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CV diseases > Vascular specifically > Flashcards

Vascular specifically Flashcards

1
Q

What are the 5 main causes of vascular disease?

A 
Gradual obstruction (Atherosclerosis/arteriolosclerosis)
Sudden obstruction (thrombosis, embolus)
Aneurysm/dissection
Vasculitis
Extrinsic vascular compression
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2
Q

What type of vessel is most often atherosclerotic?

A

Larger vessels (aorta, medium/large arteries)

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3
Q

What is meant by “essential” HTN?

A

Basically, nobody knows the precipitating factor…which also means nobody knows how to cure (treat)

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4
Q

What percentage of HTN cases are deemed “essential”?

A

95%

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5
Q

What is a big risk of a diabetic with HTN?

A

Both arteries and arterioles become obstructed

Arteriolosclerosis is a non-bypassable disease

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6
Q

What is the most common cause of life-threatening vascular events?

A

Sudden luminal occlusion

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7
Q

What is the most common cause of sudden luminal occlusion?

A

Unstable atheromatous plaques

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8
Q

What is always considered the source of an embolus?

A

Heart until proven otherwise

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9
Q

Besides thrombosis/embolus what else can cause a sudden occlusion?

A

A dissection can occlude orifices of exiting arteries (think about an aortic dissection)

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10
Q

What is the typical site of a DVT?

A

Iliofemoral veins

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11
Q

What are some general causes of DVT?

A

Surgery/trauma/sepsis

Congenital/acquired hypercoagulable state

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12
Q

What is the concern of a DVT?

A

PE and sudden death

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13
Q

How can a DVT be screened for?

A

D-dimer

CT angiography

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14
Q

What can cause a bowel infarct or Budd-Chiari syndrome?

A

Splanchnic venous thrombosis

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15
Q

What is almost always the underlying cause of unexplainable thrombi in atypical locations (mesenteric, portal, hepatic, cerebral)?

A

Congenital/acquired systemic hypercoagulable state

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16
Q

What are the two primary causes of wall weakening leading to an aneurysm?

A

Atherosclerosis

HTN

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17
Q

Besides HTN and atherosclerosis, what else can lead to a weakened wall and eventually an aneurysm?

A

Inherited connective tissue disease (Marfan’s)
Vasculitis (Takayasu’s and giant cell)
Connective tissue/autoimmune diseases
Infection of aortic/arterial wall

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18
Q

Where is atherosclerosis most likely to cause an aneurysm in smokers?

A

Infra-renal abdominal aorta

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19
Q

Where is HTN most likely to cause an aneurysm?

A

Ascending aorta

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20
Q

What are the concerns with an aneurysm?

A

Rupture

Exsanquination (fancy word for draining)

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21
Q

What type of aortic dissection involves the descending aorta and/or the aortic arch?

A

Type B

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22
Q

What does a type A aortic dissection involve?

A

Ascending aorta +/- distal aorta

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23
Q

What is the most likely pre-disposing factor in a patient over 40 with an aortic dissection?

A

HTN

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24
Q

What is the most likely pre-disposing factor in a patient under 40 with an aortic dissection?

A

Inherited connective tissue disorder (Marfan’s)

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25
Q

What arteries can be occluded by an aortic dissection?

A 
Coronary
Arch vessels
Celiac
Mesenteric
Renal
26
Q

Besides arterial occlusion, what are other possible complications of an aortic dissection?

A

Rupture into pericardial sac or left thorax

Acute aortic valve regurgitation/CHF

27
Q

What does ANCA stand for?

A

Anti-Neutrophil Cytoplasmic Antibody

28
Q

Are ANCA-associated vasculitides bad?

A

Very bad, high mortality

Very aggressive visceral vasculitic disease

29
Q

What are two non-adult causes of vasculitis?

A 
Henoch-Schnolein Purpura (IgA-related vasculitis)
Kawasaki disease (risk of coronary vasculitis)
30
Q

What is most commonly affected in vasculitis of middle-aged/elderly?

A

External carotid

31
Q

What is the usual cause of vasculitis in middle-aged/elderly?

A

Giant cell (temporal) arteritis

32
Q

What is a risk of vasculitis of middle-aged/elderly?

A

Vision loss

33
Q

How is external carotid vasculitis diagnosed?

A

Temporal artery biopsy

34
Q

How is external carotid vasculitis treated?

A

Corticosteroids (it is an immune response)

35
Q

What are two examples of ANCA-associated vasculitides?

A 
Wegener's (Anti-PR3 Abs; c-ANCA)
Microscopic polyangiitis (Anti-myeloperoxidase Abs; pANCA)
36
Q

Besides Wegener’s and Microscopic Polyangiitis, what are some other examples of life-threatening vasculitis in adults?

A

Goodpasture’s syndrome
SLE
Polyarteritis Nodosa (PN)
Churg-Strauss syndrome

37
Q

What is the differential with a pulmonary-renal syndrome?

A

ANCA-associated vasculitis
Goodpasture’s
SLE

38
Q

What should be done if suspicion of Wegener’s or pulmonary-renal syndrome?

A

CXR or chest CT

39
Q

What is the most common benign form of a vascular neoplasm?

A

Hemangioma

40
Q

Where is a hemangioma most likely to form?

A

Skin (cherry/purple papules)

41
Q

Besides the skin, where else might a hemangioma form?

A

Any visceral organ but usually liver, spleen, or soft tissue

42
Q

What is a pyogenic granuloma?

A

Capillary hemangioma secondary to trauma

Rapidly growing and friable (crumbles?)

43
Q

What are lymphangiomas?

A

Benign vascular neoplasms in the neck/axilla of children

44
Q

What is a glomus tumor?

A

Glomus cell proliferation associated with vascular channels

45
Q

Where are glomus tumors and are they noticed?

A

In the distal digits

They are PAINFUL

46
Q

What form of benign vascular neoplasm is associated with a cat scratch species (Bartonella infection)?

A

Bacillary angiomatosis

47
Q

What are vascular ecstasies?

A

Descrete lesions with dilated pre-existing vessels resembling hemangioma but a flat/non-papular

Sturge-Weber syndrome is an extreme form

48
Q

What is a systemic vascular ecstasia syndrome with risk of serious bleeding?

A

Osler-Weber-Rendu (hereditary hemorrhagic telangiectasia)

49
Q

What are arteriovenous malformations?

A

Tangled mass of arteries and veins without an intervening capillary bed

50
Q

What is the risk of arteriovenous malformations?

A

High output heart failure

In brain, a rupture with fatal cerebral hemorrhage

51
Q

What forms from a penetrating vascular injury?

A

An arteriovenous fistula

52
Q

What are examples of low-grade malignant vascular neoplasms?

A

Kaposi’s sarcoma

Epitheliod hemangioendothelioma

53
Q

What does a Kaposi’s sarcoma affect?

A

Skin +/- visceral involvement

54
Q

What infections are Kaposi’s sarcoma associated with?

55
Q

Where does an epitheloid hemangioendothelioma form?

A

Normally liver or soft tissue

56
Q

What is an example of a high-grade malignant sarcoma?

A

Angiosarcoma

57
Q

Where is an angiosarcoma likely to form in the elderly?

A

Skin of head/neck

58
Q

What does an angiosarcoma look like?

A

An aggressive reddish/purple lesion in skin

59
Q

What chronic diseases has an increased risk of developing an angiosarcoma?

A

Chronic lymphedema

Stewart-Treves Syndrome

60
Q

Who has Stewart-Treves syndrome?

A

Post-mastectomy/radiation/axillary dissection patients

CV diseases (2 decks)

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