Cardiovascular Pathology Flashcards
1
Q
In an MI, what is the extent of infarction dependent on?
A
the degree of collateral circulation
2
Q
What are the ACUTE sequelae of an MI?
A
severe angina acute CHF with dyspnea cardiogenic shock dysrrhythmias sudden death
3
Q
What are the subacute sequelae of an MI (several days to 2 weeks out)?
A
mural thormbosis with risk of embolism
left ventricular rupture
peri-infarct pericarditis
4
Q
What are all the possibilities of a left ventricular rupture?
A
can rupture the free wall leading to fatal hemopericardium
can rupture th epapillary muscle leading to flail/regurgitant mitral valve
can rupture the septal wall leading to acute VSD
5
Q
What are the crhonic sequelae of an MI?
A
left ventricular aneurysm if large enough = chronic CHF decreased LV ejection fraction secondary RV CHF post-cardiac injury syndrome (Dressler's pericarditis)
6
Q
Sudden death in atherosclerotic coronary disease has greatest risk with what? Presumably due to what?
A
with acute coronary occlusion
stable chronic atherosclerotic disease is also an issue
presumably due to sudden and fatal ventricular dysrrhythmia from ischemic aggravation to the conduction system
7
Q
Chronic systemic arterial hypertension will lead to what in the heart?
A
concentric left ventricular hypertrophy with eventual LV dilatation and failure (CHF)
note - cardiac hypertrophy from any cause carries an increased risk of sudden death
8
Q
What is pure right-sided hypertensive heart disease caused by?
A
cor pulmonale - due to chronically increased pulmonary artery pressure from COPD, fibrosis, chronic hypoxia from sleep apnea, or any pulmonary vascular disease with recurrent rhomboemboli
9
Q
Why does chronic hypoxia lead to cor pulmonale?
A
hypoxia induces vasoconstriction in the lungs (because the lungs want to shunt the blood to regions it can be oxygenated)
this leads to pulmonary hypertension
10
Q
Are the majority of clinically significant valve disease on the right or left side of the heart?
A
left side, so mitral and aortic valve
11
Q
What are the two most commonly valve issues in developed countires? Developing countries?
A
developed = calcific aortic stenosis and mitral valve prolapse
developing = rhyematic fever valvulitis with mitral stenosis
12
Q
What valve issue is caused by infectious endocarditis acutely?
A
valvular regurgitation
13
Q
What effect on the valves can long-standing connective tissue diseases like RA take?
A
the autoimmune inflammation extends form the joints to valve surfaces leading to stenosis or regurgitation
14
Q
What sort of valve issue can be seen secondary to thoracic aortic aneurysm or dissection and why?
A
aortic valve regurgitation
It stretches the valve ring so the leaflets cannot close the entire thing and you get regurg
(same concept with dilatation from CHF)
15
Q
What is the definition of cardiomyopathy?
A
an intrinsic myocardial disease NOT associated with ischemic, valvular, hypertensive or structural congenital heart disease
16
Q
What are the three clinical types of cardiomyopathies?
A
dilated
hypertrophic
restrictive
17
Q
What are some of the cuases of cardiomyopathy?
A
myocarditis - esp viral
drugs effects - alcohol, Doxorubicine
hemochromatosis
amyloidosis
18
Q
Essentially 100% of hypertrophic cardiomyopathis are what from?
A
genetic causes
19
Q
Pericardial disease is clinically dominant and life-threatening in what two situations?
A
- increased pericardial sac fluid critically compresses the heart in tamponade
- progressive pericardial space fibrosis critically compresses the heart in constrictive pericarditis
20
Q
What is the most common primary cardiac tumor in adults?
A
atrial myxoma
21
Q
Where do atrial myxomas usually form?
A
left atrium
22
Q
What is the most serious clinical sequelae of an artial myxoma?
A
prolapse into and obstruction of AV valves or systemic embolization
23
Q
What is the most common primary tumor in children?What disease?
