessels, often regresses in childhood

Answer 47

Hemangioma

Question 48

Malignant proliferation of endothelial cells, usually in skin, breast, and liver

Answer 48

Angiosarcoma

Question 49

Low grade malignant proliferation of endothelial cells presenting as purple patches, plaques or nodules

Answer 49

Kaposi Sarcoma

Question 50

TRUE OR FALSE: Hemangiomas Blanch

Answer 50

FALSE Blood is in skin, not in vessels.

Question 51

Virus associated with Kaposi Sarcoma

Answer 51

HHV-8 | human herpesvirus 8