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CPR2 Exam 1 > Vascular Pathology Part 2 - Dr. Hillard > Flashcards

Vascular Pathology Part 2 - Dr. Hillard Flashcards

1
Q

Arteriosclerosis means what and 3 types

A

hardening of the arterial wall

  1. Arteriolosclerosis
  2. Atherosclerosis
  3. Monckeberg medial sclerosis
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2
Q

Artheriolosclerosis

A

hylaine (pink) + hyperplastic (onion ring + punctate hemorrhages) arteriosclerosis
= can cause downstream Ischemia

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3
Q

MI death prevalence

A

number 1 cause of death and 1/4 of all US deaths

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4
Q

atherosclerosis genetic common cause

A

Familial hypercholesterimia

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5
Q

atherosclerosis risks and preventions

A

RISK : male, 40-60yo, FH, genes

PREVENT : female (estrogen) + premenopausal estrogenized women + exercise + alcohol

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6
Q

diets that can increase cholesterol

A

animal products, cheese, eggs

transfat foods also

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7
Q

2 diseases that increase atherosclerosis due to increased oxydation of LDL

A

DM and Hyperhomocystenimia

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8
Q

atherosclerosis what happens

A
  1. migration of SM—-> intinal thickening
  2. fibrous cap bounded by intema (internal elastic lamina)
  3. neovascularization
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9
Q

LDL oxidized causes

A

GF released to migrate more SM to intima layer thickning it

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10
Q

GFs that cause SM migration and proliferation + ECM deposition

A
  1. PDGF
  2. FGF
  3. TGF-a
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11
Q

true vs false aneurysm

A

true : dilation of A wall

false : rupture through the wall into a hematoma blood filling under extravascular Connective Tissue

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12
Q

dissection A

A

inside the intima blood fillas

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13
Q

Cystic Medial Degeneration what happens when is it seen what can it cause

A

=normal elastin replaced by fragmented elastin
= Marfan, EDS
= Aortic dissection, Aortic Aneurysm

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14
Q

EDS that effects vasculature mutation and inheritance and sx

A
  1. COL3A1
  2. AD
  3. thin skin, arterial and uterine rupture, bruising, joint hyperextension
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15
Q

most important risk factor for AAA

A

Atherosclerosis (men and age also)

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16
Q

AAA location common and common thing to see inside

A

below renal A, and above bifurcation

= bland laminated mural thrombus

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17
Q

AAA tx

A

above 5cm in diameter = surgical bypass

- otherwise watch for rupture sxs

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18
Q

AAA Inflammatory type if from and what do you see

A

IgG4
= lymphocytes and fibrosis
= plasma cells secrete IgG4

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19
Q

AAA from inflammatory type TX

A

steroids

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20
Q

Thoracic Aortic Aneurysm most important risk factor

A

HTN

marfans, Vasculitis - giant cell and takayasu, syphillis

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21
Q

TAA sx

A

compression of adjacent structures
= SOB
= Dysphagia
= Cough (recurrent laryngeal N)

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22
Q

pathogen causing TAA, sx, what it does, risk that can happen

A
  1. Teritary Syphilis
  2. after 5yr infection, genital ulcer non-painful,
  3. Obliterative endarteritis of vasa vasorum (X small vessels for the Aorta and its wall) —-> TCC**
  4. Aortic Valve Regurg
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23
Q

Aortic Dissection triad

A
  1. thoracic pain
  2. pulse abnormalities
  3. mediastinal widening CXR
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24
Q

Aortic Dissection cause

A

HTN

CT disorder

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25
Q

classification in Aortic Dissection

A

DaBakey type :
1 = start at ascending A to at least aortic arch, usually continues more
2. = only in ascending aorta
3 = starts in descending and down

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26
Q

Aortic Dissection most common location

A

proximal to left common carotid artery = DeBakey type 1

27
Q

Vasculitides disease effecting Aorta and its primary branches 2`

A
  1. Giant Cell arteritis

2. Takayasu arteritis

28
Q

Giant Cell Arteritis which 3 major arteries and sx

A 
AORTA
1. Temporal
2. vertebral 
3. opthalmic 
= headache, ocular sx (vision loss), facial pain, fever
29
Q

Giant Cell Arteritis happens why and prevalence

A

= T cell mediated autoimmune to endotheliial and SM cells

= over 50yo

30
Q

Giant Cell Artertis vessel looks like

A

occludes the artery

31
Q

Giant Cell Artertis vessel looks like

A

= BIOPSY is must

occludes the artery (giant cells with intimal thickening, fragmented disrupted internal elastic lamina**)

32
Q

Takayasu arteritis sx and prevalence

A

female under 50yo or 40yo
= weakening upper extr. PULSE*
= can have ocular disturbance*

