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mhd vascular pathology


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What are the risk factors for atherosclerosis?
age, sex, genetics, DM, HTN, hyperlipidemia, elevated homocystemia, smoking,
What muscular vessels are affected by atherosclerosis?
aorta, carotid, popliteal, iliac
What medium vessels are affected by atherosclerosis?
c. fo willis, coronary, where renal and mesenteric branch off
What infections are associated with atherosclerosis?
chlmydia pneumonia, cytomegalovirus
What are the components of a atheroma?
fibrous cap, surrounding cells, necrotic core
What is found in the fibrous cap?
smc, MGs, foam, dense CT
What is found in the cells around the fibrous cap?
MGs, SMC, t-cells
What is found in the necrotic core?
lipids, cholestrol, foam cells, debris, fibrin
What can happen to advanced atherosclerotic plaques?
rupture, hemorrhage, thrombosis, emboli, aneurysm, calcifcation-lumenal occlusion
What are complications of atherosclerosis?
Cardiac and cerebral ischemia, Peripheral vascular dx, aneurysm
What is monckeberg's medial calcific sclerosis
calcific deposits in media of medium vessels, it is non obstructive
What are the two types of ateriosclerosis from HTN?
hyaline and hyperplastic
What is characteristic of hyaline arteriosclerosis?
pink--lumen filling
Which vessels does HTN-induced arteriosclerosis affect?
small arteries and arterioles
What are the causes of hyaline arteriosclerosis?
DM, HTN, age
What does hyperplastic arteriosclerosis look like?
an onion--lumen narrowing
What causes hyperplastic arteriosclerosis?
diastolic P >120
What are the causes of aneurysms?
atherosclerosis, cystic medial degeneration, congenital, infection, trauma, vasculitis
What causes AAA?
atherosclerosis maybe genetics
Where are AAA usually found?
between renal arteries and bifurcation
What can happen to an aneurysm?
rupture, cause compression, obstruction, or embolism
What shapes can an aneurysm be?
saccular or fusiform
Where do syphilitic aneurysms occur?
thoracic aorta or arch
What kind of bug is sphilis?
a spirochete, gram neg
When do syphilitic aneurysms happen?
during 3rd stage of the dx
What is obliterative endarteritis?
there is hyperplastic thickening, there is medial ischemia, loss of elastic recoil
What can sphilitic aneurysm cause?
cardiomegaly, aortic regurg, rupture, heart failure, compression of surrounding structure
What is a Type A aortic dissection?
involves the ascending maybe in combo with descending aorta
What is Type B aortic dissection?
only the descending aorta
What can cause aortic dissection?
HTN or Marfan's syndrome
What does an aortic dissection feel like?
a ripping chest pain into the back
How do you treat aortic dissection?
aggressive BP control and surgical interventions
What are varicose veins?
abnormally dilated, tortuous veins
What causes varicose veins?
inc intraluminal p and loss of vessel wall support
How do varicose veins lead to venous stasis?
the valves are incompetent
What are the two other sites of varicosities?
esophagus and rectum
What can varicose veins evole into?
venous stasis, edema, stasis dermatitis, ulcerations
What are the risk factors for thrombophlebitis and thrombosis?
cardiac failure, pregnancy, cancer, obesity, post-op, hypercoag state
What is plegmasia alba dolens?
iliofemoral venous thrombosis occurring in pregnant women prior to or following delivery
What are the symptoms of vasculitis?
fever, malaise, arthralgia, myalgias
What causes vasculitis?
infection or immune
What is ANCA?
antineutophilic cytoplasmic antibodies
What is c-ANCA?
antibody against proteinase 3 with cytoplasmic localization
What antibody is against proteinase 3?
What antibody is against myeloperoxidase?
What is p-ANCA?
antibody against myeloperoxidase with perinuclear localization
Name a large vessel vasculitis?
gaint cell (temporal) arteritis
Which vessels does giant cell arteritis effect?
aorta, opthalmic, temporal, and vertebral
What kind of inflammation is associated with giant cell arteritis?
granulomatous with giant cells
What is the treatment for gaint cell arteritis?
What are the sign and symptoms of giant cell arteritis?
blindness diplopia, joint pain, facial pain
What areas are effected by polyarteritis nodosa?
renal and visceral sparing pulmonary
What kind of inflammation is associated with polyarteritis nodosa?
necrotizing inflammation
What can PAN cause?
aneurysm and infarction
Who is affected by PAN?
young adults
What are the signs and symptoms of PAN?
malaise, fever, wt loss, renal filure, abd pain, skin rash, HTN
Which vasculitis is associated with Hep B antigen?
What is the treatment for PAN?
What areas does Wegener Granulomatosis affect?
ENT, Lungs, Kidney (ELK)
What goes Wegener granulomatosis?
some exposure to something
What pathological triad is associated with wegener granulomatosis?
necrotizing granulomas, vasculitis, glomerulonephritis
What are the signs and symptoms of wegeners granulomatosis?
sinusitis, otitis, perforation nasal septum, nasopharyngeal erosions, lung infilitrates, hemoptysis, hematuria, renal failure
How do you treat Wegeners Granulomatosis?
What does Kawasaki syndrome effect?
medium vessels---coronaries
What is the pathology of kawasakis?
inflammation with necrosis leading to aneurysm
Who does kawasaki effect?
under 5
What are the signs of kawasaki?
fever, conjunctival/oral mucosa erythema, red palms and soles, desquamating skin rash, cervical lymph nodes enlargement
How is kawasaki treated?
ASA and IV Ig
What is cardia sequelae?
coronary artery aneurysms, rupturing, MI, death

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