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CPR2 Exam 1 > Vascular Pathology Part 1 - Dr. Hillard > Flashcards

Vascular Pathology Part 1 - Dr. Hillard Flashcards

1
Q

3 types of arteries

A
  1. Large Elastic
  2. Medium muscular
  3. small arterioles
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2
Q

vessel resistance is proportional to and inversely proportional to

A

proportional : L of vessel and Viscosity (n)

inverse proportional : radius^4

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3
Q

what vessel regulates BP

A

all the way down to arterioles

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4
Q

arteries vs veins made up of

A

arteries: thick muscular media and elastic (to hold high pressure
Veins : thin media and not that elastic + valves
Capillaries : no media

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5
Q

Arteriovenous malformation (AVM) what

A

abnormal connection from thick A to abnormal thick V

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6
Q

Arteriovenous malformation (AVM) location and look like

A
  1. head and neck usually

2. tangle of worm like vascular channels shunting blood away from A = increase heart pumping

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7
Q

Arteriovenous malformation (AVM) can cause

A

heart cant always keep up with extra pumping high CO = Cardiac failure

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8
Q

Arteriovenous malformation (AVM) result from and prevalence

A

congenital or trauma, or by surgery if chemo/hemodialysis access needed
= males, childhood or early adult . later in life

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9
Q

Arteriovenous malformation (AVM) SX

A
  1. GI bleed, pulm hemorrhage, hematuria, seizure, intracerebral hemorrhage
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10
Q

Berry Aneurysm (saccular) location

A

= circle of willis usually at anterior cerebral artery + anterior communicating A branch point

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11
Q

Berry Aneurysm (saccular) risks

A

HTN, smoking

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12
Q

Berry Aneurysm (saccular) associated with that

A

= AD polycyctic kidney disease

= CT disease like Marfans + Ehlers Danlos

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13
Q

Berry Aneurysm (saccular) sx

A
  1. severe worst headache of life, = (after rupure)

2. neck pain, double vision, loss of consciousness , V

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14
Q

most common cause of subarachnoid hemorrhage

A

Berry Aneurysm

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15
Q

Berry Aneurysm rupture associated with

A

straining during stools, sexual orgasms

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16
Q

Mycotic Aneurysm is what

A

dilation to A from infection damaging vessel wall

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17
Q

Mycotic Aneurysm from what

A

infection from usually :
= septic emboli (infective endocarditis)
= bacteria circulating , fungus

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18
Q

Fibromuscular Dysplasia is what

A

hyperplasia of muscular media and intima

= irregular thickening A , this causes outpouching of vascular not as thick areas

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19
Q

Fibromuscular Dysplasia imaging

A

angiography : beads on string

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20
Q

Fibromuscular Dysplasia prevalence

A

young women

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21
Q

Fibromuscular Dysplasia effects what locations

A

kidney renal arteries = renal artery stenosis = low BF = activated renin angiotensin

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22
Q

Fibromuscular Dysplasia ascultation

A

bruits from renal arteries
= heard on epigastric area to upper Qs and back
= from renal stenosis

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23
Q

BP =

A

BP = CO x Peripheral Resistance

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24
Q

CO =

A

CO = HR x SV

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25
Q

renin is released when 2

A
  1. low BP in afferent arterioles

2. low Na and distal convoluted tubules

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26
Q

ANP

A

released from myocytes in A and V = reduce BP

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27
Q

renin is released from

A

Afferent arterioles by juxtaglomerular cells

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28
Q

normal BP

A

120/ less then 80

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29
Q

3 things to prevent high BP

A
  1. exercise
  2. low salt intake
  3. lower weight
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30
Q

primary HTN prevalence

A

most common type and high in AA

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31
Q

secondary HTN 3 causes

A
  1. Cardiovasualr : coarctation of aorta
  2. Kidney : renal artery stenosis (fibromuscular dysplasia), polycystic kidney D)
  3. Endocrine : primary aldosteronism (Cushing, Phenochromocytoma)
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32
Q

primary hyperaldosteronism common sx

A
  1. high BP

2. muscle cramps, weakness, visual problems (low K+)

