Section 1
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Asian women <40 years old
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Last updated
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Date created
Mar 1, 2020
Cards (133)
Section 1
(50 cards)
Asian women <40 years old
Takayasu Arteritis is most commonly found in what population
Polyarteritis Nodosa; pink in the wall represents the fibrinoid necrosis
Increased p-ANCA
Key Finding in Churg-Strauss Syndrome
Vasopasm of arteries cause episodes of reduced blood flow -> causing discoloration of fingers and toes
Raynaud's Phenomena
Elevated p-ANCA (In Wegner Granulomatosis, c-ANCA is elevated)
Key Finding in Microscopic Polyangiitis
c-ANCA levels increased
What is a key finding of Wegner Granulomatosis
Coronary Artery
Kawasaki's Disease affects what artery mainly
Visual and Neurologic Symptoms Weak or absent pulse in upper extremities (radial pulse) -Cold arms, discrepant b/w arms
Symptoms of Takayasu Arteritis
Headache (Temporal Artery) Tender temporal area, firm & nodular temporal artery Visual Disturbances (Ophthalmic Artery) --> double vision Jaw Claudication Facial pain --> loss of taste Flu-like symptoms Polymyalgia Rheumatica - proximal muscle pain, morning stiffness
Symptoms of Temporal Arteritis
Polyarteritis Nodosa Kawasaki's Disease Buerger's Disease
What are examples of Medium-Vessel Vasculitis
Corticosteroids
Treatment of Takayasu Arteritis
Arteries of the digits - tibial and radial arteries
Buerger's Disease/Thromboangitis obliterans affects what arteries
ESR is >100
What is a key finding in Temporal Arteritis
Elevated ESR
Key Finding in Takayasu Arteritis
Smoking
Buerger's Disease is mainly associated with
Inflamed Vessel Wall with Giant Cells and Intimal Fibrosis
Biopsy of Temporal Arteritis shows
Fibrinoid Necrosis
Early lesion in Polyarteritis Nodosa is classified as
Intima (Endothelial Cells) Media (Smooth Muscle) Adventitia (Connective Tissue)
What are the three layers of the arterial wall
Necrotizing vasculitis involving most organs
Polyarteritis Nodosa
Aortic Arch at branch points
Takayasu Arteritis affects what arteries
"String of Pearls" Appearance
After healing, how does a Polyarteritis Nodosa present on imaging
Corticosteroids and Cyclophosphamide
Treatment of Polyarteritis Nodosa
Ulceration, Gangrene, Autoamputation of the Toes middle aged heavy smokers
Presentation of Buerger's Disease
Asian Children <5 years old
Kawasaki's Disease affects what population
Branches of the Carotid Arteries -Temporal and other cranial arteries of the head
Temporal (Giant Cell) Arteritis affects what arteries
Raynaud's Phenomena
Patients with Buerger's Disease generally also have what other disease present
Cyclophosphamide and Steroids
Treatment of Wegner Granulomatosis
Lungs
What organ is spared in Polyarteritis Nodosa
Corticosteroids
Treatment of Temporal Arteritis
Cyclophosphamide and Steroids
Treatment of Microscopic Polyangiitis
Granulomas can be seen in Churg-Strauss Syndrome, not Microscopic Polyangitis Eosinophilia can be found in Churg-Strauss Syndrome, not Microscopic Polyangitis
What is the main difference between Churg-Strauss Syndrome and Microscopic Polyangitis
Large-Vessel Vasculitis Medium Vessel Vasculitis Small-Vessel Vasculitis
What are the three categories of Vasculitis
Nasopharynx, Lungs, Kidneys
Wegner Granulomatosis affects arteries to what organs
Thrombosis Aneurism w/ Rupture
Complications of Kawasaki's Disease
Serum HBsAg
What is a key clinical finding in Polyarteritis Nodosa
>50 years old (elderly) Women > Men
Temporal (Giant Cell) Arteritis is most commonly found in what population
Temporal Arteritis
Asthma Allergic rhinitis Peripheral Eosinophilia
Presentation of Churg-Strauss Syndrome
Large Necrotizing Granulomas w/ adjacent necrotizing vasculitis
Biopsy of Wegner Granulomatosis generally reveals
Aspirin (inhibits CXO2 -> formation of TXA2) IV Immunoglobulin
Treatment of Kawasaki's Disease
Irreversible Blindness
What is a major complication of Temporal Arteritis
Wegner Granulomatosis Microscopic Polyangiitis Churg-Strauss Syndrome Henoch-Schonlein Purpura
What are examples of Small-Vessel Vasculitis
Lung and Kidneys
Microscopic Polyangiitis involves arteries going to what organs
Fever, weakness, weight loss Renal Disease --> HTN and renal lesions Abdominal pain with melana Neurologic disturbances Tender subQ nodules & palpable purpura Skin lesions Commonly: Abd pain & mononeuritis multiplex
Clinical Symptoms of Polyarteritis Nodosa
Lungs and Heart
Churg-Strauss Syndrome involves arteries to what organs
No Nasopharyngeal Involvment No Granulomas
What are the main differences between Microscopic Polyangiitis and Wegener Granulomatosis
Vasculitis due to IgA immune complex deposition
Henoch-Schonlein Purpura (HSA) is caused by
Pt is middle aged adults (~ 40 y/o) Sinusitis/otitis media* nasal ulceration** Saddle nose eye inflammation* Hemoptysis w/ Bilateral Node Infiltrates Hematuria due to Rapidly Progressing Glomerulonephritis