A
rhabdomyomas in tuberous sclerosis
24
Q
What part of the heart is the most common location for metastases from other areas?
A
pericardium (mets to the myocardium are very uncommon)
25
What is the most deadly primary cardiac tumor?
cardiac sarcoma
| super rare though
26
What are the three categories of congenital heart disease?
left to right shunts
right to left shunts
obstructive anomalies
27
What are the "don't misses" of chest pain?
```
MI
PE
dissection
pneumo
pneumonia
esophageal rupture
```
28
What are the "don't misses" of dyspnea?
```
foreign body obstruction
anaphylaxis
bronchospam from asthma
acut epulmonary edema
pulmonary embolism
pneumothorax
tamponade
pneumonia
shock from massive hemorrhage
poisoning or toxic metabolic effect on CNS respiratory control center
```
29
What are some causes other than MI for an elevated troponin?
CHF, myocarditis, pericarditis, PE
30
To be clinically useful, how high does a BNP have to be?
over 400
| between 100-400 it's not very specific
31
What is the one-month mortality rate of acute myocardial infarction?
30%
32
After the acut ephase of a coronary occlusion, what happens to the lumen in time/
recanalization
33
When can you start to see evidence of MI on autopsy histology?
12 hours post mI
34
What is the magic time limit to stop irreversible injury to the heart?
30 mintues (probably less)
35
What are the general causes of stenosis?
```
valvulitis - from RF, SLE, RA
calcific degenerative changes
congenital deformity
carcinoid syndrome
or radiation
```
36
What are the potential causes of primary valve regurgitaiton?
```
bacteiral endocardictis
chronic valvulitis from RF, AS or symphillis
myxomatous degeneration
congenital deformity
radiation
```
37
What are some causes of valve regurgitation where the disease affects valve-supporting structures?
papillary rupture post MI
choral rupture (MVP or endocarditis)
annulus dilatation from ventricular dilatation
aortic root dilatation from aneuryms or dissection
38
What is the MOST COMMON acquired valvular disease in the US?
calcific aortic stenosis
39
what is calcific aortic stenosis related to?
age-related atherosclerosis of aortic vavle cusps with secondary nodular calcification leading to stenosis
occurs on either a previously normal valve or a conginitally bicuspid vvalve
40
What is a bicuspid valve and what else is the concern with one?
you have only 2 cusps instead of 3, so you have premature or accelerated aortic stenosis due to flow abnormalities
can also be associated with aortopathy - aortic root dilatation or dissectioN!
41
What are some early clinical features of calcific aortic stenosis? late features?
early - angina, dyspnea, syncope
| late - LV decompensation with CHF or sudden death
42
Who typically has mitral valve polapse
3% of US adults - usually women (typically an indicental finding)
43
What causes mitral valve prolpase usually?
myxomatous degeneration/ballooning of the mitral valve leaflets with elongation and thinning of the chordae tendinae
44
What are some complications of artificial valves?
thromboembolism
infective endocarditis
structural deterioration
intravascular hemolysis
45
What are the two acute, life-threatening valve diseases that require urgent replacement?
1. acute aortic regurgitation from acute bacterial endo, acutely dilation aortic rot from dissection, or traumatic aortic valve rupture from non-penetrating chest trauma
2. acute mitral regurgitation wtih acute pulmonary edema form papillary musle or chordae rupture, acute bacterial endo or blunt chest trauma
46
What sort of vegetations can arise from hypercoagulable states?
non-bacterial thrombotic endocarditis with bland thrombi on cardiac valves (cancer, sepsis)
47
Of the three types of cardiomyopathies, which have LV systolic dysfuction and which have diastolic dysfunction?
dilated - systolic dysfunction (decreased EF)
hypertrophic - diastolic dysfunction (imparied relaxation with preserved EF)\
restrictive - diastolic dys with usually non-dilated, non-hypertrophic ventricles
48
What are some causes of dilated cardiomyopathy?