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33
Q

Cushing Syndrome happens from

A

high cortisol production from adrenal gland
= ACTH production (AP tumor) primary tumor
= or from lung tumor secreting ACTH

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34
Q

primary hyperaldosteronism what happens

A
  1. adenoma of the adrenal gland
  2. just hyperactive adrenal gland
    = more aldosterone
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35
Q

Cushing Syndrome sx

A
  1. HTN
  2. round face, posterior neck and back and abd fat + hair
  3. abd striae and stretch marks
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36
Q

Pheochromocytoma is what

A

tumor of chromaffin cells in adrenal medulla (secreting catecholamines NE and Epi)
= peripheral vasoconstriction (a1 activation) and higher CO (B1 activation)

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37
Q

Pheochromocytoma sx

A
  1. HTN
  2. Tachy, pounding headache, tremor, diaphoresis
  3. paroxysms of high BP (random sudden)
  4. sleep problems
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38
Q

Pheochromocytoma mutation and looks like

A

MEN2

= golden brown tumor color

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39
Q

renal artery stenosis causes what and 2 causes of this

A

HTN due to high renin release from low renal BF

  1. fibromuscular dysplasia
  2. atherosclerosis
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40
Q

renal artery stenosis can cause what besides htn

A

= ischemia in kidney
= CKD
= increase Cr

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41
Q

coarctation of aorta does what and prevalence and association

A
  1. upper body HTN, lower body hypotension weak pulse
  2. is PDA = you have cyanosis in lower extr.
  3. bicuspid aorta , males
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42
Q

coarctation of aorta auscultation

A

bruits over back on occasion heard

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43
Q

other kidney diseases that can cause htn besides renal stenosis

A
  1. polycystic kidney
  2. pyelonephritis
    = both can cause ischemia –> renin
44
Q

HTN effect on heart and aorta

A
  1. LV hypertrophy (can also back up to lungs)
  2. CHF
  3. ischemic HD, MI (atherosclerosis)
  4. Aortic Dissection
    = 1/2 of htn pts die from this
45
Q

HTN on brain and eye

A
  1. dementia
  2. cerebrovascular hemorrhage/ stroke
  3. increased intracrainal P, papilledema
  4. Rentinopathy
46
Q

Hyaline Arteriolosclerosis is what

A

changes in small arterioles = mild to moderate htn

47
Q

Hyaline Arteriolosclerosis looks like

A

vessels contain prominent pink eosinophilic hyaline material

= trapped in SM matrix of BVs small

48
Q

Hyaline Arteriolosclerosis happens due to what cause

A
  1. drugs like calcineurin inhibitors (T-cell immunosuppressor)
49
Q

Hyaline Arteriolosclerosis can cause what eventually

A

ischemia : nephrosclerosis —-> ischemic glomerulosclerosis + htn

50
Q

Hyaline Arteriolosclerosis hyaline material is made of what

A

precipitated plasma proteins (usually C3 complement)

51
Q

Hypertensive Crisis / Malignant HTN is what

A

fast high HTN

= 180-200 / over 120

52
Q

Hypertensive Crisis / Malignant HTN causes from and causes

A
  1. organ failure
  2. papilledema
    necrotizing arteriolitis, renal failure, Acute MI
53
Q

Hyperplastic arteriolosclerosis happens due to what

A

severe htn = thickening of the walls BM

54
Q

Hyperplastic arteriolosclerosis looks like what

A

SM form concentric lamellations “onion skinning”

55
Q

mild to moderate htn in asymptomatic pt : over years what happens to kidney

A
  1. hyaline arteriosclerosis : cortical scarring + thinning, shrinking kidney (PINK changes)
  2. later becomes end-stage organ damage = sx present
55
Q

mild to moderate htn in asymptomatic pt : over years what happens to kidney

A
  1. hyaline arteriosclerosis** : cortical scarring + thinning, shrinking kidney (PINK changes)
  2. later becomes end-stage organ damage = sx present
56
Q

severe htn / malignant htn changes in kidney effects

A
  1. petechial hemorrhages in kidney

2. hyperplastic arteriosclerosis** (onion skinning)

