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SS- Cardio > Cardiac Tumors and Misc. > Flashcards

Cardiac Tumors and Misc. Flashcards

1
Q

cardiac Raynaud

A

blood vessel hyper-reactivity causing vasospasm

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2
Q

Takotsubo cardiomyopathy

A

broken heart syndrome

vasospasm caused by extreme stress (emotional), myocardial ischemia, MI, or sudden death due to arrhythmia

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3
Q

prinzmetal angina

A

less than 50, Japan
variant angina
episodes of angina pectoris at rest
ST elevation

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4
Q

contraction band necrosis

A

reperfusion of dead myocardium, coronary artery vasospasm
cardiac myocytes that run out of ATP and then are exposed to an influx of Ca: enhances actin-myosin interaction causing hyper contraction and cells that cannot relax

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5
Q

venous stasis dermatitis

A

female, standing, obesity, Hx DVT, farm. Hx of venous disease
erythematous, scaling, eczematous patches affecting lower extremities
HEMOSIDERIN accumulation
MEDIAL ANKLE

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6
Q

venous stasis ulcers

A

MEDIAL ANKLE over perforating vein (along great or small saphenous vein)
irregular border, tender, shallow, exudative, granulation base

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7
Q

esophageal varices

A

increased blood flow to the veins of the gastro-esophageal junction

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8
Q

caput medusae

A

dilation of periumbilical veins of the abdominal wall

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9
Q

hemorrhoids

A

increased blood flow in veins of rectum

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10
Q

Trousseau syndrome

A

migratory thrombophlebitis

malignant tumors secrete procoagulant factors causing thrombosis

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11
Q

inferior vena cava syndrome

A

neoplasms or thrombus that compress or invade inferior vena cava
hepatocellular and renal cell carcinoma grow in veins: can occlude
Sx: lower extremity edema, distention of superficial collateral veins of lower abdomen

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12
Q

deep vein thrombosis

A

common, increases if male and older
can be fatal if embolizes
association: cancer, hospital, surgery
proximal: popliteal and above, associated with pulmonary emboli
distal: calf
Dx: asymmetry between legs over 2 cm, D dimer
PROLONGED IMMOBILIZATION

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13
Q

Homans sign

A

forcefully dorsiflex foot
calf pain: + for DVT
not very sensitive
can send embolus to lung

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14
Q

superior vena cava

A

neoplasms compress or invade superior vena cava
ex: bronchogenic carcinoma or mediastinal lymphoma
marked dilatation of veins in head, neck, arms associated with cyanosis

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15
Q

chylothorax

A

lymph from digestive system accumulates in pleural cavity causing pleural effusion

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16
Q

Sturge-Weber syndrome

A

encephalotrigeminal angiomatosis
facial port wine nevi, ipsilateral venous angiomas in corticol leptomeninges
mental retardation, seizures, hemiplegia, radiopacities of skull

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17
Q

Osler-Weber-Rendu disease

A

autosomal dominant
hereditary hemorrhagic telangiectasia (present at birth and wide distribution)
mutation in TGF-B pathway in endothelial cells
Sx: epitaxis, GI bleed hematuria when lesions rupture

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18
Q

hemangioma

A

tumor of blood vessels

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19
Q

pyogenic granuloma

A

granulation tissue type hemangioma

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20
Q

lymphangioma

A

lymph tumor

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21
Q

bacillary angiomatosis

A

looks like Kaposi

Cause: Bartonella Henselae (cat scratch)

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22
Q

Kaposi sarcoma

A

HHV-8
tumors on the borderline of benign and malignant
viral G protein induces VEGF, viral cyclin D drives proliferation, multiple KSHV proteins inhibit p53

23
Q

angiosarcoma

A

cancer of lining of blood vessels

24
Q

stent

A

tube put inside some tubular structure in the body to keep it open

25
Q

portal hypertension

A

leads to opening of portal systemic shunt
increased flow in veins causes: esophageal varices, hemorrhoids, caput medusae
cause: liver cirrhosis
ESOPHAGEAL VARICES prone to rupture

26
Q

Classic Kaposi sarcoma

A

Mediterranean, Middle Eastern, Eastern European, older men
associated with malignancy or altered immunity
asymptomatic red-purple plaques in distal lower extremities that spread proximally, localized to skin\red-purple macules composed of dilated irregular endothelial cell lined vascular spaces with lymphocytes, plasma cells, macrophages-> larger raised plaques spread proximal with spindle cells, extravasated erythrocytes, hemosiderin-laden macrophages-> nodules with hemorrhage
Tx: radiation and chemo
good prognosis

27
Q

Endemic African Kaposi sarcoma

A

younger than 40

indolent or aggressive course

28
Q

Transplant-associated Kaposi

A

solid organ transplants with T cell immune suppression
aggressive involving lymph nodes, mucosa, viscera
Tx: attenuation of immunosuppresion at risk of organ rejection

29
Q

AIDS associated Kaposi

A

2-3% of AIDS patients
involves lymph nodes and disseminates to viscera early in course
Tx: anti-retrovirals