Presentation of Wegner Granulomatosis
High Fever for >5 days Conjunctivitis Strawberry tongue - oral lesions Erythematous, Patchy Rash of Palms and Soles Peeling in genital area Enlarged Cervical Lymph Nodes
Presentation of Kawasaki's Disease
Temporal (Giant Cell) Arteritis Takayasu Arteritis
What are the two main types of Large Vessel Vasculitis
Section 2
(50 cards)
Stenosis of medium sized vessels Plaque rupture with thrombosis Plaque rupture with embolism Weakening of vessel wall
What are the major complications of Atherosclerosis
Hypertension due to an identifiable etiology
Secondary Hypertension
Myocardial Infarction or a Stroke
Plaque rupture with thrombosis can lead to
Ischemic Bowel Disease
Stenosis of mesenteric arteries can lead to
Aneurysm
Weakening of a vessel wall can lead to
Large arteries
Atherosclerosis involves
"Onion Skin" appearance
Characteristic of Hyperplastic Arteriolosclerosis
Calcification of the media of muscular medium sized arteries
Monckeberg Medial Calcific Sclerosis
Intimal plaque that obstructs blood flow
Atherosclerosis
Developmental defect of the blood vessel wall, resulting in irregular thickening of large and medium sized arteries, especially the renal artery
What is Fibromuscular Dysplasia
Hypertension with unknown etiology (Risk Factors used as causes)
Primary Hypertension
Proteins leaking into the vessel wall, producing vascular thickening
Hyaline Arteriolosclerosis
Damage to the endothelium allows lipids to leak into the intimata -> lipids are oxidized and then consumed by macrophages -> inflammation and healing leads to deposition of EC matrix and proliferation of smooth muscle
Pathogenesis of Atherosclerosis
> 180/120 mm Hg
Malignant Hypretension is usually defined as
Small Arterioles
Arteriosclerosis involves
ulnar and radial arteries
Monckeberg Medial Calcific Sclerosis affects what arteries?
Reduced vessel caliber with end-organ ischemia
Hyaline Arteriolosclerosis causes
Glomerular Scarring (Arteriolonephrosclerosis) progresses into Chronic Renal Failure
What is the prime example of Hyaline Arteriolosclerosis causing end-organ ischemia
BP > 140/90
Systemic Hypertension is defined as
IgA Nephropathy
Hematuria in HSA is caused by
Hypertension Hypercholesterolemia Smoking Diabetes
What are modifiable risk factors of atherosclerosis
Atherosclerosis Fibromuscular Dysplasia
What are some causes of Renal Artery Stenosis
HSA is usually self-limited, will reserve by itself
Abdominal Aorta Coronary Arteries Poplietal Arteries Internal Carotid Artery
What arteries are most commonly affected by Atherosclerosis
Increased risk in African Americans, Decreased risk in Asian Americans
Race Factors in Hypertension
Intimal tear with dissection of blood through media of the aortic wall
Aortic Dissection
Upper Respiratory Infection; increased IgA secretion in response to the infection
Henoch-Schonlein Purpura (HSA) usually follows what; why?
Systemic Hypertension can be either Primary (95%) or Secondary (5%)
Hyperplasia of smooth muscle causes thickening of vessel wall (in response to acute increase in BP)
Hyperplastic Arteriolosclerosis (necrotizing arteriolitis)
Fibrinoid necrosis of the vessel wall Acute Renal Failure (compared to Chronic Renal Failure of Hyaline Arteriolosclerosis)
Hyperplastic Arteriolosclerosis causes
Malignant Hypertension
Hyperplastic Arteriolosclerosis is most commonly caused by
Narrowing of small arterioles
Arteriolosclerosis
Thickening of the blood vessel wall
Arteriosclerosis
Clinically silent, damages vessels and organs over time
Benign Hypertension
Acute Organ Damage such as Acute Renal Failure, Headache, and Papilledema
Malignant Hypertension can present with
Atherosclerosis Arteriolosclerosis Monckberg Medial Sclerosis
What are the three patterns of Arteriosclerosis
Pink hyaline
Characteristic of Hyaline Arteriolosclerosis
Stenosis decreases blood flow to the glomerulus -> JGA responds to decrease volume by secreting Renin -> Renin converts Angiotensinogen to Angiotensin 1 -> Angiotensin 1 is converted to Angiotensin II by ACE -> ATII raises BP ->
How does Renal Artery Stenosis cause Hypertension?
Hyaline Arteriolosclerosis Hyperplastic Arteriolosclerosis
What are the two categories of Arteriolosclerosis
Cholesterol Clefts in an Atherosclerotic Emboli
Stress Pre-Existing Weakness of the Media Layer
What are two conditions that must be there for an Aortic Dissection to occur
Calcifications of breast vasculature as seen on mammogram
Long-standing benign hypertension (squeezes protein across vessel wall) or Diabetes (glycosylation of vessel wall allows protein to leak in)
Hyaline Arteriolosclerosis is most commonly caused by what? why?
Increased Renin Unilateral Atrophy of Kidney
Clinical Findings in Hypertension causes Renal Artery Stenosis
Angina
Stenosis of coronary arteries can lead to
Palpable purpura on the buttocks and legs GI Pain and Bleeding Acute glomerulonephritis --> Hematuria
Presentation of Henoch-Schonlein Purpura (HSA)
Section 3
(33 cards)