p.46
Vasculitis: Definitions and Pathogenesis
What is the primary mechanism behind the pathogenesis of vasculitis?
Immune-mediated processes.
p.7
Risk Factors for Atherosclerosis
What is a key inflammatory marker used in assessing the risk of atherosclerosis?
C-reactive protein (CRP).
p.46
Vasculitis: Definitions and Pathogenesis
What are some causes of vasculitis?
Infectious agents, physical and chemical injury.
p.63
Aneurysms: Definitions and Types
What are aneurysms and dissections considered in terms of disease frequency?
Relatively rare diseases.
p.22
Pathogenesis of Atherosclerosis
What does the rupture or erosion of atherosclerotic plaque expose?
Highly thrombogenic substances in the necrotic core.
p.50
Vasculitis: Definitions and Pathogenesis
What is vasculitis?
An inflammation of blood vessels.
p.13
Pathogenesis of Atherosclerosis
What is the role of smooth muscle proliferation in atherosclerosis?
It converts fatty streaks into mature atheromas and contributes to the progressive growth of atherosclerotic lesions.
p.8
Pathogenesis of Atherosclerosis
What hypothesis explains the pathogenesis of atherosclerosis?
The 'Response to injury' hypothesis.
p.21
Pathology of Atherosclerosis
How can the components of atherosclerotic plaques change?
The components and their relative proportions can alter over time.
p.49
Vasculitis: Definitions and Pathogenesis
What are some examples of physical and chemical injuries that can cause vascular damage in vasculitis?
Irradiation, trauma, and toxins.
p.2
Pathogenesis of Aneurysms
What should students be able to describe regarding aneurysms?
Pathogenesis, pathology, and complications associated with aneurysms and vessel dissection.
p.24
Pathology of Atherosclerosis
What is the significance of cap thickness in pathology?
Thinner caps are more likely to erode or rupture.
p.61
Pathogenesis of Atherosclerosis
What type of pathogenesis is associated with Eosinophilic granulomatosis with polyangiitis?
Immune-mediated and ANCA-associated.
p.48
Vasculitis: Definitions and Pathogenesis
How can pathogens indirectly cause non-infectious vasculitis?
By generating immune complexes or triggering cross reactivity.
p.8
Pathogenesis of Atherosclerosis
What is the initial insult in the pathogenesis of atherosclerosis?
Injury to endothelial cells.
p.2
Pathogenesis of Atherosclerosis
What are the key aspects of atherosclerosis that students should be able to describe?
Pathogenesis, pathology, and complications.
p.14
Pathogenesis of Atherosclerosis
What type of molecule is Seteer Ann Pango?
It is a wide molecule that interacts with cholesterol.
p.2
Vasculitis: Definitions and Pathogenesis
What is expected of students concerning primary vasculitides?
To describe the pathogenesis, pathology, and complications associated with primary vasculitides.
p.24
Pathology of Atherosclerosis
What happens to a thin cap in a pathological context?
It is more likely to erode or rupture.
p.61
Pathogenesis of Atherosclerosis
What are common clinical features of Eosinophilic granulomatosis with polyangiitis?
Allergic rhinitis, asthma, and peripheral eosinophilia.
p.26
Complications of Atherosclerosis
What is a consequence of atherosclerosis that involves narrowing of blood vessels?
Atherosclerotic stenosis.
p.11
Pathogenesis of Atherosclerosis
What happens to substances due to endothelial cell dysfunction?
They can cross over the endothelium more easily.
p.10
Pathogenesis of Atherosclerosis
What are some causes of endothelial cell injury in atherosclerosis?
Hypertension, cigarette smoking, homocysteine, infectious agents, toxins, immune reactions.
p.3
Complications of Atherosclerosis
What can atherosclerosis lead to?
Complications such as heart attacks and strokes.
p.16
Pathology of Atherosclerosis
What is the macroscopic appearance of fatty streaks?
Minute yellow spots that coalesce to form streaks, not significantly raised to disturb flow.
p.55
Pathology of Atherosclerosis
What is the primary focus of Robbins and Cotran's Pathologic Basis of Disease?
The study of the pathologic basis of various diseases.
p.45
Vasculitis: Definitions and Pathogenesis
What is vasculitis?
A general term for vessel wall inflammation.
p.11
Pathogenesis of Atherosclerosis
What is the first step in the pathogenesis of atherosclerosis?
Endothelial cell dysfunction.
p.49
Vasculitis: Definitions and Pathogenesis
Are physical and chemical injuries common causes of vascular damage in vasculitis?
No, they are not as common.
p.48
Vasculitis: Definitions and Pathogenesis
What is one way pathogens cause vasculitis?