30
Q

arterial ulcers

A

painful, punched out or stellate, surrounding skin is red and taut
ulcer is pale or has black or yellow eschar

31
Q

cardiac arrhytmia

A

disturbance in electrical signaling for coordinated cardiac myocyte contraction

32
Q

long QT syndromes

A

phase 2
early after-depolarization
left ventricle
causes: ischemic heart disease, low K, Ca, Mg, chanelopathy, etc.
complication: ventricular tachycardia
presents in childhood: syncope or sudden death

33
Q

Brugada syndrome

A

autosomal dominant: Na channel blunted: shortened or failed AP
young asian males
phase 2
re-entry
right ventricle
present at 40 yrs: syncope or sudden cardiac death due to ventricular tachycardia esp. in SLEEP
abnormal EKG at rest
elevated ST descending with upward convexity to inverted T wave in V1-V3
Tx: ICD

34
Q

catecholeminergic polymorphic ventricular tachycardia

A

genetic
phase 4
delayed after-afterdepolarization
left ventricle
mutations in RYANODINE receptor: high cystolic Ca leaked from SR, get PVT with high levels of catecholamines
present in childhood: syncope, sudden cardiac death due to ventricular tachycardia during extreme PHYSICAL or EMOTIONAL STRESS
Tx: ICD or beta blockers

35
Q

cardiomyopathy

A

diverse group of heart disease primarily involving myocardium
classified by function and structure: can move from one functional category to another

36
Q

dilated cardiomyopathy

A

impaired contractility and systolic function

when structural classification: idiopathic (some due to myocarditis or alcohol)

37
Q

hypertrophic cardiomyopathy

A

when structural classification: autosomal dominant
impaired compliance and diastolic function
Do NOT confuse with hypertensive heart disease

38
Q

restrictive cardiomyopathy

A

impaired compliance and diastolic function

cause: amyloidosis (and others)

39
Q

alcoholic cardiomyopathy

A

dilated cardiomyopathy due to alcohol

40
Q

arrhymogenic right ventricular cardiomyopathy

A

disease due to mutations in genes encoding desmosomal proteins
second hit: enteric viral infection of right heart
re-entrant ventricular tachycardia originating from right ventricle related to abnormalities in myocyte adhesion
FATTY replacement of myocytes
EKG: epsilon wave (notch in terminal QRS most prominent in V1
Tx: ICD

41
Q

myocarditis

A

infectious agents and/or inflammatory processes primarily target myocardium
VIRAL most common
can occur in Lyme disease
can get hypersensitivity myocarditis
complications: acute HF and dilated cardiomyopathy
Sx: asymptomatic to dyspnea, fatigue, pain, fever, arrhythmia, etc.

42
Q

cardiac myxomas

A

rare, females, left atrium
benign gelatinous mesenchymal neoplasms of the endocardium
Sx: dyspnea, cough, transient neurological symptoms fatigue, FEVER (produce IL-6)
signs: loud S1, diastolic rumble, diastolic tumor plop, holosystolic murmur
other: orthopnea, hemoptysis, syncope
complication: mitral obstruction, embolization, MI, sudden death
Dx: echo
Tx: surgical excision

43
Q

rhabdomyomas

A

most frequent pediatric heart tumor, preferentially in ventricles
most regress spontaneously
discovered in 1st year due to obstruction in heart
cause:
1. sporadic mutation
2. tuberous sclerosis with mutations in TSC1/2 (hamartin and tuberin) tumor suppressor genes that inhibit mTOR
SPIDER cells

44
Q

most common primary sites of cardiac metastases

A

lung and breast, melanomas, leukemias, lymphomas
retrograde lymphatic extension hematagenous seeding, direct contiguous extension, venous extension
usually silent or nonspecific features: defect in contractility or compliance

45
Q

heart transplant rejection

A 
lots of inflammatory cells
arteriopathy is the most important limitation (will need new transplant eventually): inflammatory cells attack intima and thicken it
dx: endomyocardial biopsy
tx: more immunosuppression
complication: silent MI (denervated)
46
Q

ventricular tachycardia adults

A

cause: ischemic heart disease (old MI)
re-entry around scar, usually monomorphic
complicatoin: sudden death

47
Q

normal QT

A

less than or equal 440ms

48
Q

congenital long QT syndrome type 1 (LQT1)

A

loss of function in depolarizing outward K channel (Iks)

49
Q

congenital long QT syndrome type 2 (LQT2)

A

loss of function in depolarizing outward K channel (Ikr)

50
Q

congenital long QT syndrome type 3 (LQT3)

A

inward Na channel fails to close or inactivate (Ina)

51
Q

torasades de pointes

A

polymorphic ventricular tachycardia typical of congenital long QT syndrome
early after depolarization from multiple sites
twisted ribbon
Tx: ICD

52
Q

asteroid body

A

cytoplasmic inclusion in giant cells of granulomas

seen in: SARCOIDOSIS, TB, leprosy, fungal infection, schistosomiasis, foreign body

53
Q

cardiac sarcoidosis

A

noncaseating granulomas in heart
favors base of heart and often involves conduction system
complications: arrhythmias, HF, sudden death

SS- Cardio (16 decks)

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