```
genetic
myocarditis (esp viral)
alcohol use
doxorubicine
hemochromatosis
peripartum
idiopathic
```
49
What age group is most often affected by dilated CM and how fatal is it?
20-50
| 50% mortality within 2 years - increased risk of mural thrombi
50
What is the treatment for dilated CM?
supportive heart failure measures and LV assist device
| transplant
51
What are the mutations in hypertrophic CM (in general)
60-70% are autosomal dominant defects in sarcomeric contractile protein genes
52
What ventricle is usually thickened in hypertrophic CM?
left (but sometimes right0
53
Specifically, what is thickened in hypertrophic CM?
the interventricular septum is asymmetrically thickened in the subaortic or basal region - the entire ventricle isn't always hypertrophied as in hypertension
54
What symptoms will you see in hypertrophic CM?
```
exertional dyspnea
myocardial ischemia even wihtout CAD
eventual ventricular failure
ventricular arrhythmias
sudden death
```
55
What is the treatment for hypertrophic CM?
beta blockers to decrease HR and contractility
| occasionally partial septal ablation
56
Describe restrictive CM?
non-dilated and usually non-hypertrophied ventricles with impaired ventricular filling (diastolic dusfunciton) due to primary decrease in VENTICULAR COMPLIANCE
57
How does restrictive CM tend to manifest early on?
as right heart failrue
58
Where is restrictive CM most common and dur to what?
in the tropics where it's a frequence cause of death due to endomyocardial fibrosis
59
What are some causes of restrictive CM?
idiopathic/familial, amyloidosis, diabetic CM, sarcoidosis, radiation fibrosis, doxorubicin, metabolite deposition from inborn errors of metabolism, hypereosinophilic syndrome (loeffler's endo), and endocardial fibroelastosis of childnood
60
What is arrhythmogenic right ventricle cardiomyopathy?
it's a rare CM with autosomal dominent inheritence where you get a markedly thinned right ventricular wall with fibroadipose tissue replacment leading to RV failure and conduction disturbances
61
If arrhythmogenic right ventricle cardiomyopathy is associated with palmar or planta hyperkeratosis, what is it called?
naxos syndrome
62
What is another name for stress-induced CM?
apical ballooning syndrome: takotsubo CM
63
What causes stress-induced CM?
transient systolic dysfunction due to myocardial stunning from stress-induced catecholamine surge - can present with ischemic heart sx with foci of myocardial necrosis
64
What type of CM is typically associated with hemochromatosis?
dilated type - excess hemosiderin induces myocyte toxicity
65
Transferrin stauration over what is hemochromatosis?
over 45%
66
What are the two types of CM that can be caused by cardiotoxic chemo drugs like doxorubicin and daunorubicin?
dilated or restrictive
67
What stain will show amyloidosis causing CM?
congo red
68
What organs are typically affected by amyloidosis?
heart - CHF
kidney - neprhotic syndrome
nerves - perpheral neuropathy
skin
69
What will EKG look like in amyloidosis CM? Echo?
EKG will have low voltage and possible conduction blocks
| ECHO with increased ventricular thicness and non-dilated LV cavity
70
how d ou diagnos amyloidosis/
tissue biopsy
71
What parasite attacks the heart in chagas disease?
trypanosoma cruzi
72
Besides the heart, what does chaga disease attack?
the esophagus - paralyzes them and dilates
73
what's the worst myocarditis to have?
giant cell myocarditis - nothing can be done at this point
74
What are the four disease categories of pericardial disease?
1. acute.recurrent pericarditis
2. pericardial effusiont without tamponade
3. cardiac tamponae
4. constrictive pericarditis
75
At what level of mls does pericardial effusion start to impair cardiac filling? AKA when does it become tamponade?