By directly invading vessel walls.
p.3
Pathology of Atherosclerosis
What are the main components of plaques in atherosclerosis?
Cholesterol, fatty substances, cellular waste products, and calcium.
p.16
Pathology of Atherosclerosis
What are fatty streaks in the context of atherosclerosis?
The earliest purported lesion of atherosclerosis, not all of which progress to atherosclerotic plaques.
p.32
Pathology of Atherosclerosis
What happens to blood flow during a rupture?
Blood goes out of the vessel.
p.32
Pathology of Atherosclerosis
What is the consequence of a rupture in a blood vessel?
It can lead to hemorrhage or reduced blood flow.
p.3
Risk Factors for Atherosclerosis
What factors contribute to the development of atherosclerosis?
Risk factors include high cholesterol, smoking, hypertension, and diabetes.
p.8
Pathogenesis of Atherosclerosis
What type of response does atherosclerosis represent?
A chronic inflammatory and healing response.
p.31
Aneurysms: Definitions and Types
What defines a true aneurysm?
It is bounded by all three vessel wall layers: intima, media, and adventitia.
p.3
Pathogenesis of Atherosclerosis
How does atherosclerosis affect blood flow?
It narrows the arteries, reducing blood flow to organs and tissues.
p.14
Pathogenesis of Atherosclerosis
What is the role of Seteer Ann Pango in relation to cholesterol?
It allows cholesterol to cross and stabilize plaque.
p.22
Pathogenesis of Atherosclerosis
What is the consequence of exposing thrombogenic substances in atherosclerotic plaque?
Thrombosis formation, which may partially or completely occlude the vessel lumen.
p.43
Aortic Dissection: Overview and Pathogenesis
How does the clinical presentation of aortic dissection often appear?
It often closely mimics myocardial infarction.
p.50
Vasculitis: Definitions and Pathogenesis
How is vasculitis classified?
By the size of the affected vessel.
p.61
Pathogenesis of Atherosclerosis
What morphological features are seen in Eosinophilic granulomatosis with polyangiitis?
Fibrinoid necrosis and granulomatous vasculitis with conspicuous eosinophils.
p.13
Pathogenesis of Atherosclerosis
What phenotype do intimal smooth muscle cells exhibit in atherosclerosis?
They have a proliferative and synthetic phenotype.
p.57
Pathology of Atherosclerosis
What surrounds the area affected by fibrinoid necrosis?
Surrounding inflammation.
p.62
Pathology of Atherosclerosis
What morphological features are associated with microscopic polyangiitis?
Necrotising vasculitis with fibrinoid necrosis and neutrophilic debris.
p.44
Vasculitis: Definitions and Pathogenesis
What is vasculitis?
Vasculitis is an inflammation of the blood vessels.
p.41
Aortic Dissection: Overview and Pathogenesis
What occurs during an aortic dissection?
Blood splays apart the laminar planes of the media to form a blood-filled channel within the aortic wall.
p.13
Pathogenesis of Atherosclerosis
What do smooth muscle cells synthesize that stabilizes plaques in atherosclerosis?
Extracellular matrix, specifically collagen.
p.31
Aneurysms: Definitions and Types
What is a false aneurysm (pseudoaneurysm)?
An extravascular hematoma that communicates with the intravascular space, where part of the vessel wall has been lost.
p.5
Risk Factors for Atherosclerosis
What are the constitutional risk factors for atherosclerosis?
Genetics, age, and gender.
p.44
Vasculitis: Definitions and Pathogenesis
What are the main types of blood vessels affected by vasculitis?
Arteries, veins, and capillaries.
p.19
Pathology of Atherosclerosis
What is the typical arrangement of atherosclerotic plaques?
Superficial fibrous cap, cellular area, necrotic core, and periphery.
p.26
Complications of Atherosclerosis
What occurs during acute plaque change in atherosclerosis?
It impedes blood flow and the plaque protrudes into the lumen, narrowing the blood vessel.
p.21
Pathology of Atherosclerosis
What often happens to long-standing atherosclerotic plaques?
They often undergo calcification.
p.9
Pathogenesis of Atherosclerosis
What is the most important cause of endothelial cell injury in atherosclerosis?
Haemodynamic disturbance, particularly in areas of turbulent flow.
p.28
Complications of Atherosclerosis
What is the most dangerous consequence of atherosclerosis?
Acute plaque change, which includes rupture, ulceration, erosion, or hemorrhage into the plaque.
p.39
Clinical Features of Aneurysms
What is the most common clinical feature of an abdominal aortic aneurysm?
Most cases are asymptomatic and discovered incidentally as a pulsating abdominal mass.
p.60
Pathology of Atherosclerosis
What is the title of the book edited by Mitchell RN and Kumar V?
