Vascular Pathology Flashcards
Mechanism of organ ischemia in vasculitis
Endothelial destruction - thrombosis or fibrosis occluding vessels
Most common form of vasculitis in older adults > 50, usually females
Temporal (Giant Cell) Arteritis
Symptoms of Giant Cell Arteritis
Headache
Visual disturbance
Jaw Claudication
- Temporal artery
Flu-like symptoms with joint and muscle pain in giant cell arteritis
Polymyalgia Rheumatica
Morphology of Giant Cell Arteritis
Imflamed vessel wall with giant cell (granulomatous)(multinucleaed) and fibrosis
Granulomatous vasculitis presenting in patients less than 50 yrs old, usually involves aortic arch
Takayasu Arteritis
Vasculitis which presents with weak or absent pulse in an upper extremity
Takayasu Arteritis
Medium vessel vasculitis involves what arteries?
Muscular Arteries
Necrotizing medium sized vasculitis which involves most organs
Polyarteritis Nodosa
Organ unaffected by Polyarteritis Nodosa
Lung
Polyarteritis Nodosa is associated with what antigen
HbsAg
String-of-pearls appearance on imaging from fibrinoid necrosis of vessels is associated with
Polyarteritis Nodosa
- “Nodes” of small aneurysms between fibrosed tissue are the “pearls”
Vasculitis presenting with fever, conjunctivitis, erythematous rash of palms and soles, and lymphadenopathy
Kawasaki Disease
Necrotizing vasculitis involving the digits, presenting with ulceration, gangrene, raynaud phenomenon
Buerger Disease
Small Vessel Vasculitis involve
arterioles, capillaries, venules
Necrotizing granulomatous vasculitis involving nasopharynx, lungs, kidneys
Wegener Granulomatosis
Serum marker increased in Wegener Granulomatosis which correlate with disease activity
C-ANCA
anti-neutrophil cytoplasmic antibody
Treatment for Wegeners Granulomatosis
Cyclophosphamide
Necrotizing vasculitis involving multiple organs, especially lung and kidney, with no granuloma formation
Microscopic Polyangiitis
Serum marker increased in Microscopic polyangitis
P-ANCA
Necrotizing granulomatous vasculitis with eosinophils involving multiple organs especially lungs and heart
Churg-Strauss Syndrome
Vasculitis associated with Asthma
Churg-Strauss Syndrome
Serum marker elevated in Churg-Strauss Syndrome
P-ANCA
Vasculitis due to IgA complex deposition
Henoch-Schonlein Purpura
Most common Vasculitis in children
Henoch-Schonlein Purpura
Two major causes of renal artery stenosis
Atherosclerosis Fibromuscular Dysplasia (young)
Vessel layer involved in atherosclerosis
Intima of medium and large sized vessels
Contents of atherosclerotic plaque
Necrotic Lipid Core
Fibrous Cap
Fatty Streak is
Macrophage capturing oxidized lipids deposited in intima
Amount of stenosis required to produce ischemic symptoms
> 70%
Cholesterol clefts is a hallmark of
Atherosclerotic embolus
Arteriolosclerosis caused by leaking proteins in long standing hypertension and diabetes
Hyaline arteriolosclerosis
mechanism of HTNKD and DMKD
Onion-skin appearance of vessels is associated with
Hyperplastic arteriolosclerosis
Flea-bitten appearance in a kidney causing AKI is caused by what vessel pathology
Hyperplastic arteriolosclerosis
Calcification of the tunica media, non-obstructive and not clinically significant, usually incidentally seen in mammography
Monckeberg medial calcific stenosis
Intimal tear in blood vessel, allowing blood to access the media
Aortic Dissection
Common site of aortic dissection
Proximal 10 cm of aorta
Requirements for dissection
Pre-existing media weakness (connective tissue defect, hypertension)
How does hypertension cause aortic dissection?
Sclerosis of vasa vasorum leads to poor perfusion of adventitia and media
Most common cause of death in aortic dissection
Pericardial tamponade
Requirements for aneurysm
Weakness in the aortic wall
Tree-bark appearance of the aorta is associated with
Aneurysm
Complication of thoracic aneurysm due to dilatation of aortic root
Aortic insufficiency
Location of AAA
Below renal artery, above bifurcation
Size of AAA prone to rupture
> 5 cm
Triad of symptoms in AAA rupture
hypotension, pulsatile abdominal mass, flank pain
Benign tumor comprised of blood vessels, often regresses in childhood
Hemangioma
Malignant proliferation of endothelial cells, usually in skin, breast, and liver
Angiosarcoma
Low grade malignant proliferation of endothelial cells presenting as purple patches, plaques or nodules
Kaposi Sarcoma
TRUE OR FALSE: Hemangiomas Blanch
FALSE
Blood is in skin, not in vessels.
Virus associated with Kaposi Sarcoma
HHV-8
human herpesvirus 8
