Vascular Path

Front 1

What is the study of looking at cells from living patients?

Back 1

cytopathology

Front 2

What is the study of looking at diseases and tumors of the blood and lymphatic systems?

Back 2

hematopathology

Front 3

Describe the layers of a blood vessel.

Back 3

1- intima
2- internal elastic lamina
3- media
4- external elastic lamina
5-adventitia

Front 4

The media is comprised of ____.

Back 4

smooth muscle

Front 5

The inner aspect of the media gets its nutrients by _____.

Back 5

by direct diffusion by the endothelium.

Front 6

The outer aspect of the media gets it nutrients by ___?

Back 6

the small blood vessels in the adventitia.

Front 7

Describe 4 functions of the endothelium.

Back 7

1- provides a non-thrombogenic surface
2- allows for diffusion of O2 and nutrients
3-has a synthetic and metabolic role
4- contains Weible-Palade bodies (vWF)

Front 8

What are 3 functions of the smooth muscle in the blood vessel?

Back 8

1- controls vasoconstriction and dilation.
2- produces the growth factors and cytokines.
3- responds to injury

Front 9

What is the response to endothelial injury?

Back 9

SMC proliferation and migration into the intima.

Front 10

What contributes to the intimal thickening.

Back 10

1- the proliferation of SMC
2- the SMC secretes a matrix material.

Front 11

____ is a disease that effects the small vessels. It is very important in the kidneys.

Back 11

arteriosclerosis.

Front 12

Arteriosclerosis is associated with ____?

Back 12

HTN

Front 13

_____ is medial calcificaton of the vessels?

Back 13

Monckeberg medial sclerosis (MMS)

Front 14

T or F: MMS does NOT cause lumenal narrowing.

Back 14

T: does NOT, therefore it is not a problem clinically

Front 15

T or F: Atherosclerosis contributes to over half of deaths in western society.

Back 15

true

Front 16

Name 5 arteries most affected in atherosclerosis.

Back 16

1- aorta
2- carotid
3-iliac
4-coronary
5-popliteal

Front 17

Atherosclerosis is the result of ____ to the endothelium.

Back 17

injury

Front 18

The first visible sign of Atherosclerosis?

Back 18

the fatty streak

Front 19

T or F: even babies over 1 year can have fatty streaks.

Back 19

true

Front 20

What is the earliest true lesion of atheroscerosis?

Back 20

fibrous plaque

Front 21

The fibrous plaque will progress to a ___?

Back 21

complicated plaque

Front 22

Describe a complicatied plaque.

Back 22

the surface has been disrupted. there is no endothelium preventing thrombosis. it could rupture.

Front 23

With plaque rupture you may get:

Back 23

thrombosis, hemorrhage, weakening of vessel, calcifications

Front 24

What are 3 sources of endothelial injury.

Back 24

1- hyperlipidemia
2- hypertension
3- smoking (most common cause)

Front 25

What other types of cell (other than SMC) migrates into the intima?

Back 25

macrophages and inflammatory cells.

Front 26

You can see a fatty streak b/c ___ accumulate.

Back 26

lipids

Front 27

What substance is also laid down (by the SMC) in the intima during atherosclerosis?

Back 27

collagen

Front 28

What are the non-modifiable risk factors for atherosclerosis?

Back 28

1-age
2- being male
3- genetics

Front 29

What are the modifiable risk factors for atherosclerosis?

Back 29

1- hyperlipidemia
2- hypercholesterolemia
3- hypertension
4- smoking
5- diabetes (b/c it induces hypercholesterolemia)

Front 30

Risk factors in general are _____?

Back 30

additive. 2 risk factors = 4 times the risk

Front 31

Hypertension is defined as:

Back 31

systolic >140 and diastolic >90

Front 32

HTN is an important risk factor for __ and __?

Back 32

coronary heart disease and CVA

Front 33

____ can cause HTN.

Back 33

renal disease

Front 34

Desribe malignant HTN.

Back 34

1-rapidly progressing htn.
2- diastolic > 120
3- systolic >200

(Very hard to control)

Front 35

The equation for blood pressure is ____?

Back 35

BP = CO x Peripheral resistance

Front 36

What major organ regulates blood pressure?

Back 36

the kidney

Front 37

angiotensin II causes ____ in attempt to elevate Blood pressure.

Back 37

vasoconstriction

Front 38

____ causes Na reabsorption which leads to increases blood pressure.

Back 38

aldosterone

Front 39

Name 2 types of arteriosclerosis.

Back 39

1- hyaline art.
2- hyperplastic art.

Front 40

The typical type of arteriosclerosis in repsonse to injury is ___?

Back 40

hyperplastic arteriosclerosis.

Front 41

Desribe the cyclical nature of arteriosclerosis.

Back 41

HTN causes vascular damage to the arteriole feeding the glomerulus. This results i narrowing of the lumen--which will decrease the amount of bllod flow through the glomerulus. The glomerulus thus elevates the blood pressure created more damage = cycle.

Front 42

____ is a dilatation of a blood vessel or heart wall.

Back 42

aneurysm

Front 43

The major cause of AAA is _____?

Back 43

atherosclerosis

Front 44

cystic medial degeneration can cause -____?

Back 44

an aortic aneurysm

Front 45

cystic medial degeneration is seen in ____ syndrome.

Back 45

Marfans

Front 46

Cystic medial degeneration is a change in ____?