Robbins and Cotran Pathologic Basis of Disease, 9th Ed.
p.45
Clinical Features of Aneurysms
What are common clinical manifestations of vasculitis?
Constitutional signs such as fever, myalgia, arthralgia, and malaise.
p.18
Pathology of Atherosclerosis
What types of cells are involved in the pathology of atherosclerosis?
Smooth muscle cells, macrophages, and T cells.
p.12
Pathogenesis of Atherosclerosis
How does chronic inflammation affect atherosclerosis?
It contributes to the initiation and progression of atherosclerotic lesions.
p.23
Pathology of Atherosclerosis
What are the acute pathological changes associated with atherosclerotic plaque?
Rupture, ulceration, or erosion.
p.20
Pathogenesis of Atherosclerosis
What is the role of collagen in the context of inflammation?
Collagen is involved in the structural integrity of tissues and can be affected during inflammation.
p.38
Pathology of Atherosclerosis
What does the term 'dilatation' refer to in the context of aortic pathology?
It refers to the abnormal enlargement of the aorta.
p.22
Pathogenesis of Atherosclerosis
What are acute pathological changes associated with atherosclerotic plaque?
Rupture, ulceration, or erosion.
p.3
Pathogenesis of Atherosclerosis
What is atherosclerosis?
A condition characterized by the buildup of plaques in the arterial walls.
p.11
Pathogenesis of Atherosclerosis
What are the consequences of endothelial cell dysfunction?
Increased permeability, leukocyte adhesion, monocyte adhesion, and emigration.
p.62
Vasculitis: Definitions and Pathogenesis
What is the pathogenesis of microscopic polyangiitis?
It is immune-mediated and ANCA-associated.
p.21
Pathology of Atherosclerosis
What is a key characteristic of plaques in atherosclerosis?
Plaques are dynamic and progressively enlarge.
p.22
Pathogenesis of Atherosclerosis
What is the role of the fibrous cap in atherosclerotic plaques?
It helps to stabilize the plaque and prevent rupture.
p.35
Pathogenesis of Aneurysms
How does the abnormal arrangement of elastic fibers affect blood vessels?
It decreases structural stability.
p.62
Clinical Features of Aneurysms
What are common clinical manifestations of microscopic polyangiitis?
Dependent on the bed affected, often including kidney issues (necrotising glomerulonephritis), haematuria, lung capillaritis (haemoptysis), or bowel pain and bleeding.
p.8
Pathogenesis of Atherosclerosis
How is atherosclerosis characterized in terms of the arterial wall?
As a chronic inflammatory and healing response.
p.31
Aneurysms: Definitions and Types
What is an aneurysm?
An abnormal vascular dilation.
p.62
Vasculitis: Definitions and Pathogenesis
How does microscopic polyangiitis respond to treatment?
It responds well to steroids.
p.16
Pathology of Atherosclerosis
What is observed microscopically in fatty streaks?
Aggregates of foamy histiocytes that are flat.
p.42
Pathology of Atherosclerosis
Who are the editors of the referenced book?
Mitchell RN, Kumar, V et al.
p.38
Pathology of Atherosclerosis
What is a key feature of the aortic bifurcate wall in relation to pathology?
It can weaken due to thrombus formation.
p.25
Pathology of Atherosclerosis
What is embolisation in the context of atherosclerosis?
Thickened wall plaque breaks off and lodges in another narrow vessel.
p.35
Pathogenesis of Aneurysms
What is a consequence of the breakdown of elastic fibers in blood vessel walls?
Structural weakness leading to aneurysm.
p.43
Aortic Dissection: Overview and Pathogenesis
What is a key difference between aortic dissection and myocardial infarction?
The intervention and treatment are completely different.
p.50
Vasculitis: Definitions and Pathogenesis
What is a common feature of some forms of vasculitis?
The formation of granulomas.
p.42
Pathology of Atherosclerosis
What is the title of the book referenced?
Robbins and Cotran Pathologic Basis of Disease, 9th Ed.
p.4
Pathogenesis of Atherosclerosis
What is atherosclerosis?
A form of arteriosclerosis characterized by wall thickening and loss of elasticity.
p.18
Pathology of Atherosclerosis
What are the three principal components of atherosclerosis pathology?
1. Cells (smooth muscle cells, macrophages, T cells), 2. Extracellular matrix (collagen, elastic fibers, proteoglycans), 3. Intracellular and extracellular lipid.
p.63
Complications of Atherosclerosis
What are the complications associated with acute plaque change in atherosclerosis?
They require recognition and treatment.
p.4
Pathogenesis of Atherosclerosis
What are the other forms of arteriosclerosis?
