Pathology 2 - Block 1 - Part 1

davidwurbel7's version from 2016-06-06 02:51

Vascular Pathology

Question Answer
Consists of single layer of endothelial cells. Separated by internal elastic laminaIntima
Consists of smooth muscle cells. Outer portion of media is separated by external elastic laminaMedia
Consists of connective tissue with nerve fibers and vasa vasorum. Lies externallyAdventitia
Blood vessels contained in the adventitia of larger blood vessels such as the aorta and pulmonary trunkVasa Vasorum
Supplies the outer part of the tunica media and the tunica adventitiaVasa Vasorum
Supplies the tunica intima and the inner part of the tunica mediaLuminal Blood Flow


Question Answer
Media is rich in elastic fibersLarge or Elastic Arteries
Aorta, and its large branchesLarge or Elastic Arteries
Coronary and renal arteriesMedium Sized or Muscular Arteries
Media is chiefly composed of smooth muscle cellsMedium Sized or Muscular Arteries
The ones within the substance of tissues and organsSmall Arteries and Arterioles
Have an endothelial lining but no media. Blood flow is very slow. Well suited for exchange of diffusible substances between blood and tissuesCapillaries
Have larger diameter, larger lumens and less well organized walls. Predisposed to irregular dilatations, compression, and easy penetration by tumor cells. Have valves that prevent backflow of bloodVein
Thin walled, endothelial lined channels. Drain interstitial fluid and inflammatory cells back to blood. Important pathway for spread of bacteria and tumor cellsLymphatic Vessel
Carcinomas generally spread by these vesselsBlood Vessels
Sarcomas generally spread by these vesselsLymphatic Vessels
Leukocyte extravasation and vascular leakage occurs in this part of a capillary bedPostcapillary Venules


Question Answer
C5a, Leukotrieme B4 and IL-8 are the chemoattractants for thisNeutrophils
Superficial Migratory Thrombophlebitis is associated with this conditionMucus-Producing Metastatic Cancers
Mucor, Asperguillus, and Canadida infect the blood vessel wall causing this in blood vesselInflammation
Pathological change in the blood vessel causing stenosis or obstruction leading to theseIschemia/Infarction
Pathological change in the blood vessel causing weakening of blood vessel wall leading to theseAneurysm/Dissection/Rupture
The most common embolism is this formThromboemboli
Deposition of lipid in the wall of the arteryAtherosclerosis
Hardening of arteries due the deposition of material (calcium, lipid, other) in the wall of the blood vesselArteriosclerosis
A group of diseases that result in thickening and loss of elasticity of arterial wallsArteriosclerosis
Disease characterized by calcium deposits in muscular arteriesMonckeberg Medial Calcific Sclerosis
Monckeberg Medial Calcific Sclerosis usually occurs in these arteriesMuscular Arteries
Hardening of the walls of small arteries and arteriolesArteriolosclerosis
Refers to pink, glassy appearance of arterial wall under microscopyHyaline
Increased protein is deposited in the arteriole vessel wall that occludes the lumenHyaline Arteriolosclerosis
Hyaline Arteriolosclerosis that occurs in association with this condition is due to non-enzymatic glycosylation of protein in the basement membrane renders them permeable to plasma proteinsDiabetes Mellitus
Hyaline Arteriolosclerosis that occurs in association with this condition is due to increased intraluminal pressure pushes plasma proteins into the wall of the arterioleBenign Hypertension
This condition occurs in association with this malignant hypertension and progressive systemic sclerosis (scleroderma)Hyperplastic Arteriolosclerosis
Smooth muscle proliferation resulting in wall thickening and luminal narrowingHyperplastic Arteriolosclerosis
Protein accumulation causing hyaline arteriolosclerosis leading to the narrowing of the lumen. This leads to ischemic damage to the kidney causing loss of renal parenchyma. This change in the kidney is referred to as thisBenign Nephrosclerosis
Acute increase in blood pressure causes smooth muscle cell proliferation in an onion skin pattern in renal arterioles leads to this conditionHyperplastic Arteriolosclerosis