Back 46

the elastic walls of the arteries.

Front 47

T or F: Infections like Salmonella can cause aortic aneurysms.

Back 47

True, syphilis used to be a major cause as well

Front 48

Trauma can cause ___ and ____formation.

Back 48

aneurysm, aortic dissection

Front 49

Obstructions in blood flow can cause ______ blood flow. This leads to the formation of _____?

Back 49

turbulent, thrombosis

Front 50

An embolus can ____ distal arteries and cause _____ of distal tissues.

Back 50

plug, necrosis

Front 51

_____ is the most significant event that can happen to an aneurysm.

Back 51

rupture

Front 52

The risk of rupture is related to the ___ of the aneurysm.

Back 52

size

Front 53

Does an aneurysm of < 4cm pose a high risk?

Back 53

no, not a high risk. it has a risk of <1% per year.

Front 54

Aneurysms present as ____?

Back 54

pulsatile abdominal masses. they expand with each heartbeat.

Front 55

A dissecting aneurysm is when _____ goes into the ____ of the blood vessel.

Back 55

blood, media

Front 56

____ is the major risk factor for dissecting aneuryms.

Back 56

HTN

Front 57

A dissecting aneuryms presents with ______ pain.

Back 57

sudden, sharp pain

Front 58

What medication are patients with dissecting aneuryms treated with to prevent rupture?

Back 58

anti-hypertensives

Front 59

Name the order of events during aortic dissection.

Back 59

1- medial damage
2- intimal tear
3- blood under high pressure dissects down into the media
4- the blood tracks along the lenbth of the aorta.

Front 60

_____ is inflammation of the vessel walls.

Back 60

vasculitis

Front 61

What 3 things classify vasculitis?

Back 61

1- location
2- size of vessel involved
3- ANCA production (Antineutrophil Cytoplasmic Autoantibody)

Front 62

What are the 2 forms of ANCA?

Back 62

1- cANCA (Cytoplasmic)
2- pANCA (periplasmic)

Front 63

Patients with vasculitis present with ___?

Back 63

fever, muscle pain, joint pain, feeling tired

Front 64

_____ AKA "temporal" arteritis is the most common vasculitis.

Back 64

Giant cell arteritis. (we will see this!!) Most common site is temporal artery.

Front 65

Giant cell arteritis occurs in _____ people and is caused by ______ of the arterial wall.

Back 65

old, granulomatous inflammation

Front 66

Patients with giant cell arteritis will complain with ____.

Back 66

headaches

Front 67

T or F: giant cell arteritis can cause blindness.

Back 67

true

Front 68

____ is characterized by weakened pulses. This affects the ______ of the aortic arch.

Back 68

Takayasu Arteritis, branches

Front 69

Patients with Takayasu arteritis will have ____ pressure in their arms than in the legs.

Back 69

lower

Front 70

Takayasu arteritis causes renal ______ and therefore also leads to ______.

Back 70

narrowing, and HTN

Front 71

Is Takayasu arteritis more common in males or females?

Back 71

young females

Front 72

______ affects the upper respiratory tract, lungs, mouth, and throat.

Back 72

Wegener's Granulomatosis

Front 73

Wegener's granulomatosis is a __________ vasculitis.

Back 73

necrotizing

Front 74

The triad of Wegener's histological findings are:

Back 74

1- vasculitis
2-granuloma formation
3-geographic necrosis

Front 75

______ is positive in 95% of Wegener's patients.

Back 75

c-ANCA

Front 76

T or F: Wegener's is more common in males.

Back 76

True

Front 77

Patients with Wegener's granulomatosis present with:(4 things)

Back 77

1- cough and fever
2- chronic sinusitis
3- mucosal ulceration
4-renal disease

Front 78

Varicose veins are ___ veins of the upper and lower ____.

Back 78

dilated, legs

Front 79

T or F: Varicose veins are rarely clinically significant.

Back 79

True

Front 80

Alcoholism leads to ______. (talking about veins in this question.)

Back 80

esophageal vairces

Front 81

______ is a clinically significant affect to the deep leg veins.

Back 81

Thrombophlebitis.

Front 82

Patients with thrombophlebitis present with:

Back 82

1- edema in lower legs
2- heat and tenderness
3-Homan sign (pain with dorsiflexion of foot)
4- **may lead to pulmonary embolism**

Front 83

_____ patients are at risk for pulmonary embolism.

Back 83

Hosptialized

Front 84

A lung tumor can cause ________.

Back 84

inferior vena cave syndrome (compression of IVC)

Front 85

A thymic tumor could cause ___?

Back 85

superior vena cava syndrome

Front 86

Compression of the vena cava causes ____ and _____.

Back 86

cyanosis, venous dilatation

Front 87

____ is caused by group A beta-hemolytic strep.

Back 87

Lymphangitis

Front 88

____ is an inflammatory process involving the lymphatics.

Back 88

lymphangitis

Front 89

______ is a very common vascular neoplasm. It is benign.

Back 89

hemangioma

Front 90

_____ is a malignant vascular neoplasm seen in AIDS/ immunocompromized patients.

Back 90

Kaposi's sarcoma

Front 91

Karposi's sarcoma is also associated with ____?

Back 91

Human Herpes virus 8

Front 92

____ is a maligant vascular neoplasm and can be found in the heart.

Back 92

angiosarcoma