Arteriolosclerosis (associated with hypertension) and Monckeberg’s medial sclerosis (associated with aging, not clinically significant).
p.27
Complications of Atherosclerosis
What is a consequence of atherosclerotic stenosis?
Plaques gradually occlude vessel lumen, compromising blood flow.
p.34
Pathology of Atherosclerosis
What is a key microscopic manifestation of aneurysm pathology?
Cystic medial degeneration.
p.9
Pathogenesis of Atherosclerosis
How does hypercholesterolaemia contribute to endothelial cell injury?
It directly impairs endothelial cell function by increasing local reactive oxygen species.
p.42
Pathology of Atherosclerosis
What is the publisher of the referenced book?
Elsevier Saunders, Philadelphia.
p.59
Pathogenesis of Aneurysms
What type of pathogenesis is Granulomatosis with polyangiitis associated with?
Immune-mediated and ANCA-associated.
p.27
Complications of Atherosclerosis
What is considered 'critical stenosis'?
When occlusion causes a 70% decrease in cross-sectional area, leading to stable angina.
p.27
Complications of Atherosclerosis
What specific organ can be affected by mesenteric occlusion?
The bowel, leading to bowel ischaemia.
p.30
Aortic Dissection: Overview and Pathogenesis
What is aortic dissection?
A serious condition where the inner layer of the aorta tears, causing blood to flow between the layers of the aorta.
p.44
Vasculitis: Definitions and Pathogenesis
How is vasculitis diagnosed?
Through blood tests, imaging studies, and sometimes biopsy.
p.54
Clinical Features of Aneurysms
What are common clinical symptoms of Takayasu arteritis?
Ocular and neurologic disturbances, constitutional symptoms.
p.27
Complications of Atherosclerosis
What is ischaemic encephalopathy?
A condition that can occur in the brain due to atherosclerosis.
p.44
Vasculitis: Definitions and Pathogenesis
What are potential complications of untreated vasculitis?
Organ damage and increased risk of stroke or heart attack.
p.6
Risk Factors for Atherosclerosis
What lifestyle factors contribute to hyperlipidaemia?
Exercise, obesity, and cigarette smoking.
p.40
Clinical Features of Aneurysms
What respiratory issue can arise from a thoracic aortic aneurysm?
Respiratory difficulties due to encroachment on the lungs and airways.
p.30
Clinical Features of Aneurysms
What symptoms might indicate an aortic dissection?
Sudden severe chest or back pain, often described as a tearing sensation.
p.52
Pathology of Atherosclerosis
What morphological features are associated with giant cell arteritis?
Granulomatous vasculitis with elastic tissue fragmentation and multinucleated giant cells.
p.52
Pathology of Atherosclerosis
Which vessels are primarily affected in giant cell arteritis?
Temporal arteries (head) and the aorta.
p.33
Pathogenesis of Aneurysms
What happens when the vasa vasorum are stenosed in relation to aneurysms?
It can lead to ischemia of the outer media, affecting vessel dilation.
p.41
Aortic Dissection: Overview and Pathogenesis
What are the two main patient populations affected by aortic dissection?
Men aged 40-60 years with hypertension and younger patients with connective tissue diseases that have cystic medial degeneration.
p.46
Vasculitis: Definitions and Pathogenesis
How does vasculitis commonly manifest?
It can occur quickly and may affect various blood vessels.
p.41
Aortic Dissection: Overview and Pathogenesis
In which directions can an aortic dissection extend?
Proximally towards the heart or distally towards the aortic bifurcation.
p.7
Risk Factors for Atherosclerosis
What are the components of metabolic syndrome?
Central obesity, insulin resistance, hypertension, dyslipidemia, hypercoagulability, and a proinflammatory state.
p.46
Vasculitis: Definitions and Pathogenesis
Is vasculitis more common in men or women?
It is more common in men.
p.41
Aortic Dissection: Overview and Pathogenesis
What can happen if an aortic dissection ruptures through the adventitia?
It can cause massive intra-abdominal/thoracic hemorrhage or cardiac tamponade, leading to sudden death.
p.23
Pathogenesis of Atherosclerosis
Why is plaque stability clinically important?
Medications can contribute to plaque stabilization.
p.17
Pathology of Atherosclerosis
How does atherosclerosis affect the vessel wall?
It causes patchy and eccentric involvement.
p.7
Risk Factors for Atherosclerosis
What lipid abnormalities are associated with metabolic syndrome?
Elevated LDL and depressed HDL.
p.12
Pathogenesis of Atherosclerosis
What components are involved in the formation of atherosclerotic plaques?