200-300 cc acutely (but can get over 1000 cc chronically)
76
What will the symptoms be with tamponade?
hypotension, soft or absent heart sounds, jugular venous distention and other signs of heart failure like dyspnea and hepatic engorgment
77
What are the common causes of tamponade?
neoplastic effusion
purulent pericarditis
uremia
acute/idiopathic pericarditis
78
What is the most likely to cause FATAL tamponade
retrograde aortic dissection with intrapericardial rupture
ruptured acute MI
penetrating chest wounds
79
What is the most common pericardial disorder?
acute pericarditis
80
While acute pericarditis is usually a benign viral infection in developed countires, what are some things that can cause it in developing countries?
HIV?AIDS
| TB
81
What are some of the iseus with chronic/recurrent pericarditis and effusion?
you can get a chronic constrictive pericarditis which leads to impaired ventricular filling
may mimic restrictive CM
82
What is the treatment for constrictive pericarditis? OPtions for chronic pericarditis?
constrictive pericarditis - pericardial resection
chronic pericarditis - pericardial surgical window or installation of sclerosing agents to obliterate the pericardial space
83
Myxomas are the most common primary cardiac tumors - usually left atria of adult females. WHat does it look like on path?
myxoma cells with a predominant mucopolysaccharide matrix
84
Why do you want to repair left to right shunts early?
because as pulmonary fibrosis builds up, pulmonary pressure increases and can reach a point where the shunt is reversed to a right to left shunt with eisemenger syndrome - irreversible disease
85
20% of us have a probe-patent/valve competent defect in the foramen ovale. What does this mean?
This means that the valve of the foramen ovale is usually closed because LA pressure exceeds RA pressure
But if RA increases and excessd LA pressure, it will open (valsalva, coughing, acute hypertension from PE)
86
IF the valve competent defect opens, what are we at risk for?
paradoxical embolism - a venous system emboli may enter the left heart directly and can cause stroke.
87
Which ventricle undergoes hypertrophy or hypoplasia in pulmonary stenosis?aortic stenosis?
```
pulmonary = RV
aortic = LV
```
88
What may be vital to survival until surgical repair if the stenosis/atresia is severe?
PDA
89
Cyanosis in an infant is most common from what?
a pulmonary disease - not cardiac
90
85% of adult sudden cardiac death are related to what?
atherosclerotic CAD or a diagnosable cariomyopathy
91
What are the most common sudden cardiac death causes in children?
myocarditis and coronary artery anomalies
| but up to 30% have no known itiology
92
With a sudden death with negative forensic autopsy,, negative toxicology and normal heart anatomy, what is it?
fatal dysrrhythmia from congneital ion channel disortdr - long QT, Brugada, Catecholaminergic polymorphic ventricular tachycardia
93
What are some miscellaneous causes of sudden cardiac death?
coronary artery spasm
occult metabolic disorders - hyperkalemia
occult Wolff-Parkinson-White syndrome
commotio cordis (dyssrhytmia dur to blunt chest trauma)
fright response - ventricular fibrillation due to overhwelming sympathetic discharge
94
What are the 5 mechanisms of vascular disease in the periphery?
1. gradual lumen obstruction with atherosclerosis or arteriolosclerosis
2. Sudden lumen obsstruction by thrombosis, embolism or dixxection
3. aneurysm/dissection
4. Vasculitis
5. Extrinsic vascular compression (compartment syndrome, vena cava syndrome)
95
If hypertension or DM are cormorbid with atherosclerosis, what iwll happen?
1. larger vessel atherosclerosis is accelerated
| 2. arterioles beomc egradually obstructed in arteriologsclerosis
96
Where do DVTs arise most often?
the iliofemoral veins
97
Splanchnic venous thrombosis will lead to what?
infarction of the bowel or Budd-Chiari syndrome
98
What vasculitis do we see in the skin?
leukocytoclastic vasculitis
but this isn't one we really worry about
99
Visceral vasculitic diseases are often associated with what group of antibioties?
ANCA
100
Most vasculitis diseases are in adults except for what?