57
Q

Myocardial vessel vasospasm is what

A

cardial Raynaud’s phenomenon

= can lead to MI from vasospasm

58
Q

Myocardial vessel vasospasm causes 5

A
  1. cocaine (vascular contraction, vasospasm –> MI
  2. high catecholamines
  3. high thyroid (more catecholamine sensitivity)
  4. systemic scleroderma ABs
  5. Takotsubo cardiomyopathy (broken heart syndrome), elderly women
59
Q

Varicose Veins are what

A

abnormal dilated, twisted veins, from prolonged high intraluminal P
= incompetence of venous valves + dilation of veins

60
Q

Varicose Veins risks

A

stasis, edema, thrombosis (Rare)
= stasis dematitis (brown yellow shiny skin)
= pruritis
= infection, poor healing wounds

61
Q

Portal htn from what causes

A
  1. venous htn
  2. cirrhosis
  3. hepatic V thrombosis or obstruction
62
Q

Portal htn can lead to what

A

1 esophageal varices

  1. Splenomegaly
  2. Hemorrhoids
  3. Distended superficial epigastric veins (caput medusae)
63
Q

Superior Vena Cava Syndrome caused by what

A

obstruction / compression of SVC usually by intrathoracic tumor

  1. bronchogenic lung carcinoma
  2. lymphoma (Hodgkins)
64
Q

Superior Vena Cava Syndrome SX

A
  1. face, neck swelling
  2. SOB (pulm vessels compressed)
  3. WORSE with bending forward or laying down
  4. distended veins on neck or chest
  5. confusion / headaches
65
Q

Inferior Vena Cava Syndrome happens from what

A

compression / obstruction of IVC

  1. HCC
  2. Renal cell carcinoma
66
Q

Inferior Vena Cava Syndrome sx

A
  1. Lower EXR edema

2. distention of superficial collateral veins or lower abd

67
Q

Thrombophlebitis is what

A

venous thrombosis from inflammation from clot formation

68
Q

3 causes of paradoxical embolism

A
  1. ASD / VSD
  2. AVM
  3. PDA
69
Q

risks DVT

A
  1. immobilization ** most high risk

2. hypercoagulation

70
Q

hypercoagulation causes that increases thrombosis

A
  1. Factor V Leiden mutation
  2. Prothrombin mutation
  3. Mucin producing adenocarcinoma = procoag
  4. tumor procoag that appears at random and disappears then appears at different place = TROUSSEAU SIGN of Malignancy (pancreatic + lung carcinoma)
71
Q

Lymphangitis is what

A

lymphatic channel inflammation from Group A B-hemolytic streptococcus

72
Q

Lymphangitis looks like

A

red painful subQ streaks on skin
lymphadenopathy
= can pregress to cellulitis + Abscess with fever

73
Q

Lymphedema is what

A

swelling from fluid buildup due to blocked lymphatics

74
Q

Lymphedema cause

A

Primary : Milroy disease (Lymph agenesis)
Secondary : blockage (tumor, surgery, mastectomy, post radiation fibrosis), Peau d’orange = dimpling texture of skin when lymph drain will with tumor in breast cancer

75
Q

Vascular Ectasias - Nevus Simplex

A

Birth mark in infants on forehead and eyelid, nose, upper lip, = regresses with time (ecstatic vessels)

76
Q

Port wine stains

A

Nevus flammus , progressive ectasia
Persists into adulthood
More uncommon

77
Q

Sturge Weber syndrome

A

Trigeminal nerve facial port wine nevi
= glaucoma, intellectual disability later,
= seizures , large facial talengetaia
= BV maturation, somatic tissue to not heritable

78
Q

Spider Telangiectasia is what and location

A

Dilation of small BVs and caps,
= permanent
= lesion forming (red papule with red radial lines
= neck, face, upper chest