Lipids, smooth muscle cells, inflammatory cells, and extracellular matrix proteins.
p.6
Risk Factors for Atherosclerosis
How does diabetes mellitus affect atherosclerosis?
It induces hypercholesterolaemia, accelerating atherosclerosis.
p.30
Pathology of Atherosclerosis
How can aneurysms be diagnosed?
Through imaging techniques such as ultrasound, CT scan, or MRI.
p.54
Pathology of Atherosclerosis
What are the histological features of Takayasu arteritis?
Intimal and adventitial fibrosis with luminal narrowing.
p.56
Pathology of Atherosclerosis
What morphological changes occur in acute lesions of polyarteritis nodosa?
Fibrinoid necrosis of vessel walls with associated neutrophils.
p.17
Pathology of Atherosclerosis
What are the main components of atherosclerotic plaque?
Lipid accumulation and intimal thickening.
p.39
Complications of Aneurysms
What serious complication can occur from an abdominal aortic aneurysm?
Rupture into the peritoneal cavity or retroperitoneal tissues with massive, potentially fatal hemorrhage.
p.18
Pathology of Atherosclerosis
What components make up the extracellular matrix in atherosclerosis?
Collagen, elastic fibers, and proteoglycans.
p.55
Pathology of Atherosclerosis
What is efibrosis?
A process involving the formation of fibrous tissue, often in response to chronic inflammation.
p.39
Complications of Aneurysms
What is the risk of rupture in an abdominal aortic aneurysm related to?
The size of the aneurysm.
p.18
Pathology of Atherosclerosis
What role do lipids play in atherosclerosis pathology?
They exist in both intracellular and extracellular forms and vary in proportions in each lesion of the plaque.
p.34
Pathology of Atherosclerosis
What happens to the elastic material in the vessel media during aneurysm pathology?
There is a loss of elastic material.
p.18
Pathology of Atherosclerosis
How do varying proportions of components in atherosclerosis lesions affect complications?
They determine the risk of complications.
p.5
Risk Factors for Atherosclerosis
What is a significant characteristic of atherosclerosis in terms of its progression?
It is a progressive process that remains silent for a long time.
p.27
Complications of Atherosclerosis
What peripheral condition can result from atherosclerosis?
Peripheral vascular disease, which causes intermittent claudication.
p.54
Pathology of Atherosclerosis
What type of vasculitis morphology is seen in Takayasu arteritis?
Granulomatous vasculitis with elastic tissue fragmentation and multinucleated giant cells.
p.40
Clinical Features of Aneurysms
What swallowing difficulty can occur due to a thoracic aortic aneurysm?
Difficulty in swallowing due to compression of the esophagus.
p.58
Pathology of Atherosclerosis
What type of inflammation is seen in Kawasaki disease?
Transmural inflammation with fibrinoid necrosis of the vessels.
p.40
Clinical Features of Aneurysms
What type of pain can be caused by a thoracic aortic aneurysm?
Pain caused by erosion of bone (i.e., ribs and vertebral bodies).
p.47
Vasculitis: Definitions and Pathogenesis
What is notable about the presence of immune complexes in ANCA-associated vasculitis?
There is a paucity of immune complexes.
p.52
Complications of Atherosclerosis
What can happen if giant cell arteritis is not treated promptly?
It can lead to permanent complications, including blindness.
p.6
Risk Factors for Atherosclerosis
What is a major modifiable risk factor for atherosclerosis?
Hyperlipidaemia (hypercholesterolaemia).
p.5
Risk Factors for Atherosclerosis
How is genetics related to atherosclerosis?
It is often polygenic, with family history being very important; specific inherited conditions like familial hypercholesterolaemia are strongly associated.
p.23
Pathogenesis of Atherosclerosis
What factors contribute to the risk of atherosclerotic plaque changes?
Intrinsic factors (plaque structure and composition) and extrinsic factors (blood pressure, platelet activity, vessel spasm).
p.6
Risk Factors for Atherosclerosis
Which type of lipoprotein is specifically increased in hyperlipidaemia?
Low-density lipoprotein (LDL).
p.5
Risk Factors for Atherosclerosis
At what age does atherosclerosis typically manifest clinically?
Usually between 40 to 60 years old.
p.23
Pathology of Atherosclerosis
What contributes to plaque stability?
Less inflammation, more collagen, and less lipid.
p.55
Pathology of Atherosclerosis
What is a common feature of chronic inflammation?
The presence of giant cells.
p.7
Risk Factors for Atherosclerosis
How does lifestyle affect hemostasis in relation to atherosclerosis?
Certain lifestyle factors can decrease clotting and influence atherosclerosis.
p.51
Types of Vasculitis and Their Clinical Manifestations
What is Kawasaki disease?