Henoch Schonlien Purpura and Kawasaki disease
101
What is henochschonlein purpora associated with"
igA deposiion in vasculitis
102
Vasculitis that affects the external carotid with risk of vision loss and headache is what?
giant cell temporal arterieis
103
How do you diagnose and treat giant cell temporal arterieis
Dx with temporal artery biopsy and Rx with corticosteroids
104
What two vasculitidies are associated with anti-neutrophil cytoplasmic antibody?
```
Wegener's (c-ANCA)
Microscopic polyangiitis (p-ANCA)
```
105
What antibody is associated with Goodpastur'es syndrome?
anti-glomerular basement membrane antibodies (anti-GBM)
106
What chronic isease is churg strauss associated with?
asthma
107
What is pulmonary-renal syndrome?
1. diffuse pulomonary hemorrhage
| 2. rapidly progressive glomerulonephritis
108
What is the DD for pulmonary-renal syndrome?
ANCA-associated vasculitis (Wegener's and Microscopid polyangiitis) vs. Goodpasture's vs. SLE
109
What serological testing should you do to diagnos vasculitis?
1. ESR and CRP
2. ANtibody detection: pANCA, c-ANCA, anti-GBM, anti-dsDNA, igA detection in tissues
3. complement
4. hep B and Hep C serology
110
What imaging studies vasculitides can be diagnosed with imaging of the aorta? organ-directed angiography?
Chest X-ray or CT?
aorta - Takayasu's
organ-directed - polyarteritis nodosa
chest XR - Wegener's and pulmonary-renal syndrome
111
What vasculitis affects distal extremity arteries in heavy smokers?
thromboangiitis obliterans = Buerger's Disease
112
What is the most common vascular neoplasm - venign?
hemangiomas (perfer skin but can involve visceral organs)
113
What is a hemangiomas that grows rapidly after trauma?
pyogenic granuloma = usually in kids
114
What is another term for a lymphangioma?
cystic hygroma - large growths with lymph inside - usually in the neck and axilla or young children
benign
115
Very painful small tumors of distal digits are usually what?
glomus tumors
116
Bacillary angiomatosis is a vascular proliferation associated with what virus in immunosuppressed patients?
Bartonella infections = cat scratch species
117
what are Vascular ectasias
benign discrete lesions with dilated preexisting vessels looking like hemangiomas but flat/non-paular. They're super common skin and mucous membranes
118
Vascular ectasias are the most common form of what birth marks? Extreme oforms of this is what syndrome?
port wine stains
sturge-weber syndrome
119
If you have systemic vascular ectasia syndrome, what is the risk? What is this caused?
you run risk of serious bleeding with epistaxis, GI and GU bleeds
Called Osler-Weber-Rendu (Hereditary hemorrhagic telangiectasia)
120
What are arteriovenous malformations?
where tangle mass of arteries and veins don't have an intervening capillary bed.
121
If AVMs are large enough, what can they cause in the heart?
high output heart failure
122
What can AVMs lead to in the brain?
there is a risk of rupture with fatal cerebral hemorrhage
123
What is an arteriovenous fistula?
After a penetrating vascular injury, an arterial aneurysm can rpture into an adjacent vein, forming a fistula
124
Why do some people have arteriovenous istulas on purpose?
surgically created for hemodialysis
125
What are the three malignant vascular proliferations?
1. kaposia's sarcoma
2. epithelioid hemangioendothelioma
3. angiosarcoma (high grade vascular neoplasia)
126
What virus is kaposi's associated with?
HHV-8
| and HIV or otherimmunosuppressed
127
Where do angiosarcomas tend to occur?
skin of head and neck in the elderly, but any visceral soft tissue site will do
128
What do angiosarcomas look like/
aggressive reddish/purple lesions in the skin
129
Who is at higher risk for angiosarcomas?
patients with chronic lymphedema (post mastcectomy, post radiation, axillary dissection patients)
130
WHat are the symptoms of PVD?
