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?: c-ANCA
What antibody is against myeloperoxidase?: p-ANCA
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?: corticosteroids
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?: NAD
What is the treatment for PAN?: immunosuppression
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?: immunosuppression
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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