A medium vessel vasculitis.
p.39
Complications of Aneurysms
What can cause embolism in the context of an abdominal aortic aneurysm?
Atheroma or mural thrombus.
p.12
Pathogenesis of Atherosclerosis
What is the effect of T-cells in the context of atherosclerosis?
They release inflammatory cytokines that activate macrophages and stimulate smooth muscle proliferation.
p.30
Complications of Atherosclerosis
What are the potential complications of an aneurysm?
Rupture, which can lead to severe internal bleeding and death.
p.40
Clinical Features of Aneurysms
What persistent symptom may result from a thoracic aortic aneurysm?
Persistent cough due to compression of the recurrent laryngeal nerves.
p.36
Pathogenesis of Aneurysms
How does trauma contribute to aneurysm development?
It can directly damage blood vessel walls.
p.31
Aneurysms: Definitions and Types
What is dissection in the context of vascular pathology?
Blood entering the arterial wall itself, dissecting between the layers.
p.9
Pathogenesis of Atherosclerosis
What happens to lipoproteins (LDL) in the intima during atherosclerosis?
They accumulate and are oxidized by free radicals, becoming toxic to endothelial cells, smooth muscle cells, and macrophages.
p.12
Pathogenesis of Atherosclerosis
What triggers chronic inflammation in atherosclerosis?
Accumulation of cholesterol crystals and free fatty acids in macrophages and other cells.
p.51
Types of Vasculitis and Their Clinical Manifestations
What condition is classified as Takayasu arteritis?
A large vessel vasculitis.
p.6
Risk Factors for Atherosclerosis
What is the effect of high-density lipoprotein (HDL) in relation to atherosclerosis?
Reduced levels of HDL are a risk factor.
p.5
Risk Factors for Atherosclerosis
How does gender affect the risk of atherosclerosis?
Premenopausal women are relatively protected, but post-menopausal women see an increase in incidence that approaches that of males.
p.60
Pathology of Atherosclerosis
What type of investigation is mentioned in relation to Cavinatra?
Histo micro investigation.
p.33
Pathogenesis of Aneurysms
How does Vitamin C deficiency affect aneurysm pathogenesis?
It leads to defective collagen cross-linking.
p.7
Pathogenesis of Atherosclerosis
What role does inflammation play in atherosclerosis?
It is intimately linked with the pathogenesis of atherosclerosis.
p.27
Complications of Atherosclerosis
What are the symptoms of intermittent claudication?
Chest pain with exertion relieved by rest, similar to angina but in leg muscles.
p.23
Complications of Atherosclerosis
What can result from thrombus formation in relation to atherosclerotic plaques?
Occlusion of the vessel lumen.
p.51
Types of Vasculitis and Their Clinical Manifestations
What is microscopic polyangiitis?
A type of small vessel vasculitis.
p.44
Vasculitis: Definitions and Pathogenesis
What can cause vasculitis?
Infections, autoimmune diseases, and certain medications.
p.59
Pathogenesis of Aneurysms
What are the three main components of the triad in Granulomatosis with polyangiitis?
Granulomatous inflammation in respiratory tracts, necrotising vasculitis in small vessels, and renal disease in the form of glomerulonephritis.
p.9
Pathogenesis of Atherosclerosis
What is the effect of oxidized LDL on the body?
It is recognized as non-self, leading to an immune response.
p.12
Pathogenesis of Atherosclerosis
What role do innate immune receptors play in atherosclerosis?
They activate the production of pro-inflammatory cytokine IL-1, which recruits and activates leukocytes.
p.4
Pathogenesis of Atherosclerosis
What diseases does atherosclerosis underlie?
Coronary, cerebral, and peripheral vascular disease.
p.59
Pathogenesis of Aneurysms
How are granulomas related to necrotising vasculitis in Granulomatosis with polyangiitis?
Granulomas are usually separate from the necrotising vasculitis.
p.40
Epidemiology of Aneurysms
Which syndromes are increasingly associated with thoracic aortic aneurysms?
Marfan syndrome and Loeys-Dietz syndrome.
p.39
Complications of Aneurysms
What adjacent structures can be impinged upon by an abdominal aortic aneurysm?
Structures such as the ureter or vertebrae.
p.56
Clinical Features of Aneurysms
What are common clinical symptoms of polyarteritis nodosa?
Non-specific symptoms, often remitting and relapsing.
p.37
Pathology of Aneurysms
What does the intimal surface of an abdominal aortic aneurysm show?
Severe atherosclerotic disease.
p.47
Vasculitis: Definitions and Pathogenesis
What do ANCA release that contributes to inflammation?
