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42 Cards in this Set
- Front
- Back
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Giant Cell (TEMPORAL) arteritis: what is it?
What does it look like? |
most common form of systemic vasculitis; affects large and small arteries, primarily those in the head
nodular thickening, lumen reduction, granulomatous inflammation(w/ giant cells), and fragmentation of the internal elastic lamina |
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What causes Giant Cell (TEMPORAL) arteritis?
How does it present? |
cause is unknown but immunogenic mech is suspected
PW facial pain headache tenderness of temporal artery visual impairments Polymagia rheumatica Rare b4 age 50 |
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Takayasu Arteritis: what is it?
What does it look like? |
also known and the pulseless disease; characterized by inflammation and stenosis of medium to large arteries (aortic arch and its branches= AORTIC ARCH SYNDROME)
Granulomatous vasculitis and fibrous thickening w/ narrowing or virtual obliteration of origins |
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What causes Takayasu Arteritis?
How does it present? |
cause is unknown but immunogenic mech is suspected
absent pulse nonspecefic findings such as fever, night sweats, malaise, arthritis, eye problems and skin nodules |
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What is Polyateritis nodosa?
What does it look like? |
a segmental transmural necrotizing arteritis characterized by necrotizing immune complex formation of small and medium sized arteries; also fibrinoid necrosis in any organ
-destruction of arterial media and internal elastic lammella resulting in aneurysmal nodules -necrotic lesions in the kidney, coronary arteries, musculoskeletal system, GI tract, aand CNS |
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What causes Polyarteritis nodosa?
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- Imparied perfusion leads to ulcers, infarcts, ischemic atrophy of hemorrhage
- associated w/ hepatitus B in 30% of patients |
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What are the clinical manifestations of Polyarteritis nodosa?
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manifested by fever, wieght loss, malaise, abdominal pain, headache, mylagia, and HT
elevated serum Abs to neutrophilic myeloperoxidase symptoms remmitant and episodic fatal if untreated, steroids give remission in 90% of cases typically affects young adults |
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What is Kawasaki Disease?
What causes it? |
leading cause of acquired heart disease in North America and Japan; a PAN like vasculitis often involving the coronary arteries in young children and infants
cause is unknown but there is evidence for immune reaction |
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How does Kawasaki Disease present?
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associated w/ mucocutaneous syndrome manifested by:
fever conjunctival and oral erythema and erosion edema of hands and feet erythma of the palms and soles skin rash cervical lymph node enlargement 20% develop cardiac sequelae(aneurysm) acute fatalities in 1% |
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Microscopic polyangitis
(Microscopic polyarteritis, Hypersensitivity/ Leukocytoclastic Vasculitis) What is it? |
group of immune complex mediated vasculitides (necrtotizing vasculitis) characterized by acute inflammation of small bvs(arterioles, venules, capillaries)
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What causes Microscopic polyangitis?
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usually and immune reaction to drugs, microorganisms, heterologous proteins or tumor antigens
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What are clinical manifestations of Microscopic polyangitis?
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presents with hemoptysis, arthhralgia, abdominal pain, hematuria, proteinuria, hemorrhage, muscle pain and weakness
palpable purpura when skin is involved but can involve any site inc. glomeruli or GI tract 70% have pANCAs most respond well to removal of offending agent |
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Wegener granulomatosis: what is it?
What does it look like? |
acute necrotizing vasculitis of small to medium sized vessels of the U/L respiraory tract and/or kidneys
fibrinoid necrosis of small arteries and veins, infiltration of neutrophils w/ subsequent mononuclear cell infiltration, granuloma formation w/ giant cells |
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What causes Wegener granulomatosis?
What are clinical features (b/s presentaion)? |
may represent some form of hypersensitivity to to inhaled infectious or environmental agents
affects males more than females w/ peak incidence in fifth decade cytoplasmic ANCAs present in serum |
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How does Wegener granulomatosis present?
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persistant pneumonitit with nodular and cavitary infiltrates
chronic sinunitis mucosal ulcerations of nasopharynx renal disease skin rashes muscle pains articular involvement fever 80% die w/in year if untreated |
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What is Thromboangitis obliterans(Burger disease)?
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an acute inflammation involving small to medium sized arteries of extremeties that can extend to adjacent veins & nerves
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What are clinical manifestations of Thromboangitis obliterans(Burger disease)?
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mosty common in men
usually occurs before age 35 in cigarette smokers due to hypersensitivity to tobacco extracts results in painful ischemic disease w/ later complications inc. ulceration of toes, feet, and fingers; occasionally gangrene |
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Raynaud Phenomenon: what is it and what causes it?