33
Q

Takayasu arteritis happens why

A

granulomatous autoimmune vasculitis to AORTA and (its pulm, coronary, renal As)

34
Q

Takayasu arteritis vessel looks like

A

Giant cells with intimal thickening looks like Giant cell arteritis

35
Q

Polyarteritis nodosa

A

HEPB

young adults

36
Q

Polyarteritis nodosa locations and sxs

A
  1. renal, heart, GI, skin vessels

2. rapid increase HTN, abd pain/blood, myaligia, renovascular htn

37
Q

Polyarteritis nodosa vessel looks like

A

fibrinoid necrosis , inflammation segmental

38
Q

Kawasaki Disease also called and prevalence

A

Mucocutaneous LN Syndrome

= children, infants

39
Q

Kawasaki Disease location and due to what

A 
coronary a (aneurysm rupture of these As)
= viral trigger usually, activating T-cell and M
40
Q

Kawasaki Disease sx

A 
= fever
= strawberry tongue super red 
= conjunctivitis 
= red palm and soles, lips 
= genital rash
41
Q

Churg- Strauss Syndrome what happens and why

A

= necrotizing granulomatosis allergic reaction

= EOSINOPHILS

42
Q

Churg- Strauss Syndrome sx and dx

A
  1. asthma, hypereosinophilia, lung infiltrates, purpura palpable on skin, GI bleeding, renal disease
  2. ANCA +
43
Q

Churg- Strauss Syndrome risk

A

MI, cardiomyopathy, myocarditis*,

44
Q

Wegeners Granulomatosis is what and vessels look like

A

Granulomatosis necrosis vasculitis RESPIRATORY + polyangitis
= can have renal necrosis

45
Q

Wegeners Granulomatosis happens from what cell and prevalence

A

T-cell mediated hypersensitivity

= male over 40yo

46
Q

Wegeners Granulomatosis dx

A

PR3-ANCA (c-ANCA)

47
Q

kidneys histology in Wegeners Granulomatosis

A

epithelial cells grow around compressing it = crescentic glomerulonephritis + focal necrosis

48
Q

Microscopic Polyangiitis location and disease stages in vessel

A
  1. A, V, caps all (unlike PAN)

2. uniform stage of disease in all vessels (unlike PAN)

49
Q

Microscopic Polyangiitis location in body it effects and dx

A
  1. Kindey, Lung, peripheral nerves, GI

2. MPO- ANCA

50
Q

Microscopic Polyangiitis vessels have NO

A

immunoglobulin deposits (like in immune complex vasculitis)

51
Q

Behcets Disease is what TRIAD and association and what happens in vessel + Tx BOARDS ONLY

A
  1. oral ulcer, genital ulcer, uveitis
  2. HLA-B51
  3. NEUTROPHILIC vasculitis
  4. steroids
52
Q

Thromboangiitis Obliterans

A 
BUERGER DISEASE
= tibial and radial As vasculitis
= smokers (hypersensitive to toxins)**
= under 35yo
= gangrene of fingers and toes
53
Q

Buergers disease sx stages

A
  1. Raynauds
  2. intermittent pain with exertion
  3. pain in rest
  4. ulcer –> gangrene
54
Q

Raynauds phenomenon has 3 colors

A

RED = vasodilation (proximal)
WHTIE = vasoconstriction (central)
BLUE = O2 insufficiency
(all happen)

55
Q

Raynaud’s Phenomenon usually induced by

A

cold or emotion

56
Q

Giant cell arteritis associated with

A

Polymyalgia rheumatica (stiff neck and shoulders)

57
Q

PCI

A

percutaneous coronary intervention - for MI prevention , catheter into coronary artery

58
Q

Balloon angioplasty + endovascular stent work how

A
  1. go into vessel and balloon at site of plaque (compressing it
  2. stent is placed to prevent rupture or thrombosis of any part of it + give antithrombotic drugs
59
Q

how to prevent thrombosis and replaquing in area where you have ballooned and stented

A

Drug eluting stents (release antiproliferative drugs)

60
Q

coronary metallic stent

A

expandible metallic mesh (can injure vessel and cause restenosis so give ANTI-thrombotics)

61
Q

vascular grafts is used for what

A

replace or bypass and vascular segment with a lot of atherosclerosis

62
Q

vascular grafts is for what vessels

A

large vessels only like in AAA (place in artery and go past it)

63
Q

CABG is what

A

coronary artery graft (graft saphenous vein, internal mammary A**) harvest that vein or A and use that to bypass a vessel

64
Q
  • ANCA is seen in what vasculitis usually
A
  1. Polyarteritis nodosa
  2. Buerger
  3. Giant cell
  4. Takayasu
  5. Behcets

CPR2 Exam 1 (19 decks)

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