```
stroke
claudicaiton
mesenteric ischemia
renovascular hypertension
massive hemorrhage/shockdeath from rupture arotic aneurysm or dissection
```
131
What is superior vena cava syndrome caused by?
compression of the SVC from surrounding malignant mediastinal adenopathy - usually lung cancer
132
What is post-thrombotic/phelvitic syndrome?
it's chronic venous insufficiency resulting from deep venous thrombosis - they get pain, dilatation, edema, skin changes and venous ulcers/stasis dermatitis
133
What arteriolosclerosis do you get with HTN?
hyaline arterioloscerlsosis of small musclar arteries and arterioles
134
What arteriolosclerosis do you see in malignant hyeprtension? What's another name for it?
hyperplastic arteriolosclerosis/fibrinoid necrosis
135
What is the most common cause of secondary hypertension?
renal disease
136
What is renovascular hypertension usually caused by?
renal artery stenosis from atherosclerosis
137
What are key lab features of primary renal disease and secondary hypertenson?
icnreased creatiine and proteinuria
138
If you have a hypertension in young and middle-aged women with abdominal bruits, what's the diagnosis?
ibromuscular dysplasia - narrowing of medium =s-zed arterial lumens by medial fibroplasia of unknown cause - affects renal and cerebral vessels
139
What is the characteristic angiographic finding in fibromuscular dysplasia?
"string of beads" appearance from alternating fibromuscular webs/stenoses and aneurysmal dilatations along the vessels
140
What are 5 secondary hypertension causes related to adrenal.endocrine disease?
1. primary aldosteronism
2. CUshing's syndrome (cortisol levels)
3. hypo or hyperthyroidism (with hypercalcemia)
4. oral contraceptives
5. pheochromcytoma
141
IF you have paroxysmal hyeprtension with hedaches, palpitations and diaphoresis, what is the cause typically?
pheochromocytoma - measure urine catecholamines
142
WHat causes neruologic high blood pressure?
increased intracranial pressure (also psychoenic or sleep apnea)
143
What is the hypertensive end-organ effect on the brain?
1. risk of stroke
2. microvascular aneurysm rupture with hemorrhage (most lethal)
3. imapried cognitive from large vessel stroke or multiple lacunar infarcts
4. hypertensive encephalopathy
144
What happens in hypertensive encephalopathy?
in malignant hypertension the vessels can't stand the pressure nand eventually vasodilate leading to loss of autoregulation of cerebral blood flow and death.
145
What is the end-organ effect of HTN on the kidney?
renal disease - lumen stenosis in pre-glomerular/afferent arterioles leading to ischemic glomerulosclerosis
also loss of renal blood flow autoregulation leading to hyperperfusion gomerular injury leading to complete glomerulosclerosis
146
What happens to the kidney in malignant hypertension?
fibrinoid necrosis of afferent arterioles leading to rapid renal failure
147
What happens to general peripheral arterial system in chronic hypertension?
1. high risk for systemic atherosclerosis (esp large peripheral vessels)
2. slowly progressive stenosis with claudication
3. thoracic aortic aneurysms and aortic dissection
148
WHat cormorbiity makes all the HTN organ effects worse?
diabetes
149
What is calciphylaxis?
calcification of arterioles leading to lumen obstruction - typically in uremic patients. you end up with massive skin necrosis.
150
What are the three types of structural disease in aortic disease?
dilatation;aneurysm
dissection
traumatic disruption
151
why is the aorta most susceptible?
it has the highest wall tension (highest radius)
152
What is the risk of thoracic aorta rupture in a year if over 6 cm?
7%
153
What is the risk fo abdominal aorta rupture in 5-years if over 5 cm?
