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CPR Exam 1 > Vascular Pathology > Flashcards

Vascular Pathology Flashcards

1
Q

What histological structure do arteries contain that veins do not?

A

Internal Elastic Membrane.
Arteries= Elastic
Veins= Distensible

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2
Q

At what level of systemic circulation is blood pressure mainly controlled?

A

Arterioles

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3
Q

What can cause arteriovenous malformations?

A
  1. Rupture of arterial aneurysm into adjacent vein
  2. Penetrating injury that pierces artery and vein
  3. Inflammatory necrosis
  4. Iatrogenic (gain vascular access)
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4
Q

Complications of AVM’s

A

Seizures
Hemorrhage
Neural Deficits if in brain

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5
Q

Describe a Berry Aneurysm

A

Aneurysm in the circle of Willis most commonly between anterior cerebral and anterior communicating arteries.

“Worst HA of your life”

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6
Q

Risk factors for a Saccular (Berry) Aneurysm

A
  1. HTN
  2. Smoking
  3. Polycystic Kidney Dz
  4. Marfan’s or Ehler-Danlos
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7
Q

Fibromuscular Dysplasia

A

Focal thickening of M/L arteries that creates a “beads on a string” angiography.

Commonly affects renal arteries. Epigastric abd bruit commonly present

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8
Q

2 most important receptors that control heart rate and contractility

A

B1- “1 heart” increases Inotropy and rate

M2- decreased HR and Inotropy

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9
Q

RAAS pathway

A

Macula Densa/JG cells sense low Na+ levels/Low Pressure

JG releases Renin converts angiotensinogen to angiotensin
Angiotensin–> Angiotensin II–> Aldosterone/vasoconstriciton–> resorbed Na and H2O

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10
Q

Primary HTN

A

most common
Modifiable factors: Diet, exercise, Salt consumption, stress
Non-modifiable: Age, genetics

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11
Q

What blood pressure defines HTN

A

140/90

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12
Q

Secondary HTN

A

caused by Kidney, Endocrine, or CV problems

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13
Q

3 causes of primary hyperaldosteronism

A
  1. Idiopathic
  2. Adrenal Adenoma
  3. Glucocorticoid suppression
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14
Q

Cushing DISEASE

A

Increased ACTH release causing Increased Cortisol

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15
Q

Cushing SYNDROME

A

Increased Cortisol caused by adrenal release; Independent of ACTH release

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16
Q

Pheochromocytoma

A

Catecholamine-releasing tumor.
HTN, Tachy, HA, diaphoresis, tremor.

Test urine for plasma metanephrines

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17
Q

Primary cause of Renal Artery Stenosis

A

Atheroslcerosis

Fibromuscular Dysplasia

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18
Q

Symptoms of Coartctation of the Aorta

A

HTN in UE with Hypotension in LE

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19
Q

Hyaline Arteriosclerosis vs. Hyperplastic Arteriosclerosis

A

Hyaline: Narrowing due to chronic HTN
Hyperplastic: Malignant HTN “onion skinning”

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20
Q

Hypertensive Crisis

A

Rapid increase in BP to >180/120

Renal failure, encephalopathy, HF, papilledema

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21
Q

3 types of Arteriosclerosis

A
  1. Arteriosclerosis due to HTN
  2. Atherosclerosis due to plaque
  3. Monckeburg medial sclerosis due to calcification (not clinically significant)
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22
Q

Major risk factors for the development of Atherosclerosis

A

Non-modifiable:

  1. Genetics
  2. FH
  3. Age (>40)
  4. Male

Modifiable:

  1. Hyperlipidemia
  2. Hypertension
  3. Smoking
  4. the betus
  5. Stress, obesity, hyperhomocysteinemia
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23
Q

How does Atherosclerosis occur?

A

Vascular Injury causes activation of endothelium that leads to pro coagulation, inflammation, SM hypertrophy, and increased ECM.

Happens between Internal elastic membrane and endothelium

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24
Q

Growth factors the cause smooth muscle proliferation and ECM deposition

A
  1. PDGF
  2. FGF
  3. TGF-a
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25
Q

3 bad outcomes from atherosclerotic plaque in a vessel

A
  1. Aneurysm and rupture
  2. Occlusion by thrombus
  3. Critical Stenosis
26
Q

True vs. False Aneurysm

A

True: intact endothelium and outpouching of all layers (similar to true diverticulum)

False: defect in wall that causes a space between muscular intima and adventitia

27
Q

Describe a dissection

A

Tear in intimate that causes blood to collect in a new space between endothelium and muscle intima

28
Q

Marfan Syndrome

A 
Defect in Fibrillin-1 gene
Increased TGF-B causes elastic weakening
MVP
Arachnodactyly 
Lense subluxation
29
Q

Ehlor Danlos Syndrome

A 
Defect in collagen synthesis
Hypermobile joints
Berry Aneurysms
Stretchy skin
Poor wound healing
30
Q

What can an infection with treponema pallidum cause in the CV system?

