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Vitamin A
essential to maintainance of mucus secreting epi, derivated of retinol

Night Blindness, Squamous metaplasia of trachea, bronchi, renal pelvis etc., Xerophthalmia and blindness or keratomalacia

Too Much - alopecia, hepatocellular damage and bone changes
Vitamin D
Rickets in Children and as osteomalacia in adults - due to defienct calcification of osteoid matrix

Too Much - growth retardation, hypercalciuria, nephrocalcinosis, renal calculi
Vitamin K
Carboxylation of glutamyl residues to form its active gamma carboxyglutamyl forms. For clotting factors 2,7,9,10, protein C

hemmorgaic diathesis - prolongation of prothrombin and activated PTT.

hemmorgagic disease of newborn
Monckeberg arteriosclerosis
media of medium art (radial and ulnar art)

ring like calcifications in media
Does not obstruct flow cause doesnt affect intima

pipestem arteries
Hyaline Arteriosclerosis
hyaline thickening of walls

benign nephrosclerosis in kidneys
Hyperplastic Arteriosclerosis
concentric laminated, onionskin thickening of arteriolar walls

necrotizing arteriolitis - intramural deposition of fibroniod material

Malignant neprosclerosis in kidneys
Pg 134 - read
Insudation hypothesis
Infiltration of the intima with lipid and protein is primary athergenic even - process accelerated by hypercholesteremia
Encrustation (Thrombogenic ) hypothesis
Orginization of repeated mural thrombi on the intimal surface leads to buildup of plauques
Smooth muscle migration and proliferation that may be incited by the hyperlipidemia. Smooth muscle growths are monoclonal.
Reaction to injury formation
Hyperlipidemia initiates endothethial injury by promoting foam cell formation - chemotactic factors released - monocytes and lipid enter subendothelium - release of mitogenic factors - proliferation and fibrosis - monos and SMC engulf lipid and contribute to deposition of lipid.

B VLDL rec and scavenger receptor help monos become foam
Atherosclerotic aneurysm
usually in descending , esp in abdominal, aorta
Aneurysms due to cystic medial necrosis
most frequent aneruysms of aortic root
Berry Anerysms
small saccular lesions, circle of willis

bifurcations of cerebral arteries

assoc with APKD

most frequent cause of subarachniod hemmorage
Syphilitic aneurysm
tertiary syphilis

caused by syphilitic aortitis - oblierative endartitis

Involves Ascending aorta - leads to Aortic valve insuff
Dissecting Aneurysm
longitudinal intraluminal tear usually in ascending aorta

severe tearing chest pain

results in aortic rupture

assoc with hypertension or cystic medial necrosis
AV fistula(aneurysm
abnormal communication between an artery and vein

secondary to trauma

results in ischemic changes, aneuryms formation, inc venous pressure and high output cardiac failure
arises usually in deeps veins of lower ext

caused by venous stasis - preg, cardiac fail, vv, bedrest

can cause embolism and pulmonary infarction

with inflamm - thromboplebitis
Varicose Veins
dilated and tortous veins, usually superficial veins of lower ext

inc venous pressure - preg, obes, thromboplebitis
Spider Telangiectasia
dilated small vessels surrounded by radiating fine channels

associated with hyperestrinism seen in chronic liver disease and preg
HH Telangiectasia
AD, localized dilation and convulation of venules and cappilaries of skin and mucous membranes

complicated by epistaxis and GI bleeding
malformation of larger vessel, composed of channels filled with blood

port wine stain, most common tumor in infancy
Capillary Hemangioma
tangle of closely packed cappilaries-like channels
Cavernous Hemangioma
large cavernous vascular spaces in skin and muscosal surfaces

occurs in Von Hippel Lindau disease - AD, hemangioblastomas of cerebellum, brainstem, retina; inc incidence of RCC
Glomus Tumor(Glomangioma)
small purplish, painful subungual nodule on finger or toe
Cystic hygroma
cavernous lymphangioma and occurs in neck or axilla
malignant vascular tumor

toxic exposure to arsenic, thorotrast, and PVC(in liver)
Kaposi Sarcoma
malignant vascular tumor

Classic - Askh. Jews
Endemic - young African men and children
Epidemic - component of AIDS, assoc with coinf with KS herpesvirus
Polyarteritis nodosa
necrotizing immune complex inflammation of small and medium art

destruction of arterial media and IEL causing aneurysmal nodules

assoc Hep B inf

generalixed symtoms

accompained by P-ANCA(perinuclear antineutrophilic cytoplasmic antibodies)
Chugg Strauss
necrotizing vasculitis

prominent involvement of pulmonary vasculature, periperhal eosinophilia, asthma
Hypersensitivity vasculitis
immune complex mediated vasculitides - acute inflammation of small blood vessels

multuple lesions that tend to be of same age

palpable purpura
Henoch Schonlein purpura
young children, poststrep in orgin

hemorrhagic urticaria of extensor surfaces of arms, legs

assoc with antecedent upper resp inf
Serum Sickness
seen in exp model where rabbits, after bovine serum albumin develop generalixed deposition of antigen-antibody complexes
Wegener granulomatosis
Necrotixing granulomatous vasculitis of resp tract, kidneys

respiratory signs and symtoms, paranasal sinuses

necrotizing glomerulonephritis

fibronoid necrosis of small art, early infiltratoin of neutrophils, granuloma formation

Giant Cell Arteritides
medium to large sized arteries, granuloma formation with giant cells

2 dis: Temperol arteritides, Takayasu arteritides
Temporal arteritis
most frequently occuring vasculitis

systemic vasculitis, in elderly

affects branches of carotid artery

headache, tenderness, palpable nodules along artery, visual prob, polymyalgia rheumatica
Takayasu diease
inflammatoin and stenosis of medium and large arteries

involvement of aortic arch producing aortic arch syndrome

Absent pulses in carotid, radial, ulnar; nonspecific findings
Mucocutaneous lymph node syndrome (Kawasaki disease)
acute, self limitied illness of infants and young children

acute necrotizing vasculitis of small and med art

fever; hem edema of conjunctiva, lips, oral; cervical lymphadenopathy
Thromboangiitis obliterans(beuger)
acute inflammation involving small to medium arteries

painful ischemic diesease

cigarette smoking

Jewish pop, young men
Lymphomatoid granulomatosis
infiltration of lymphocytoid and plasmacytoid cells

may develop into a neoplasm, usually Tcell nonHodgkin lymphoma
Raynaud disease
recurrent vasospasm of small arteries, resultant pallor

preceded by chilling
Raynaud phenomenon
Like Raynaud disease, but secondary to disorder - SLE, scleroderma
Reach 144-145

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