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29 Cards in this Set
- Front
- Back
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What is an aneurysm?
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Localized abnormal dilation of vessel
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What CT factors lead to an aneurysm?
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CT inherently weak
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What is the defect in CT with Marfan's, Ehlers-Danlos, and Vit C deficiency?
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Marfan - defective synthesis of fibrillin, abnormal TGF-B, weakening of elastic tissue
ED - Defective collagen type 3 VitC - Altered collagen cross linking |
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How is the balance of collagen degradation and synthesis altered by inflammation?
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Increased MMP production = more degraded ECM
Decreased TIMP production |
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What is cystic medial degeneration?
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Loss of blood flow --> Scarring, inadequate ECM synthesis, inc amount of ground substance
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Which 2 disorders predispose to aneurysms and what location do they predispose to?
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Atherosclerosis - abdominal
HTN - ascending aorta |
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What is a mycotic aneurysm?
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Infection of major artery that weakens wall
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Who is more likely to get AAA?
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Male smokers over 50yo
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What is the major cause of AAA?
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Destruction/thinning of aortic media
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Where are AAA's usually located?
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Below renal AA, above bifurcation
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What is the gross appearance of AAA?
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Large bulging sac above bifurcation
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What are 5 clinical consequences of AAA?
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Rupture
Impingment on adjacent structure Occlusion of branch vessel Embolism from atheroma or mural thrombus Creation of abdominal mass |
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What size aneurysm is at greatest risk for rupture?
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>5cm
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What are the clinical symptoms associated with thoracic aortic aneurysm?
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Resp. difficulties, difficulty swallowing, persistent cough, pain from erosion of bone, cardiac disease, rupture
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What disease is TAA associated with, and what is the pathology?
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Syphillis - ischemic damage to media from imflammation
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What is dissection?
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Formation of blood filled channel in vessel wall
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What 2 groups of patients do dissections occur in?
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Men 40-60, 90% have HTN
Pt's with CT abnormalities |
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What is the major risk factor for dissections?
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HTN
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What is the most frequent detectable lesion?
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Cystic medial degeneration
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What is the most frequent detectable microscopic lesion?
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Initial intimal tear
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What are the 2 types of debakey classification for dissections?
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Type A - affect ascending or both ascending/descending
Type B - Distal to subclavian |
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What are the classical symptoms of dissection?
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Sudden excruciating pain anterior chest, radiating to the back, moving downward
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What are the 2 most common mechanisms of vasculitis?
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Direct invasion of infectious pathogen
Immune-mediated |
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What are the common sx with vasculitis?
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FV, myalgias, arthralgias, malaise, tissue ischemia
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What are the 3 mechanisms which initiate noninfectious vasculitis?
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Immune complex deposition
Antineutrophil cytoplasmic antibodies Anti-endothelial cell antibodies |
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What is an ANCA?
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Antineutrophil cytoplasmic antibodies, circulating antibodies that react with neutrophil cytoplasmic agents
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What are p-ANCA and c-ANCA now called?
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p = MPO-ANCA
c = PR3-ANCA |
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Which vasculitis has c-ANCA?
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Wegener granulomatosis
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Which two vasculitis's has p-ANCA?
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Microscopic polyangiitis, Churg-Strauss
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