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Vascular Pathology 2
Vascular Pathology 2
40
English
Pre-School
05/16/2009

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Term
Hemangioma
Definition
What I have: benign tumor of blood vessels, regress spontaneously. Capillary or cavernous
Term
Berry Aneurysm
Definition
saccular aneurysm in muscular arteries
Term
Berry Aneurysm: causes
Definition
weak media at branch points
Term
____% of people have a berry aneurysm intracranial
Definition
2
Term
Most intracranial berry aneurysms occur in
Definition
Anterior or middle cerebral arteries (communicating)
Term
Berry Aneurysm: complications
Definition
HTN-->rupture
Term
Arteriovenous Malformation
Definition
maldevelopment-->pulsatile shunt causes know of dilated vessels. Can bleed if in brain. Ok in other organs
Term
Arteriovenous Fistula
Definition
Post traumatic (after vascular trauma, artery and vein can heal together) or surgically placed (hemodialysis)
Term
Vasospasm of Arteries
Definition
Raynaud Syndrome (distal arteries in women), Prinzmetal Angina (Coronary arteries-->angina), Migraine (cranial arteries)
Term
Infective Vasculitis
Definition
Syphilis, TB, Rickettsial, bacterial , fungal, viral
Term
Non-Infective Vasculitis: large vessel
Definition
Immune Mediated: Giant cell: older men, most common form, cranial arteries, chronic inflammatory infiltrate, responds to corticosteroids
Term
Non-Infective Vasculitis: medium vessel
Definition
Polyarteritis Nodosa: middle aged men with HBV, acute inflammatory infiltrate (thrombosis occludes), many sites, does not respond to steroids
Term
Arteriosclerosis
Definition
hardening of the arterial wall
Term
Arteriosclerosis: associated with
Definition
HTN, diabetes
Term
Atherosclerosis
Definition
a type of arteriosclerosis associated with lipid rich deposits
Term
Transplant Vasculopathy
Definition
proliferative arteriosclerosis of arteries within a transplanted organ(Chronic Rejection): intimal hyperplasia with lipid rich areas
Term
Vein-Graft Remodelling
Definition
proliferative arteriosclerosis of arterialized vein graft due to hemodynamic factors (Coronary artery bypass graft): thickening of concentric smooth muscle and intima
Term
Arteriosclerosis can cause what changes in the vessel wall
Definition
1) onion-skinning: layers of medial smooth muscle hyperplasia due to malignant HTN. 2) Medial thickening from ECM due to HTN or diabetes
Term
Response to injury hypothesis
Definition
1) intimal hyperplasia 2) Inflammation, proliferation, fibrosis.
Term
Causes of EC injury
Definition
HTN, hyperlipidemia, smoking, radiation, cyclosporin, immune reaction (systemic sclerosis, transplant), local hemodynamic factors
Term
Atherosclerosis: epidemiology
Definition
primary cause of morbidity and mortality in developed world
Term
Atherosclerosis: involves
Definition
INTIMAL disorder of large and medium arteries. Focal accumulation of lipid, matrix and inflammatory cells
Term
Primary determinant of acute coronary artery sundromes due to atherosclerosis is
Definition
composition of plaques (rather than size)
Term
Atherosclerosis risk factors
Definition
hyperlipidemia, smoking, HTN, diabetes, family history, age, sex, homocysteine
Term
Atherosclerosis: pathogenesis
Definition
1) Chronic EC injury 2) EC dysfunction-->increased permeability (leukocyte adhesion, LDL) 3) Smooth muscle emigration from media to intima, macrophage activation 4) macrophages and smooth muscle engulf lipid--Fatty Streak 4) necrotic core and fibrous
Term
Sites of Atherosclerosis
Definition
Abdominal aorta and illiac arteries, coronary arteries, thoracic aorta femoral and popliteal, internal carotid, intracranial
Term
Most atherosclerotic lesions are concentric or eccentric
Definition
Eccentric (75%)
Term
Most atherosclerotic lesions are of epicardial vessels or myocardial vessels
Definition
epicardial
Term
Key compensatory mechansims of coronary artery atherosclerosis
Definition
remodeling and dilation associated with medial hypertrophy. Can preserve vessel lumen diameter
Term
Intimal thickening
Definition
usual aging process (senile arteriosclerosis), intimal foam cell deposition is the start of atherosclerosis
Term
Necrotic core of an atherosclerotic plaque
Definition
foam cells, cholesterol clefts, matrix
Term
Necrotic core with fibrocalcific plaques are better than thin fibrous caps are better bc
Definition
they can pop and release tissue factor that causes massive thrombosis
Term
Most MIs are caused by
Definition
coronary artery thrombosis in the proximal 1/2 of LADA
Term
plaque induced thrombosis can also be due to
Definition
erosion (women, smokers, peripheral arteries). Rupture more common
Term
Layers within atheroma suggest
Definition
episodic growth and healing
Term
How much stenosis is required from an atheroma to experience symptoms>
Definition
75% exercise-->angina; 90% ar rest-->angina
Term
Atherosclerosis: complications
Definition
aneurism and rupture, occlusion by thrombosis, stenosis; stroke if in brain
Term
Atherosclerosis: management
Definition
smoking cessation, lose weight, decrease lipidemia, control diabetes, control HTN, exercise
Term
Atherosclerosis: preventive meds
Definition
statins (improve lipoprotein profile), aspirin (prevents thrombosis), heparin (anticoagulant) and inhibitors of platelet fibrinogen receptor
Term
C reactive protein
Definition
Acute phase protein produced by liver in response to inflammation
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