Beaver Flashcards
40 year old male presents with upper respiratory lesions from inflammatory sinusitis. It resulted from mucosal granuolomas, which were also seen as nodules in the lungs. He also showed evidence of renal disease. What is likely present with active disease?
c-ANCA (cytoplasmic staining of granulocytes)
What is the exteremely common result of many forms of heart disease? It can lead to diminshed cardiac output and damming of blood back into the peripheral venous system.
Heart failure
What do you see with the liver and portal system in congestive heart failure?
liver is increased in SIZE and WEIGHT –> see congestive hepatomegaly
What causes the increases liver size in right sied CHF?
elevated pressure in the portal vein –> can lead to tense, congested nutmeg liver
In what population, besides men between 40 and 60, is the dissection of blood between and along planes of media + formation of blood filled channel in aortic wall leading to massive hemorrhage common?
common with connective tissue abnormalities that affect the aorta like with Marfan Syndrome
With an aortic dissection, an the onset of excruciating pain the chest that radiates to the back, what is the most common cause of death and what can occur from a retrograde dissection?
- cause of death = rupture outward into any of the 3 body cavities
- retrograde dissection INTO aortic root can cause disruption of AORTIC VALVULAR APPARATUS
After an aortic dissection, what microscopic findings would you see?
- most frequent PRE-EXISTING LESION = cystic MEDIAL degeneration
- see loss and fragmentation of ELASTIC and FIBROMUSCULAR ELEMENTS in the MEDIA
- medial degenration often occurs w/Marfan syndrome
Granulomatous vasculitis of MEDIUM and LARGER arteries that occurs in females younger than 40. May see low blood pressure, weak pulses in upper extremities, ocular disturbances, and neurological deficits.
Takayasu Arteritis
The most common AIDs associated cancer, Kaposi Sarcoma, has lesions that are often infected with which virus?
human herpesvirus 8 (HHV-8)
- sexually transmited
- establishes latent form of infection
After an MI, cardiac troponin (T and I) are released. they are the most sensitive and specific markers - they regulate calcium mediated contraction of cardiac and skeletal muscle. When do you find troponins in circulation?
- not found RIGHT after MI
- rise at 2-4 hours - peak at 48 hours
- remains elevated for 7-10 days after acute event
What complications do you see with an MI?
- Half of deaths occur within 1 hour
- sudden death due to ventricular fibrillation
-
rupture of ventricular free wall
- 3-7 days after onset - lateral wall most common
- more common w/anterior wall
- older than 60, female, hypertension, no hypertrophy
- usually fatal
Most likely causative organism of acute endocarditis in an IV drug abuser. Often destructive, tumultuous infection frequently of normal heart valve. leads to death within days.
S. aureus
Common cause of subacute endocarditis. typically organism of low virulence that causes infection in previously abnormal heart valve.
Streptococcus viridans
myocarditis is an inflammatory process caused by viruses that can lead to myocardial injury. The heart may be normal or dilated. What do we see histologically?
interstitial inflammatory infiltrate (predominantely lymphocytic) and focal necrosis of MYOCYTES adjacent to the inflammatory cells
Hypertrophic cardiomyopathy causes heart to be THICK walled, HEAVY, and HYPERCONTRACTING - primary dysfunction is disatolic. Some complications include afib, infective endocarditis, ventricular arrythmias AND….
sudden death in young athletes - most common cause of unexplained death in them
What morphologic changes are seen with Takayasu Arteritis
- unvolvement of aortic arch
- irregular thickening
- see mononuclear infiltrate - may see giant cells
