53 terms

Pathoma Vascular Pathology

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most common form of vasculitis in older adults, usually women
temporal (giant cell) arteritis
granulomatous vasculitis involving branches of carotid artery
temporal (giant cell) arteritis
presentation of temporal (giant cell arteritis)
1. headache (temporal artery involvement)
2. visual disturbances (ophthalmic artery)
3. jaw claudication
4. flu-like symptoms
5. polymylagia rheumatica - joint and muscle pain
treatment of temporal (giant cell) arteritis
corticosteroids
risk if you don't treat temporal (giant cell) arteritis
blindness
granulomatous vasculitis that involves aortic arch at branch points
takayasu arteritis
age group of takayasu arteritis
younger than 50 - Asian females
symptoms of takayasu arteritis
1. visual
2. neurologic
3. weak or absent pulse in upper extremity (pulseless disease)
which vasculitis conditions are ESR elevated?
temporal (giant cell) arteritis
takayasu arteritis
Medium vessel vasculitis types (3)
1. polyarteritis nodosa
2. kawasaki disease
3. buerger disease
necrotizing vasculitis involving multiple organs, but lungs are spared
polyarteritis nodosa
age group of polyarteritis nodosa
young adults
symptoms of polyarteritis nodosa
hypertension (renal artery involvement)
abdominal pain with melena (mesenteric artery involvement)
neurologic disturbances
skin lesions
associated with serum Hep B surface antigen
polyarteritis nodosa
string of pearls
polyarteritis nodosa
treatment of polyarteritis nodosa
corticosteroids and cyclophosphamide
Asian children < 4 yrs
Kawasaki disease
signs of kawasaki disease
1. fever
2. conjunctivitis
3. erythematous rash of palms and soles
4. enlarged cervical lymph nodes
treatment of kawasaki disease
aspirin and IVIG (intravenous immunoglobulin)
which artery involvement in kawasaki disease
coronary artery -> thrombosis with myocardial infarction
aneurysm with rupture
necrotizing vasculitis involving digits
buerger disease
symptoms of buerger disease
ulceration
gangrene
autoamputation of fingers and toes
Raynaud phenomenon
high risk factor fo Buerger disease
smoking
treatment of Buerger disease
cessation of smoking
Small vessel vasculitis (4)
1. Wegener Granulomatosis
2. microscopic polyangiitis
3. churg-strauss syndrome
4. henoch-schonlein purpura
necrotizing granulomatous vasculitis involving nasopharynx, lungs, kidneys
wegener granulomatosis
age group of wegener granulomatosis
middle-aged male
symptoms of wegener granulomatosis
1. sinusitis / nasopharyngeal ulceration
2. hemoptysis with bilateral nodular lung infiltrates
3. hematuria due to rapidly progressive glomerulonephritis
serum marker for wegener granulomatosis ?
c-ANCA
biopsy of wegener granulomatosis
necrotizing granulomas with adjacent necrotizing vasculitis
treatment of wegener granulomatosis
cyclophosphamide and steroids
necrotizing vasculitis involving many organs, esp. lung and kidney
microsopic polyangitis
serum markers for microscopic polyangitis
p-ANCA
treatment of microscopic polyangitis
corticosteroids + cyclophosphamide
necrotizing granulomatous inflammation with eosinophils involving multiple organs, especially lung and heart
churg-strauss syndrome
difference between churg strauss syndrome and microscopic polyangitis
churg strauss -> asthma, peripheral eosinophilia, granulomas
serum levels for churg strauss syndrome
p-ANCA
vasculitis due to IgA immune complex deposition
Henoch Schonlein Purpura
Henoch Schonlein Purpura age group
children
symptoms of Henoch Schonlein Purpura
1. palpable purpura on buttocks and legs
2. GI pain and bleeding
3. hematuria (IgA nephropathy)
usually occurs after upper respiratory infection
Henoch Schonlein Purpura
treatment of Henoch Schonlein Purpura
steroids
intimal plaque that obstructs blood flow
atherosclerosis
atherosclerosis affects which vessels?
large and medium-sized -> internal carotid, coronary, abdominal, popliteal
risk factors for atherosclerosis
modifiable -> hypertension, hypercholesterolemia, smoking, diabetes
nonmodifiable -> age, gender, genetics
complications of atherosclerosis (4)
1. stenosis of medium sized vessels -> peripheral vascular disease, angina, ischemic bowel disease
2. plaque rupture -> thrombosis -> MI, stroke
3. plaque rupture -> embolization -> cholesterol crystals in emboli
4. weakening of wall -> aneurysm
narrowing of small arterioles
arteriolosclerosis
hyaline arteriolosclerosis result of long-standing ...?
benign hypertension + diabetes
hyperplastic arteriolosclerosis result of
malignant hypertension
classic sign of hyaline arteriolosclerosis
glomerular scarring
fela-bitten appearance
hyperplastic arteriolosclerosis
2 causes of aortic dissection
high stress region + pre-existing weakness of media
symptoms of dissection
sharp, tearing chest pain that radiates to the back
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