20-40%
154
What is the risk with thrombosis within an aneurysm?
downstream embolism
155
What population get AAAs most often?
males over 50 - 95% are atherosclerotic
| stron association with smoking
156
Where do AAAs usually form?
below the renal arteries
157
How do we fix AAAs? At what size?
use surveillance with ultrasound until over 5 cm, then do endovascular stenting
158
WHen you see an ascending thoracic aortic aneurysm, what can you think of until proven otherwise?
hypertension or marfan's until proven otherwise
159
When do we fix thoracic arotic aneurysms?
if symptomatic
if over 5.5 cm or over 5 in marfan's when ascending
over 6.5 cm when descending
over 1 cm per year growth
160
In ascending aortic aneurysms, there are variable degrees of cystic medial encrosis, greatest with what?
marfans
161
A tree-bark appearing aortic aneurysm is associated with what disease?
tertiary syphilis
162
Acutely, does Hb dictate whether you transfuse?
NO - for up to 12 hours an acute hemorrhage, Hgb levels do not accurately reflect red cell mass
163
Why will an aortic dissection mimic MI symptoms?
when it does retrograde dissection into the aortic root and and occludes the coronary ostia
164
How can an aortic dissection cause paralysis/
if it atnegrade dissects into the descending thoracic and cuts off blood supply to the spinal cord
165
What pleural space does an aortic dissection usually dissect into?
the left pleural space - usually leading to exsanguination
166
What are some other risk factors besides HTN and atherosclerosis and connective tissues diseases for aortic dissection?
```
aortitis
positive family history
cardiac surgery or cath procedures
high intensity weight lifting
crack cocaine
third trimester of pregnancy
```
167
How do you treat an aortic dissection?
aggressive BP control and lower cardiac contractility
urgent surgery for a type A dissection
no surgery, just med management for a type B dissection
168
What's the diagnosis with palpable purpur?
luekocytoclastic vasculitis until proven otherwise
169
Again, two causes of pulmonary/renal syndrome?
anti-neutrophil cytoplasmic antibody vasculitis: wegener's granulomatosis and microscopic polyangiitis
170
Headache, scalp pain and visual symptoms in a patient over 50 years of age....
giant cell (temporal) arteritis
171
What virus is polyarteritic nodosa associated with?
hep B
172
Which one has an associateion with hep C?
cryoglobulinemia vasculitis
173
What is required for diangnosis of most vasculitis types?
tissue biopsy
174
What part of the body does takayasu arteritis affect?
large and medium sized arteries esp the arotic arch and branch vessels of young women
175
What are the symptoms of takayasus?
weak arm pulses with claudication and raynauds
neurologic and ocular ysmptoms (affecting carotids) abdominal pain (affecting celiac) hypertension, renal failure (renal arteries), led claudication (iliac arteries)
176
WHat's the treatment for takayasu?
glucocorticoids (with or without methotrexate)
177
40-50% of Giant cell arteritis will have what that leads to aching joints and morning stiffness?
polymyalgia rheymatica
178
!0% of patients with giant cell arteritis will develop what?
aortic aneyrusm
179
What is mucocutaneous lymph node syndrome?
Kawasakie disease
180
Who get's kawaskai disease?
kids under 4
181
What is kawasaki related to in terms of vascular pathology?
arteritis that favors coronary arteries with risk of stenosis, aneurysm, thrombosis rupture, MI or sudden tdeath
182
What do we give in kawasaki?
IV gamma globulin with aspirin to reduce CAD
183
Which vasculitis is Ig=A related?
henoch schonlein purpura
184
What actually hursts kids lont-term with henoch schonlein purpura?
the GI and kidney effects
185
Again, what is hte most common cause of croglobulinemic vasculitis?
hep C
186
What is the classic triad of involvement for Wegener's
ENT disease with nasal or insu symptoms
pulmonary disease with nodules, cough, hemoptysis, etc
kidney disease rapidly progressive glomerulonephritis
187
WHat' shte miracle drug for wegener's
cytoxan
188
What vasculitis is associatd with asthma?
churg strauss