Question Answer
A disease of large elastic and medium sized muscular arteries characterized by formation of atheromas deposited in the intima of arteriesAtherosclerosis
Atherosclerosis is most common in this blood vesselAbdominal Aorta
The initial lesion of atherosclerosis is thisFatty Streak
The characteristic lesion of atherosclerosis is thisAtheroma
This part of an atheroma is composed of smooth muscle cells and collagen fibersSuperficial Cap
This part of an atheroma intercellular and extracellular lipids, foamy macrophages, necrotic cells and cholesterol crystalsNecrotic Center
This superficial cap of an atheroma is covered by these cells in the blood vesselEndothelial Cells
This inflammatory cells are present in the necrotic centerLymphocytes
Blood vessels that form within an atheroma to supply the living lymphocytes and macrophages with the necrotic centerNeovascular Blood Vessel
An atheroma with a lot of macrophages producing MMPs will produce this type of atheromaUnstable Atheroma
When a blockage in an artery reaches 70%, the blockage is termed this if pain occurs when demand exceeds supplyCritical Blockage
Ischemic pain in the lower leg due to exertionClaudication
Leg pain that comes on with exertion and is relieved by restIntermittent Claudication
The theory for the formation of an atheroma that is most favored is this theoryReaction to Injury Theory
CMV and Herpes simplex virus and chlamydia have been isolated in these in blood vesselsAtheroma
Plaques have densely collagenous and thickened fibrous caps with minimal inflammation and negligible underlying atheromatous coreStable Plague
Plaques characterized by thin fibrous caps, large lipid cores, and increased inflammationVulnerable Plague
A measure of the risk of future MI can be measured by thisC-RP Level
Index measure of the amount of inflammationC-RP Level
Risk factors of Age, Male gender and Family history are this type of risk factor for atherosclerosisNon-Modifiable Risk Factors
Risk factors of Hyperlipidemia, Hypertension, Cigarette smoking and Diabetes mellitus are this type of risk factor for atherosclerosisModifiable Risk Factors
Risk factors of Hyperhomocystinemia, C-Reactive proein, Obesity, Physical inactivity, Stress (type A personality), High carbohydrate intake and Chlamydia pneumoniae infection are this type of risk factor for atherosclerosisMinor Risk Factors
A value of >160 mg/dL enhances the risk of atherosclerosisLDL Cholesterol
A value of <35mg/dL decreases the risk of atherosclerosisHDL Cholesterol


Question Answer
Localized abnormal dilations of arteries and heart chambersAneurysm
A syphilitic aneurysm is usually located hereArch of the Aorta
An aneurysm arising due to infection by either a fungus or bacteriaMycotic Aneurysm
An AAA is usually caused by thisAtherosclerosis
Sac-like shaped aneurysmSaccular Aneurysm
Barrel shaped aneurysmFusiform Aneurysm
The most common aneurysm is this aneurysmAbdominal Aortic Aneurysm
A pulsatile mass can be palpated. Abrupt onset of severe back pain is followed by hypotension are the symptoms of thisAbdominal Aortic Aneurysm Rupture
This is the gold standard test to diagnose an Abdominal Aortic AneurysmAbdominal Ultrasound
Obstruction of the arteries composing the vasa vasorumEndarteritis Obliterans
Endarteritis obliterans of the vasa vasorum will lead to thisSyphilitic Aortic Aneurysm
This organism can infect the vasa vasorum of the aorta leading to endarteritis oblitereansTreponema pallidum
"Tree-barking“ of aorta is due to this of injuries to the wall of the aortaFibrosis
Result from weakening of the vessel wall due to a microbial infectionMycotic Aneurysm
Mucor, Aspergillus and Candida can infect blood vessel wall causingFungal Vasculitis
Small spherical aneurysms most commonly located at the bifurcation of cerebral vesselsBerry Aneurysm
These can rupture and lead to fatal subarachnoid hemorrhageBerry Aneurysm
(Insert 18-26)

Aortic Dissection

(Insert 1-4)
Question Answer
The basis of this condition is weakening of the aortic mediaAortic Dissection
This condition results in hyaline arteriolosclerosis of vasa vasorum causing decreased flow causes atrophy of media leading to aortic dissectionHypertension
Genetic condition that leads to weakness of connective tissue of tunica mediaMarfan and Ehlers Danlos Syndromes
The change in the tunica media are characterized by focal loss of elastic and muscle fibers in tunica media which leads to “cystic” spaces filled with myxoid materialCystic Medial Degeneration
Glycosaminoglycans are also calledMyxiod
The "cystic" spaces in cystic medial degeneration is filled with thisGlycosaminoglycan
This usually occurs Usually within 10 cm of aortic valveIntima Tear
Dissection involves ascending aorta with or without the descending aortaType A Aortic Dissection
Most common and worst type of aortic dissectionType A Aortic Dissection
Dissection that begins below the subclavian artery and does not involve the ascending aortaType B Aortic Discection
Clinical finding include acute onset of severe retrosternal pain radiating to the back*. Pain described as tearing*. AV regurgitation: due to aortic valve ring dilation; a radiograph or echocardiogram shows widening of the aortic valve root. Loss of upper extremity pulse: compression of the subclavian arteryAortic Dissection
This can occur into the pericardial sac (tamponade most common cause of death), pleural cavity or peritoneal cavityRupture