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parysomal pallor or cyanosis of the digits due to cold-induced vasconstriction of distal digital bvs
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What are clinical features of Raynaud Phenomenon?
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median age of onset 14, patients usually present at age >30
fingers usually change colors, red, white, blue severe episodes, skin lesions CT disorders should be looked at for underlying cause |
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Varicose Veins: what are they and what causes them?
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abnormally dilated, tortuous veins in mainly the superficial veins of legs; also present in esophagus and anus
caused by variations in wall thickness, phlebosclerosis, increased venous pressure |
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What is clinical course of Varicose Veins?
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most commonc in obese women over age 50
presents with edema, pain, thrombosis stasis dermatitis, ulceration, poor wound healing, infections, and embolisms (rare) |
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Thrombophlebitis and Phlebothromosis...
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arises most often in the deep veins of the lower extremeties
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What factors predispose to Thrombophlebitis and Phlebothrombosis?
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cardiac failure, neoplasi, pregnancy, obesity, postoperative state, prolonged bed rest or immobilization
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What are clinical manifestations of Thrombophlebitis and Phlebothromosis?
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migratory thrombophlebitis
leg thrombi usually don't produce symptoms --> Homan sign may give rise to pulmonary embolism *plegmasia alba dolens: ileofemoral venous thrombosis in pre and post partum women |
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What is Lymphangitis?
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occurs when bacteria infections spread through lymphatics
they cause painful subcutaneous red streaks, and lymph node enlargement may lead to septicemia |
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What is Lymphedema?
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an abnormal accumulation of interstitial fluid
LOOK AT THE NOTES FOR THIS ONE!! |
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What are General Hemangiomas?
Are they malignant? |
localized, superficial lesions most often of the head or neck
may be internal, 1/3 are on the liver rarely malignant |
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Capillary Hamangioma: what is it?
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the largest single type of vascular tumor that consists of tangles of closesly packed cappilary like channels that may occur in the skin, subq tissue, lips, liver, spleen, or kidneys
juvenile(strawberry) hemangioma: in 1/200 newborns |
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Describe Cavernous Hemangiomas?
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consist of larger cavernous vascular spaces in the skin and mucosal surfaces and internal organs such as liver pancreas and spleen
can occur in von Hippel-Lindau disease |
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What is pyogenic granuloma?
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hemangioma
exophytic, polypoid red nodule on the skin, gingiva or oral mucosa, bleed easily and often ulcerate resembles exuberant granulation tissue can recur following removal *Granuloma Gravidarum - occurs in 1% of pregnacies |
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Lymphanigoma Circumscription?
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capillary lymphangioma
occurs in head an neck region and axilla histologically similar to hemangiomas w/o the blood |
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Cystic hygroma
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cavernous hygroma
occurs in neck and axilla of children can be large up to 15 cms |
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Glomus Tumor
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glomangioma
most common in the distal portions of digits, under fingernails painful slightly elveated red-blue nodules glomus cells proliferate forming nests, aggregates and masses |
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Spider telangiectasia
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small dilated vessel surrounded by radiating fine channels on face, neck and upper chest
associated with hyperestrinism seen in chronic liver disease and pregnacy |
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Hereditary hemorrhagic telangiectasia
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autosomal dominant condition characterized by local dilationand convolution of venules and capillaries of the skin and mucous membranes
Ossle-Weber-Rendu disease |
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What causes port wine stains and birthmarks?
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Nevus Flemmeus
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What is Baccillary Angiomatosis?
What causes it? |
oppurtunistic infection involving skin, bones, brain; manifests as vascular proliferations resembles tumors
caused by infection with gram negative bacilli of the Bartonella family |
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What is Kaposi Sarcoma?
What are the 4 types? |
low grade malignant vascular tumor that occurs in several forms
Chronic (classic or European) Lymphadenopathic Transplant associated AIDS associated |
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What does Kaposi sarcoma look like histologically?
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dense proliferation of spindle cells, plump endothelial cells and extravasated RBCs
atypia and mitoses are common |
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What is the pathogenesis is associated with Kaposi sarcoma?
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majority of the lesions are infected with KS associated herpes virus (human herpes virus 8)
Immunosuppresion is an important cofactor |
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What is hemangioendothelioma?
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wide spectrum of vascular neoplasms intermediate in behavior between a benign and malignant tumor
epitheliod occur in medium to large sized veins |
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What are the malignant vascular tumors?
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angiosarcoma - rare malignant tumors occuring in the skin soft tissue, breast and liver
Hemangiopericytoma - neoplasm with fleshy spongy consistency derived from pericytes, slowly growing masses in the pelvic retroperitoneumor lower ext of middle aged women |
