Fill-In-The-Blank: these statements are conceptual; as such there may be other correct answers in addition to the ones provided.
triad describes the three elements leading to thrombosis: , , and .
Acute unilateral leg swelling is a symptom of .
Pulmonary emboli usually begin as in leg veins as a result of .
Thrombi that develop in the left appendage are frequently caused by and can lead to brain .
Atherosclerosis is the deposition of in the arterial walls.
Dissections of the coronary arteries can fill the pericardium with blood resulting in .
Congenital brain aneurysms are called aneurysms, whereas Charcot aneurysms are due to .
The primary cause of aortic aneurysms is .
Superficial dilated or veins are generally cosmetic, whereas deeper venous insufficiency can lead to and .
The skin manifestation of vasculitis is .
A common vasculitis that causes headache, scalp / jaw pain, and visual disturbances is arteritis.
Amaurosis fugax is the temporary .
A good lab test for granulomatosis with polyangiitis is . This vasculitis can cause , , and .
Vasoconstriction of extremities is called . Its primary form is typically benign and brought on by .
Benign vascular tumors are called . The infantile or "" form of this tumor increases after birth but often later.
The malignant vascular tumor is associated with solar damage, chronic lymphedema, or .
sarcoma occurs in immunosuppressed patients, but can also be geography-associated.
Multiple Choice Questions:
1) You see a patient with both renal dysfunction and bloody cough, in addition to ruling out tuberculosis, you order a C-ANCA blood test to rule out: Ankylosing Spondylitis Granulomatosis with Polyangiitis Temporal Arteritis Metastatic Angiosarcoma
Explanation: Patients with Granulomatosis with Polyangiitis can have pathology of both the lung and kidney. Bloody noses may also be evident. A C-ANCA blood test has fairly good specificity and sensitivity for this disease.
2) You see an elderly patient with scalp/jaw pain and unilateral visual changes; you suspect this patient may have: Ankylosing Spondylitis Granulomatosis with Polyangiitis Temporal Arteritis Metastatic Angiosarcoma
Explanation: Temporal (giant cell) arteritis is the most common vasculitis and leads to the symptoms mentioned, particularly in elderly patients.
3) You see a young patient that notices their fingers often turn blue/white when exposed to cold; you: Reassure the patient that although the symptoms may be concerning, the condition is benign. Follow-up with a rheumatologist for a workup for autoimmune disease Biopsy the skin to assess for a vasculopathy Test for HHV-8
Explanation: Raynaud Phenomenon is a very common constriction of the extremities due to cold or stress; It is visually always a benign condition.
4) You see a patient who complains of sudden, unilateral leg swelling after a long plane flight; you: Tell the patient to elevate the leg and follow-up in a few days (watchful-waiting) Order immediate follow-up including a vascular ultrasound to rule out a DVT Assess the patient for an femoral artery dissection Order a C-ANCA blood test
Explanation: Sudden unilateral leg swelling in this scenario is a symptom of deep venous thrombosis (DVT). DVT must be diagnosed and treated (e.g., with heparin) to avoid pulmonary embolism (a potential fatal consequence).
5) You see a patient who has the "worst headache of my life;" you: Treat the patient with thrombolytic therapy Check the patient's blood pressure and provide oral anti-hypertensive medication if necessary Order a contrast CT to see if they patient may have a hemorrhagic or thrombotic stroke Provide an analgesic and follow-up in a few days
Explanation: The patients system is a classic sign of a leaking (hemorrhagic) aneurysm, and is an emergency. Thrombolytic therapy would make the situation worse. A CT scan will help determine if the patient has a leaking aneurysm.