79
Q

Spider Telangiectasia risks

A 
High Estrogen (dilates BVs)
= pregnancy and liver disease
80
Q

Hereditary Hemorrhagic Telangiectasia other name and what is it

A

Osler- Weber - Rendu Disease

1. Abnormal BV formation causing Telangiectasia and AVM on skin, brain , bladder, GI (tongue, lips, face)

81
Q

Osler- Weber - Rendu Disease mutation

A

TGF-B signaling pathway mutation

82
Q

Hemangiomas is what and location

A

Being common child vascular tumor (increased BV proliferation)
= head and neck
= usually superficial

83
Q

Congenital Hemangiomas other name and what is it

A

Strawberry Hemangiomas
= at birth
= capillary Hemangiomas, raised plaque, lobular well demarcated lobular BV collection
= grow fast few months then regress by 7yo

84
Q

Internal Hemangiomas usually involve

A

Liver

85
Q

Cavernous Hemangiomas is what

A

Large dial aged BVs
= deep tissues like Von Hippel - Lindau Disease , vascular lesions in brain, pancreas, liver, cerebellum, retina
=clotting blood looking, large cave like spaces full of blood

86
Q

Pyogenic Granuloma other name and is what

A 
Lobular Capillary hemangioma 
= fast BV proliferation 
= oral mucosa lips, mouth, fingers 
= can ulcerate SEEN IN PREGNANCY ****
= lobulated proliferation of BV
87
Q

Glomus Tumor from what and the function of this

A

Mesenchymal tumor of SM from glomus body (dermal structure taking blood away from skin surface when cold to prevent heat loss)
= thermoregulation

88
Q

Glomus Tumor what happens and what it does sx

A

From SM origin benign
Under finger nail
Bluish tumor
Painful by tactile stimulation and temp changes

89
Q

Lymphangioma simple is what

A

Capillary dilation with no Blood

Lymph benign neoplasm

90
Q

Cavernous Lymphangioma is what

A

Neck or axillary , congenital malformation when lymphatics dont communicate with n=venous system
= large neck masses (up to 15cm) HUGE DILATED lymph spaces
= cystic hygroma (other name)

91
Q

Cavernous Lymphangioma associated with

A

Turner syndrome and other development problems like trisomy 21, Klinefelter

92
Q

Cavernous Lymphangioma tx

A

Surgery respect if possible

93
Q

Bacillary Angiomatosis is what

A

Vascular proliferation from gram - BARTONELLA BACILLI

94
Q

Bacillary Angiomatosis looks like and dx

A
  1. Being red papule lesions

2. Bacteria seen on silver stain

95
Q

Bacillary Angiomatosis prevalence

A

Immunocompromised

96
Q

Bacillary Angiomatosis tx

A

ABs

97
Q

BARTONELLA henselae is from what

A

Cat scratch disease

98
Q

Karposi Sarcoma is caused by what

A

HHV- 8

99
Q

Karposi Sarcoma 4 types

A
  1. Classic Sporadic : lower extr. East Europe , Mediterranean, male
  2. Endemic : Africa, children , cutaneous involvement
  3. Iatrogenic : immunosuppressed
  4. AIDS associated : skin and mucous membranes and then to LNs
100
Q

Karposi Sarcoma looks like

A

Macule patch ——> Red purple nodules and plaques on lower limbs, back, face, genitals

101
Q

Angiosarcoma is what and involves what organ

A

Malignant tumor from vasculature

= liver

102
Q

Angiosarcoma risk factors **

A
  1. arsenic (wood pesticide, agr. Pesticide) , Thorotrast, PVC production (Vinyl chloride) = effect liver
  2. Lymphedema : axillary mastectomy from breast cancer tx —> lymphangiosarcoma
  3. Radiation for Carcinoma
103
Q

Angiosarcoma histology

A

Well to poor defined vascular spaces with BV lined by cytology Atypia (large endothelial cells and nuclei)

104
Q

Angiosarcoma dx

A

Stain for CD31

105
Q

Liver Angiosarcoma looks like

A

Dark red purple nodules on the liver surface

CPR2 Exam 1 (19 decks)

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