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Terms
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- Vitamin A
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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
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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
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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
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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
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hyaline thickening of walls
benign nephrosclerosis in kidneys - Hyperplastic Arteriosclerosis
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concentric laminated, onionskin thickening of arteriolar walls
necrotizing arteriolitis - intramural deposition of fibroniod material
Malignant neprosclerosis in kidneys - Atherosclerosis
- Pg 134 - read
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Arterosclerosis
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
- Monoclonal
- Smooth muscle migration and proliferation that may be incited by the hyperlipidemia. Smooth muscle growths are monoclonal.
- Reaction to injury formation
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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
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small saccular lesions, circle of willis
bifurcations of cerebral arteries
assoc with APKD
most frequent cause of subarachniod hemmorage - Syphilitic aneurysm
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tertiary syphilis
caused by syphilitic aortitis - oblierative endartitis
Involves Ascending aorta - leads to Aortic valve insuff - Dissecting Aneurysm
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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
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abnormal communication between an artery and vein
secondary to trauma
results in ischemic changes, aneuryms formation, inc venous pressure and high output cardiac failure - Phlebothrombosis
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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
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dilated and tortous veins, usually superficial veins of lower ext
inc venous pressure - preg, obes, thromboplebitis - Spider Telangiectasia
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dilated small vessels surrounded by radiating fine channels
associated with hyperestrinism seen in chronic liver disease and preg - HH Telangiectasia
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AD, localized dilation and convulation of venules and cappilaries of skin and mucous membranes
complicated by epistaxis and GI bleeding - Hemangioma
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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
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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
- Hemangiosarcoma
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malignant vascular tumor
toxic exposure to arsenic, thorotrast, and PVC(in liver) - Kaposi Sarcoma
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malignant vascular tumor
Classic - Askh. Jews
Endemic - young African men and children
Epidemic - component of AIDS, assoc with coinf with KS herpesvirus - Polyarteritis nodosa
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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
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necrotizing vasculitis
prominent involvement of pulmonary vasculature, periperhal eosinophilia, asthma - Hypersensitivity vasculitis
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immune complex mediated vasculitides - acute inflammation of small blood vessels
multuple lesions that tend to be of same age
palpable purpura - Henoch Schonlein purpura
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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
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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
C-ANCA - Giant Cell Arteritides
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medium to large sized arteries, granuloma formation with giant cells
2 dis: Temperol arteritides, Takayasu arteritides - Temporal arteritis
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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
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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)
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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)
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acute inflammation involving small to medium arteries
painful ischemic diesease
cigarette smoking
Jewish pop, young men - Lymphomatoid granulomatosis
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infiltration of lymphocytoid and plasmacytoid cells
may develop into a neoplasm, usually Tcell nonHodgkin lymphoma - Raynaud disease
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recurrent vasospasm of small arteries, resultant pallor
preceded by chilling - Raynaud phenomenon
- Like Raynaud disease, but secondary to disorder - SLE, scleroderma
- Hypertension
- Reach 144-145