Ward Prep: Brs Ch 9 Vascular System

Front 1

Which organs/body parts are affected by ischemia from atherosclerosis

Back 1

Heart (ischemic HD/MI), brain (stroke), bowel (ischemic bowel dz), limbs (peripheral vascular occlusive disease => claudication), kidney (renal arterial ischemia, 2° htn)

Front 2

risk factors for atherosclerosis

Back 2

age, gender (men, post menopausal women), hypercholesterolemia (w/ high LDL/HDL ratio > 4:1), htxn, DM, cigarettes. Also: obseisty, physical inactivity, stress, hyperuricemia, hyperhomocysteinemia, chlamydia pneumoniae, OC w/ smoking

Front 3

Pathogensis of atherosclerotic plaques (vaguely)

Back 3

vascular injury => moncyte accumulation with cholesterol deposits = foam cells => fibrous cap rupture => thrombus/emolism

Front 4

Where do atherosclerotic aneurysms most frequently occur?

Back 4

abdominal aorta (also found in iliac arters, arch, thoracic aorta)

Front 5

Berry aneurysms: where? Relation to atherosclerosis? Consequence?

Back 5

Circle of willis. No relation to atherosclerosis; they occur at points congenital weakness. Subarachnoid hemorrhage.

Front 6

Syphilitic aneurysm. What stage of syphilis? What part of the aorta? Complication?

Back 6

Tertiary syphilis. Ascending aorta. Aortic value insufficiecny

Front 7

Aortic dissction. What is it? A/w? Radiographic finding? Complication?

Back 7

Longitudinal intraluminal tear. Hypertension, marfan syndrome. Widening of the mediastinum. Aortic rupture (e.g. into pericardial sac => cardiac tamponade)

Front 8

Predisposing factors for venous thrombosis

Back 8

(Virchow's triad) pregnancy, cardiac failure, physical inactivity, varicose veins

Front 9

Describe pulmonary infarct from pulmonary embolism

Back 9

Hemorrhagic, subpleural, wedge-shaped

Front 10

Predisposing factors for varicose veins

Back 10

Increased venous pressure from pregnancy, obesity, thrombophlebitis, prolonged standing

Front 11

Spider telangiectasia. What is it? When does it happen?

Back 11

Small dilated vessel with radiating channels. Hyperestrinism (e.g. chronic liver dz or pregnancy)

Front 12

Osler-Weber-Rendu syndrome. Other name? Complications?

Back 12

Hereditary Hemorrhagic Telangiectasia. Epistaxis and GI bleed.

Front 13

Capillary hemangioma. What is it

Back 13

proliferation of tangled capillaries in skin or organs. Benign vascular neoplasm

Front 14

Cavernous hamangioma. What is it? A/w with what dz (other findings of the dz)

Back 14

Carvernous vascular space in skin or organs. Benign vascular neoplasm. A/w von Hippel Lindau disease (CNS hemangioblastomas, cysts and adenomas in multiple organs, RCC)

Front 15

Glomangioma (glomus tumor). What is it

Back 15

painful subungal benign vascular tumor

Front 16

Cystic hygroma. What is it? Where does it occur

Back 16

cavernous lympangioma in neck or axilla

Front 17

kaposi sarcoma, what is it? who gets it?

Back 17

malignant vascular tumor. Old european men, young african men, immunocompromisd (AIDS, transplant pt). HHV8

Front 18

Name 9 vasculidities.

Back 18

Polyarteritis nodosa, Churg-Strauss syndrome, Henoch-Schonlein purprua (hypersensitivity vasculidities), Wegeners granulomatosis, Giant cell (temporal arteritis), Takayasu arteritis, Kawasaki disease (mucocutaenous lymph node syndrome), Buerger dz (thromboangiitis obliterans), Lymphomatoid granulomatosis

Front 19

Which vasculidities affect kids?

Back 19

Henoch-Schnolein purpura and Kawasaki dz

Front 20

In which vasculidities are giant cells in the lesions?

Back 20

Churg-strauss syndrome, Wegeners granulomatosis, Giant cell (temporal) arteritis, Temporal arteritis, Lymphomatoid granulomatosis

Front 21

Which vasculidities are caused by IC deposition?

Back 21

Polyarteritis nodosa, Henoch-Schonlein purpura (other hypersensitivity vasculidities too)

Front 22

Which vasculidities cause visual disturbances?