A

Tertiary Syphillis can cause:
Aortitis
destruction of vasa vasorum (obliterative endarteritis)

Leads to Thoracic aortic aneurysm and Aortic valve regurge

31
Q

Number one cause of AAA

A

Atherosclerosis

Remember the number one cause of Thoracic aortic aneurysm is HTN

32
Q

What demographic should AAA be on the differential for?

A

Smokers and men >50y with abdominal pain, hypotension

33
Q

What diameter is the threshold for a non ruptured AAA to consider surgery

A

5cm

34
Q

4 causes of a thoracic aortic aneurysm

A
  1. HTN
  2. Syphilis
  3. CT disorders (Marfan’s, Ehler-Danlos)
  4. Temporal and Takayasu Arteritis
35
Q

Triad of findings to consider an Aortic Dissection

A
  1. Thoracic pain
  2. Pulse abnormal
  3. Mediastinal widening
36
Q

Describe the Debakey dissection types

A

Debakey I: Includes the aortic arch, ascending, and descending (most common)
Debakey II: Ascending aorta only
Debakey III: descending aorta only

37
Q

Temporal Arteritis

A
  1. Older >50y
  2. Unilateral HA
  3. Potential vision loss
  4. Anti-endothelial Ab
  5. Start Steroids right away
38
Q

Takayasu Arteritis

A
  1. Younger
  2. “Pulseless” Disease
  3. Fever, Myalgia, Arthritis, Vision issues, Night sweats
  4. Mononuclear infiltrates
39
Q

PAN

A
  1. Hep B association
  2. Type III HS (Immune-complexes)
  3. Black stool
  4. Malignant HTN
40
Q

Kawasaki Disease

A
  1. Infants and children (most common acquired heart disease in children)
  2. Conjunctivitis
  3. Fever
  4. Coronary Aneurysm
  5. Strawberry tongue
  6. Give Aspirin to the kid
41
Q

Churg-Strauss Syndrome

A

Eosinophilic Granulomatosis

  1. Asthma, hypereosinophilia, lung infiltrates
  2. MPO-ANCA
  3. Can cause cardiomyopathy/myocarditis and infarction
42
Q

Wegner’s Disease

A
  1. PR3-ANCA
  2. Sinusitis
  3. Saddle nose
  4. Nasal Perforation
  5. Glomerulonephritis
  6. Cavitary Lung granulomas
43
Q

Behcet’s Disease

A

Becky gives blowjobs and gets cum in her eye on a B-51 plane
Genital and mouth ulcers, uveitis
HLA-B51

44
Q

Buerger Disease

A

Acute and Chronic thrombosis in tibial and arterial arteries.
Smokers <35y

45
Q

Raynauds Phenomenon

A

Vasospasm of small arteries
Primary: Symmetric involvement of digits with spontaneous remission
Secondary: Asymmetric involvement with progression

46
Q

Myocardial Vessel Vasospasm

A 
Excessie vasoconstriction of coronary vessels 
Caused by: 
1. cocaine, caffeine
2. Epinephrine/NE release
3. Elevated thyroid hormones 
4. Autoimmune
47
Q

Takotsubo Cardiomyopathy

A

“Broken Heart Syndrome”

Myocardial vessel vasospasm caused by emotional distress that leads to a surge of catecholamines

48
Q

Varicose Veins

A

Stasis and congestion in superficial veins caused by valvular incompetence.
Can lead to stasis dermatitis

49
Q

Vena Cava Syndromes

A

Obstruction of the SVC or IVC by neoplasms or thrombi causes dilation of veins. Can cause swelling, distention, and edema

50
Q

Lymphangitis

A

inflammation of lymphatic channels

Most commonly caused by Group A B-hemolytic strep

51
Q

Describe Peau d’ orange sign

A

draining lymphatics of skin overlying breast cancer cells shows a pitting edema

52
Q

Nevus Simplex

A

Birth mark that regresses over time

53
Q

Port-wine stain

A

angioectasia that usually persists into adulthood

54
Q

Sturge-Weber Syndrome

A

Trigeminal port wine nevi accompanied by mental retardation, seizures, and skull radio-opacities

55
Q

What is the most common benign tumor of infancy and childhood?

A

Hemangiomas

56
Q

Most common type of Hemangioma

A

Capillary Hemangioma found on skin, membranes, or viscera

57
Q

Strawberry Hemangioma

A

Present at birth, usually regress

58
Q

Cavernous Hemangioma

A

Dilated vascular channels making an indistinct lesion

59
Q

Pyogenic Granuloma

A

Pregnancy tumor often in oral mucosa

60
Q

What diseases are Cavernous lymphangiomas associated with?

A

Turner Syndrome
Down’s
Klinefelter

61
Q

What skin finding is associated with Catscratch Disease?

A

Bacillary Angiomatosis: benign, red papules

CPR Exam 1 (19 decks)

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