Vascular Tumors and Tumor Like Conditions

Question Answer
Hemangioma, Lymphangioma, Glomus tumor, Reactive vascular proliferations, Bacillary angiomatosis and Vascular ectasias are categorized as this type of vascular conditionBenign tumors, Developmental and Acquired Conditions
Kaposi sarcoma and Hemagioendothelioma are categorized as this type of vascular conditionIntermediate Grade Neoplasms
Angiosarcoma and Hemangiopericytoma are categorized as this type of vascular conditionMalignant Neoplasms
Temperature receptor found near blood vessels that regulator blood flow based on temperatureGlomus Body
These are benign tumor/hamartoma of mature small capillary channels. Locations: skin, mucous membrane and viscera composed of closely packed capillary sized thin walled vesselsCapillary Hemangiomas
This is a variant of capillary hemangioma. Commonly seen on the face in new born. Slightly raised, bright red, lobulated vascular tumors. Grow rapidly for a few months and begin regressing at age 1-3 years. 80% totally gone by 8 years. No treatment necessaryStrawberry (Juvenile Capillary) Hemangiomas
Composed of large vascular channels. MC benign tumor of the liver/spleen and placenta. May rupture in liver/spleen. Association with von-Hippel-Lindau diseaseCavernous Hemangiomas
The most common benign blood vessel tumor in adults. Appear during third or fourth decade of life. Do not regress spontaneously. Number increases with age. Always occur on the skin and appear as small bright red papular lesions. Composed of congested capillaries and post capillary venulesCherry Hemangioma
A benign, extremely painful tumor. Location in digits below the nail beds (subungual). Tumors usually less than 1 cm to pin point size. Composed of masses of glomus cellsGlomus Tumor
A potentially fatal infectious disease. Caused by Bartonella henselae and Bartonella quintana. The bacteria induce proliferation of small blood vessels. Occurs as opportunistic infection in AIDS patientsBacillary Angiomatosis
Red nodular masses composed of capillary proliferations. Look like lesions of Kaposi Sarcoma. Have numerous neutrophils, nuclear dust and purplish granular material. Can be located on the skin, lymphnodes and visceral organsBacillary Angiomatosis
A malignant tumor derived from endothelial cells. MC cancer in AIDS. Due to Herpes virus 8 (HHSV-8)Kaposi Sarcoma
Lesion may occur anywhere - Skin (MC location), mucous membrane, LN, viscera. Begins as painful purple or brown to red solitary to multiple lesions, progress from flat lesion to plaque to nodular to ulcer. Microscopy shows lesion are composed of sheets of spindle cells creating slit-like vascular channels with areas of microhemorrhages and hemosiderin deposits.Kaposi Sarcoma
Highly malignant tumors derived from the vessel endothelium. Composed of anaplastic endothelial cells with or without vascular channels. Metastasize widely and frequently fatalAngiosarcoma
Associated with exposure to vinyl chloride (plastic manufacturer), arsenic (pesticides), throtrast (radio contrast material)Liver Angiosarcoma
Angiosarcoma positive for this endothelial cell markerCD31
Tumor composed of lymphatic channels resembling capillariesSimple Lymphangioma
Tumor that occur in the neck or axilla in children. Composed of dilated lymphatic channels filled with lymphic fluidCavernous lymphangioma (cystic hygroma)
Malignant tumor arising from endothelial cell of lymph vesselsLymphangiosarcoma
A group of conditions characterized by localized dilations of preexisting vesselsVascular Ectasias
Dilation of preformed vessels creating a focal red lesion usually located on skin or mucous membraneTelangiectasia
Ordinary birth mark. Pink to blue flat lesions ( on head and neck). Dilation of dermal vessels; often regressesNevus Flammeus
A variant of nevus flammeus that does not regressPort Wine Stain
Genetic condition with port wine stain in the distribution of the ophthalmic branch of trigeminal nerve. CNS vascular abnormalities located in the leptomeninges, The vessels calcify (look like rail road track). Bleed: Focus of seizure activity. Mental retardationSturge-Weber Syndrome
MC genetic vascular disorder. Characterized by dilated vessels on skin and mucous membranes in mouth and GI tract. Presents with epistaxis, hematemesis, or GI bleed.Hereditary Hemorrhagic Telangiectasia
Hereditary hemorrhagic telangiectasia is also know as thisOsler-Weber-Rendu Disease
A red dot in the center with reddish extensions radiating out for some distance around it. Most common on the face and trunk. Associated with hyperestrinism (high estrogen levels) in women and cirrhosis in menSpider Angioma