Pathology Exam 1
Terms
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- What is the function of endothelial cells?
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1. synthetic and metabolic (endothelin, NO, thrombogenic factors etc.)
2. transfer of molecules
3. non-thrombogenic blood-tissue interface - What is the function of smooth muscle?
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1. controlvasoconstriction and dilatation
2. produce growth factors and cytokines
3. response to vascular injury - Arteriosclerosis
- hardening of the arteries
- What are the three forms of arteriosclerosis?
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1. atherosclerosis (most common/important)
2. arteriolosclerosis (HTN)
3. Monckeberg medial sclerosis - What arteries are affected by atherosclerosis?
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1. aorta
2. carotid
3. iliac
4. coronary
5. popliteal - Atherosclerosis
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-contributes to half of deaths in Western society
-MI - 20-25% of deaths
-considered to by a response to injury of endothelium - What are the risk factors for atherosclerosis? (7)
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1. age
2. sex M
3. genetics
4. hyperlipidemia
5. HTN
6. cigarette smoking
7. diabetes - Hypertension
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-140/90
-cornary heart disease and CVA
-95% idiopathic
-renal disease and adrenal disease - Malignant Hypertension
- rapidly rising with diastolic over 120mmHg
- Aneurysm
- localized dilatation of the BV or heart wall
- What are the major causes of aortic aneurysms?
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-atherosclerosis - AAA
-cystic medial degeneration
-trauma, congenital defects, infections - Abdominal Aortic Aneurysms
- caused from atherosclerosis with risk of rupture being related to size and a 50% mortality rate from rupture
- What are the clinical consequences of and AAA?
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-rupture
-obstruction
-embolism
-compression of the adjacent structures - Aortic Dissection
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-dissection of blood into arterial media
-HTN risk factor
-due to medial damage
-may rupture
-sudden onset of sharp pain - What is the treatment for aortic dissection?
- antiHTN, surgery, save 65-75% of patients
- Vasculitis
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-inflammation of the vessel walls
-classified by location and antineutrophil cytoplasmic autoantibody (ANCA) production - How do patients present with vasculitis?
- fever, myalgia, arthralgia, malaise
- ANCA production
- classifies vasculitis (c-ANCA, p-ANCA)
- Giant Cell Arteritis
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*most common vasculitis
-granulomatous inflammation involving arteries of head (temp.) - What are symptoms of giant cell arteritis and diagnosis and treatment?
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-older patient, may cause blindness, pain/headache, biopsy required for diagnosis
-treated with anti-inflamm. agents/steroids - Takayasu Arteritis
- fibrous thickening or aortic arch and branches with ocular disturbances and weakened pulses (>females)
- What are the side effects of Takayasu Arteritis?
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-lower blood pressure and pulse in upper extremity than lower extremity
-renal artery narrowing by 50%- HTN - Wegener's Granulomatosis
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-necrotizing vasculitis causing acute necrotizing granulomas of upper respiratory tract or lung and necrotizing granulomatous vasculitis of small to medium sized vessels with renal disease, glomerulonephritis
*95% = c-ANCA positive - What age and sex is Wegener's granulomatosis?
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40 yo
males - What is the clinical presentation of Wegener's Granulomatosis?
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-persistent pneumonitis
-chronic sinusitis
-muscosal ulceration
-renal disease - Varicose Veins
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-dilated superficial veins of upper and lower legs
-secondary to inc. venouspressure: standing, preg., familial tendency
-complications: rare, ulcer
-esophageal arices
-hemorrhoids -
Thrombophlebitis
Phelebothrombosis - -thromobosed vein with inflamm. 90% in deep leg
- What are risk factors for thrombophlebitis?
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1. postop state
2. preg.
3. neoplasia
4. cardiac failure
5. prolonged bed rest - Deep Vein Thrombosis clinical presentation
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-edema, heat, tenderness, pain with pressure or dorsiflexion of the foot (Homan sign)
-may lead to pulm. embolism - What is Homan sign?
- pain with pressure or dorsiflexion of the foot with deep vein thrombosis
- Sup. and Inf. Vena Cava Syndromes
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-caused by compression of the vena cava with obstruction
-cyanosis and venous delatation - Lymphangitis
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-group A Beta-hemolytic strep
-subcuaneous red streaks and lymph node enlargement
-may lead to septicemia - Hemangioma
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-vascular neoplasm, benign, tongue, conj. etc.
-inc. in vessels filled with blood - Kaposi's Sarcoma
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-vascular neoplasm in Jewish pop. classic or european that is endemci and trasplant and AIDS assoc.
-25% of AIDS patients with HHV* infection - Angiosarcoma
- -vascular neoplasm that is malignant soft and red, often found in heart