Proteolytic enzymes and reactive oxygen species.
p.36
Pathogenesis of Aneurysms
What role does vasculitis play in aneurysm formation?
It can weaken blood vessel walls.
p.51
Types of Vasculitis and Their Clinical Manifestations
What is an example of a large vessel vasculitis?
Giant cell temporal vasculitis.
p.60
Pathology of Atherosclerosis
Who are the editors of the 9th edition of Robbins and Cotran Pathologic Basis of Disease?
Mitchell RN, Kumar V et al.
p.20
Pathogenesis of Atherosclerosis
What does a necrotic center in a lesion indicate?
It indicates tissue death, often due to lack of blood supply.
p.19
Pathology of Atherosclerosis
What types of cells are found in the cellular area beneath the fibrous cap?
Macrophages, T cells, and smooth muscle cells.
p.20
Pathogenesis of Atherosclerosis
What is the relationship between lipids and cardiovascular disease (CVD)?
High levels of lipids can contribute to the development of CVD by forming plaques.
p.56
Vasculitis: Definitions and Pathogenesis
What is the pathogenesis of polyarteritis nodosa?
It is immune-mediated, with one third associated with immune complex deposition.
p.19
Pathology of Atherosclerosis
What is neovascularization in the context of atherosclerosis?
Proliferating small vessels at the periphery of the plaque.
p.47
Vasculitis: Definitions and Pathogenesis
What condition can cause vascular deposition of circulating antigen-antibody complexes?
Systemic lupus erythematosus.
p.1
Pathology of Atherosclerosis
Which institution is Dr. Adam Botha affiliated with?
University of the Witwatersrand / National Health Laboratory Service.
p.47
Vasculitis: Definitions and Pathogenesis
What leads to vascular injury in immune complex-associated vasculitis?
Complement activation and recruitment of inflammatory cells.
p.47
Vasculitis: Definitions and Pathogenesis
What are Antineutrophil cytoplasmic antibodies (ANCA) associated with?
A heterogeneous group of autoantibodies that activate neutrophils.
p.40
Complications of Aneurysms
What cardiac issue can result from a thoracic aortic aneurysm?
Aortic valve dilation with valvular insufficiency or narrowing.
p.40
Complications of Aneurysms
What are the three common complications of thoracic aortic aneurysms?
Rupture, dissection, and cardiac disease.
p.37
Aneurysms: Definitions and Types
What is an abdominal aortic aneurysm?
An aneurysm located below the renal arteries and above the bifurcation of the aorta.
p.19
Pathology of Atherosclerosis
What composes the superficial fibrous cap in atherosclerosis?
Smooth muscle cells and collagen.
p.63
Aneurysms: Definitions and Types
What is necessary for managing aneurysms and dissections?
Emergent therapy due to disastrous complications.
p.58
Pathogenesis of Aneurysms
What is the pathogenesis of Kawasaki disease?
Immune-mediated, involving anti-endothelial cell antibodies.
p.44
Vasculitis: Definitions and Pathogenesis
What are common symptoms of vasculitis?
Fever, fatigue, weight loss, and muscle pain.
p.59
Pathogenesis of Aneurysms
What type of renal disease is associated with Granulomatosis with polyangiitis?
Necrotising often crescentic glomerulonephritis.
p.19
Pathology of Atherosclerosis
What is found in the necrotic core of an atherosclerotic plaque?
Lipid, foam cells, fibrin, and thrombus.
p.33
Pathogenesis of Aneurysms
What defect is associated with Ehlers-Danlos syndrome that contributes to aneurysm formation?
Defective collagen III synthesis.
p.58
Clinical Features of Aneurysms
What is another name for Kawasaki disease?
Muco-cutaneous lymph node syndrome.
p.51
Types of Vasculitis and Their Clinical Manifestations
Name a small vessel vasculitis.
Granulomatosis with polyangiitis (Wegener granulomatosis).
p.52
Complications of Atherosclerosis
How does giant cell arteritis respond to treatment?
It responds well to steroids.
p.28
Complications of Atherosclerosis
What can occur following acute plaque change in atherosclerosis?
Partial or complete vascular thrombosis.
p.33
Pathogenesis of Aneurysms
What is a key factor in the pathogenesis of aneurysms?
Poor intrinsic quality of vessel matrix.
p.45
Vasculitis: Definitions and Pathogenesis
How is vasculitis usually classified?
By pathogenesis and size of vessel affected.
p.27
Complications of Atherosclerosis
What condition can atherosclerosis cause in the heart?
Chronic ischaemic heart disease.
p.45
Vasculitis: Definitions and Pathogenesis
What is a common consequence of vasculitis affecting blood vessels?
