What does rupture of a berry aneurysm lead to?
stroke
Aortic aneurysm, ascending
Tertiary syphilis
Where do berry aneurysms occur?
At the bifurcations in the Circle of Willis
What is the most common complication of a berry aneurysm?
Rupture of the aneurysm
What is the most common site for a berry aneurysm?
The bifurcation of the anterior communicating artery
Worst headache of my life
Berry aneurysm - associated with adult polycystic kidney disease
Aneurysm, dissecting
HTN
How does syphilis change the aorta?
Causes dilation of the aorta and valve ring. Can result in aortic aneurysm or aortic valve incompetence
Anti-neutrophil antibodies (ANCAs)
Vasculitis
Vasculitis
Temporal arteritis (risk of ipsilateral blindness due to thrombosis of ophthalmic artery)
What is Wegner’s granulomatosis?
Focal necrotizing vasculitis and granulomas in the lung and upper airway with necrotizing glomerulonephritis
What is Buerger’s disease?
Known as smoker’s disease and thromboangitis obliterans; idiopathic, segmental, thrombosing vasculitis of intermediate and small peripheral arteries and veins.
What is temporal arteritis?
Vasculitis that affects medium and small arteries, usually branches of the carotid artery.
PR3-ANCA
Wegener granulomatosis
MPO- ANCA
- microscopic polyangiitis
- Churg- Strauss syndrome
MPO- ANCA
- Anti-myeloperoxidase
- lysosome granule
- (p-ANCA)
PR3-ANCA
- Antiproteinase-3
- neutrophil azurophilic granules
- (c- ANCA)
What are the signs of polyarteritis nodosa?
- Cotton wool spots
- Microaneurysms
- Pericarditis
- Myocarditis
- Palpable purpura
- Elevated ESR
- P-ANCA positive serum
What is an association of polyarteritis nodosa?
Hepatitis B infection (30% of patients)
What is the treatment of polyarteritis nodosa?
Corticosteroids, azathioprine, and/or cyclophosphamide
What is polyarteritis nodosa?
Necrotizing immune complex inflammation of small or medium-sized muscular arteries, typically involving renal or visceral vessels.
Polyarteritis nodosa clinical:
- malaise, fever, weight loss
- hypertention due to renal artery involvement
- abdominal pain and bloody stools caused by vascular gastrointestinal lesions
- diffuse muscular aches and pains
- peripheral neuritis
- predominantly affecting motor nerves
