Cv System - Vascular Diseases By Leech

Front 1

What causes localized vasculitis? How about systemic?

Back 1

localized- it's secondary to trauma, infection, or toxin.

systemic- immune origin from antigen-antibody complex

Front 2

true vs false aneurysm

Back 2

localized abnormal dilation of vessel...

true aneurysm has complete arterial wall. thinning of the full thickness of the wall (all three layers)

false aneurysm has missing part of vessel wall

morbidity/mortality secondary to rupture, pressure on adjacent structures, occlusion of proximate vessels, embolism from mural thrombosis.

Front 3

What causes aneurysms?

Back 3

atherosclerosis and cystic medial degeneration. the most common site for atherosclerosis is the abdominal aorta between the renal arteries and the iliac bifurcation or in common iliac.

Front 4

increase risks for AAAs

Back 4

men older than 50 yrs and bulge greater than 5cm. under 5cm and that's more operative.

Front 5

Describe syphilitic aneurysms.

Back 5

seen in teriary stage of syphilis, usually involving only the ascending and arch of aorta. may involve the aortic valve-> insufficiency-> left ventricular overload-> masive hypertrophy (cor bovinum). rarely ruptures.

Front 6

Who gets aortic dissections?

Back 6

underlying issue is hypertension. increase risk (90%) for men 40-60 with HTN.
-Marfans
-trauma, diagnostic, therapeutic procedure.

present with sudden pain usually in anterior chest radiating to the back and downward.

Front 7

Classification of aortic dissections

Back 7

Type A- proximal. more common. involves ascending aorta. more dangerous.

Type B- distal. distal to subclavian a.

Front 8

Whats the most common form of vasculitides?

Back 8

Giant cell arteritis is the most common form. more in gals than guys. 50% have systemic symptoms. also present with headache, facial pain, vision problems.

Front 9

What does giant cell arteritis histologically present?

Back 9

focal granulomatous inflammation in small/medium vessels in the head and temporal arteries in elderly.

tx with steroids.

Front 10

Describe Takayasu Arteries

Back 10

most common in asian women 15-45 yrs old. histologically look like Giant Cell.
-aka Pulseless Arteritis

Front 11

Polyarteritis Nodosa

Back 11

-PAN is a systemic disease of young adults.
-sx are fever, malaise, wt loss
-assd with Hep B antigen
-tx with immunosuppressive therapy
-histologically- segmental fibrinoid necrosis or arterial wall and neutrophilic infiltrate
- positive P-ANCA test.

Front 12

Where can you get this polyarteritis nodosa?

Back 12

any organ except the lungs.

Front 13

Whats the difference between PAN and microscopic polyangiitis?

Back 13

it's like PAN except involves the smaller vessels. it goes away with removal of offending agent. may be confined to the skin or may involve other sites (lung, heart, kidney brain)
-strong association with P-ANCA

Front 14

Kawasaki Disease

Back 14

-acute illness of infants (up to 4yrs)
-fever, skin rash, lymphadenopathy, 20% have coronary disease
-self limited, rarely fatal.
-histo similar to PAN

Front 15

Which immunoregulatory problems are associated with Kawasaki?

Back 15

T cell activation
auto antibodies to endothelial cells
circulating immune complexes.

Front 16

Wegener Graunlomatosis: the triad is..

Back 16

1.focal necrotizing vasculitis of lung and upper airway
2. necrotizing granulomas of upper and lower respiratory tract
3. necrotizing glomerulitis

upper respiratory lung and renal problems... think wegeners

-ppl in their 40s. w/o tx 80% die in a year. w/ tx 90% responsd
-unknown cause; 90% have C-ANCA

Front 17

Thromboangiitis Obliterans (Buerger Disease)

Back 17

-seen in heavy smokers, before 35 yrs
-small arteries and veins of extremities
-starts with nodular phlebitis, then Raynaud-like cold sensitivity and leg claudication
-can cause 4+ pain and gangrene
-histo-> segmental thrombosis, acute, chronic inflammation of medium and small arteries and veins in extremities.

Front 18

Raynaud Disease

Back 18

-unknown etiology
-exaggerated of normal central and local vasomotor responses to cold or emotion
-pallor/cyanosis of digits, nose, ears in young healthy women.

Front 19

What is Raynaud Phenomenon?

Back 19

arterial insufficiency of extremities secondary to arterial narrowing induced by atherosclerosis, SLE, scleroderma, Buerger Disease.

Front 20

What are varicose veins

Back 20

dilated, tortuous veins, typically superficial secondary to increase in intraluminal pressure.
-frequent thrombosis but rare emboli
-more in women
-may be secondary to heredity defects in wall development, obesity, compression.

Front 21

Thrombophlebitis and phlebothrmobosis

Back 21

-both come from thrombosis which leads to inflammation
-secondary to CHF, neoplasia, pregnancy, postoperative, prolonged immobilization, local infection.
-most in the deep legs
-common source of emboli

Front 22

What is Migratory Thrombophlebitis?

Back 22

aka Trousseau Syndrome
-multiple venous thrombi appearing and disappearing. possibly secondary to hypercoagulability seen with cancer, particularly visceral adenomas.

Front 23

Superior/Inferior Vena Cava Syndrome usually comes from...

Back 23

neoplasms that compress or invade the SVC-> the most common bronchogenic carcinoma or mediastinal lymphoma

-clinically: cyanosis and marked dilation of veins of head, neck, arms.

Front 24

what is Lymphangitis?

Back 24

infection involving the lymphatics draining a locus of inflammation, frequently resulting from beta hemolytic strep, usually regionally lymphadenopathy.

Front 25

what is Lymphedema?

Back 25

obstruction with lymphatic dilation and abnormal accumulation of interstitial fluid in the drainage site.

Front 26

most common causes of Lymphangitis and Lymphedema

Back 26

-malignancy
-surgical resection of regional lymph nodes
-filariasis
-post radiation fibrosis
-post inflammatory thrombosis with lymphatic scarring.