Ischaemia of downstream organs.
p.47
Vasculitis: Definitions and Pathogenesis
What type of vasculitis is associated with the deposition of antigen-antibody complexes?
Immune complex-associated vasculitis.
p.30
Pathogenesis of Aneurysms
What are common causes of aneurysms?
High blood pressure, atherosclerosis, and genetic conditions.
p.33
Pathogenesis of Aneurysms
What role do matrix metalloproteinases play in aneurysm pathogenesis?
Increased activity by inflammatory cells can contribute to aneurysm formation.
p.52
Pathology of Atherosclerosis
What type of fibrosis is observed in giant cell arteritis?
Intimal and adventitial fibrosis with luminal narrowing.
p.30
Complications of Atherosclerosis
What is the treatment for a ruptured aneurysm?
Emergency surgery is often required to repair the vessel.
p.56
Pathology of Atherosclerosis
What characterizes healed lesions in polyarteritis nodosa?
Marked fibrotic thickening of the artery.
p.4
Pathogenesis of Atherosclerosis
What characterizes atherosclerosis?
Elevated intimal plaques composed of lipids, proliferating smooth muscle cells, inflammatory cells, and increased extracellular matrix.
p.40
Aneurysms: Definitions and Types
What are the types of aneurysms based on their location?
Thoracic aortic aneurysm.
p.63
Vasculitis: Definitions and Pathogenesis
Why is it important to recognize and diagnose vasculitides?
Because of easily administered therapy and good outcomes with prompt treatment.
p.39
Complications of Aneurysms
What can happen if a vessel branching off from the aorta is obstructed?
Ischemic injury to the supplied tissue, such as the iliac, renal, mesenteric, or vertebral arteries.
p.20
Pathogenesis of Atherosclerosis
What can completely block off a lumen in blood vessels?
Clotting or plaque buildup.
p.54
Clinical Features of Aneurysms
What is referred to as 'pulseless disease' in Takayasu arteritis?
Weakening of upper limb perfusion.
p.58
Clinical Features of Aneurysms
What are some clinical presentations of Kawasaki disease?
Conjunctival and oral erythema, erosions, erythema of palms and soles, desquamative rash, and cervical lymph node involvement.
p.33
Pathogenesis of Aneurysms
What imbalance contributes to aneurysm development?
Imbalance in matrix synthesis and degradation.
p.56
Complications of Atherosclerosis
What is the prognosis for untreated polyarteritis nodosa?
It is fatal, but 90% achieve remission with immunosuppressives.
p.47
Vasculitis: Definitions and Pathogenesis
What are autoendothelial cell antibodies associated with?
Specific vasculitides, such as Kawasaki disease.
p.45
Vasculitis: Definitions and Pathogenesis
What can be affected by vasculitis?
Vessels of any type and virtually any organ.
p.17
Pathology of Atherosclerosis
What is the appearance of atherosclerotic plaques macroscopically?
White-yellow encroachment on the lumen.
p.30
Aneurysms: Definitions and Types
What is an aneurysm?
An abnormal bulge or dilation in the wall of a blood vessel.
p.52
Pathogenesis of Aneurysms
What type of immune response is involved in giant cell (temporal) arteritis?
T-cell mediated immune response.
p.52
Clinical Features of Aneurysms
What are the common clinical symptoms of giant cell arteritis?
Headache, facial pain, ocular symptoms (50% risk of blindness), and constitutional symptoms.
p.6
Risk Factors for Atherosclerosis
How can diet influence hyperlipidaemia?
Through cholesterol and saturated fat intake.
p.34
Pathology of Atherosclerosis
What is a characteristic feature of aneurysms regarding stability?
They do not have stability.
p.23
Pathology of Atherosclerosis
What characterizes a vulnerable plaque?
Increased inflammation, less collagen, and a larger lipid core.
p.23
Pathogenesis of Atherosclerosis
What effect does adrenergic stimulation have on atherosclerotic plaques?
It causes blood pressure spikes, local vasoconstriction, and platelet activation.
p.37
Pathology of Aneurysms
What type of thrombus is found within an abdominal aortic aneurysm?
A bland, poorly organized thrombus.
p.33
Pathogenesis of Aneurysms
What happens to smooth muscle cells in the context of aneurysms?
Loss of medial smooth muscle cells or changes in their synthesis.
p.33
Pathogenesis of Aneurysms
How can ischemia affect the inner vessel media in aneurysms?
Thick atherosclerotic plaques can impede blood flow, leading to ischemia.
p.47
Vasculitis: Definitions and Pathogenesis
What type of diagnostic tests are available for ANCA-associated vasculitis?
Helpful serological diagnostic tests to detect circulating ANCA.