Back 22

temporal (giant cell) arteritis, takayasu arteritis

Front 23

Polyarteritis nodosa. Pathophys? What size arteries? A/w? Manifestations/organs? What organ does it not affect?

Back 23

IC deposition in small/medium arteries => necrosis, thrombosis. A/w ab vs. HBV. Ischemia/infarction: coronary arteries => IHD, msk => pain, GI => n/v/pain, melena. Does not affect lungs.

Front 24

Churg-Strauss syndrome. What is it/what organ does it affect? Blood cell finding? A/w?

Back 24

"allergic granulomatous angiitis". vasculitis of pulmonary vasculature. Eosinophilia. Asthma.

Front 25

Henoch-Schonlein purpura. What is it? Who gets it? Cause of exacerbation?

Back 25

Hypersensitivity vasculitis leading to hemorrhagic purpura in kids. Precipitated by exogenous antigens: drugs, food, upper repsiratory tract infection (e.g. strep).

Front 26

Wegeners granulomatosis. What is it? What organs are affected? Autoabs?

Back 26

Granulomatous vasculitis of small/med vessels in repsiratory tract and kidneys. A/w c-ANCA

Front 27

Temporal (giant cell) arteritis. Which arteries? Manifesations? Physical finding? A/w

Back 27

Granulomatous vasculitis of branches of caroid artery. Temporal => h/a, jaw claudication, ophthalmic artery => visual disturbances. Palpable nodules along temporal artery. A/w polymyalgia rheumatica (proximal musc pain/stiffness but not weakness… weakness is polymyositis or dermatomyositis)

Front 28

Takayasu arteritis. Nickname? Which arteries, manifestations? Who gets this?

Back 28

"Pulseless dz". Vasculitis of aortic arch and branches => stenosis => Absent pulse in carotid/ulnar/radial, visual disturbances. Young azn F

Front 29

Kawasaki disease. Other name? Manifestations? Who gets it?

Back 29

Mucocutaneous lymph node syndrome. 1) Hemorrhagic edema of conjunctivae, lips/oral mucosa. 2) Coronary artery vasculitis w/ aneurysm formation. Kids.

Front 30

Breuger disease. Other name? What is it, manifestations? Who?

Back 30

Thromboangiitis obliterans. Vasculitis of extermities => hand/foot pain. Especially tibial and radial artery. Smokers, jewish peope.

Front 31

Lymphomatoid granulomatosis. What is it?

Back 31

Granulomatous vasculitis with lymphocyte-like cell infiltrate. May progress to T-cell non-Hodgkin lymphoma

Front 32

Which is the most common vasculitis

Back 32

Temporal arteritis (giant cell)

Front 33

Distinguish between Raynaud dz and Raynaud phenomenon

Back 33

Raynaud dz is recurrent vasospasm of arteries in fingers toes => cyanosis, usu precip by cold. Phenonemon is 2° to underlying disorder (clasically, SLE or scleroderma [progressive systemic sclerosis])

Front 34

Kidney changes in essential hypertension?

Back 34

benign nephrosclerosis (hardening/thickening of renal vasculature)

Front 35

Kidney changes in malignant hypertension?

Back 35

malignant nephrosclerosis: necrosis => capillary rupture ("flea-bitten" kidney)

Front 36

Causes of 2° hypertension of renal origin (2). Mechanism

Back 36

any dz of renal parenchyma, unilateral renal artery stenosis. Macula densa's juxtaglomerular cells sense less flow => renin => angiotensin I converted to angiotensin II (vasconstriction + aldo secretion) => aldo promotes Na/water reabs.

Front 37

Name 6 endocrine disorders that cause 2° hypertension

Back 37

Conn syndrome (1° aldosteronism from adrenocortical adenoma or bilateral adrenal hyperplasia; also see in Na dec K), acromegaly, cushing syndrome (pituitary or adrenocortical origin, or CVS), pheochromocytoma, hyperthyroidism, DMII (diabetic glomeruloscerlosis)

Front 38

where is the hypertension in coarctation of the aorta

Back 38

upper limbs only

Front 39

Malignant hypertension. What is it, manifestations, who gets it. Death by?

Back 39

Complication of 1° or 2° htn => inc diastolic bp, papilledema (edema of optic disc, focal retinal hemorrhages, LVH, malignant nephrosclerosis. Young black males. Death: CHF, cerebrovascular accident, renal failure.