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CPR II Exam #1 > Cardiovascular Pathology Etc. > Flashcards

Cardiovascular Pathology Etc. Flashcards

1
Q

Vascultis associated with neutrophils

A

Behcet DZ

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2
Q

Vasculitis associated with eosinophils

A

Churg-Strauss DZ

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3
Q

Which is the only vasculitis involving the aorta?

A

Giant Cell Arteritis

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4
Q

“Pauci-immune” means

A

Abs direted against cellular constituents and do NOT form circulating immune complex

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5
Q

3 major histological features of Giant cell arteritis

A

Multinucleated giant cells
Fragmented elastic lamina and intimal thickening
Patchy and focal sites of involvement

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6
Q

What kind of vasculitis is Takayasu arteritis?

A

Granulomatosus vasculitis of medium and large arteries.

-Pulmonary, Coronary, Renal aa.

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7
Q

Age group common for Takayasu arteritis

A

<50 y/o

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8
Q

What causes the pulseless disease in Takayasu arteritis?

A

Narrowing of brachiocephalic, carotid and subclavian aa.

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9
Q

In what disease are pulmonary vessels spared from vasculitis?

A

PAN

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10
Q

What is Segmental Transmural necrotization?

In which diseases is it found?

A

Necrotizing inflammation w/ a predilection for branch points.

PAN and Microscopic polyangiitis

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11
Q

SX of PAN

A

Rapidly accelerating HTN
Abdominal pain an bloody stool
Diffuse myalgia and neuritis.

Renal involvement is major COD.

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12
Q

How can Kawasaki DZ lead to acute MI?

A

Affected sites may form aneurysms -> thrombosis or rupture -> acute MI

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13
Q

Presenting SX of Kawasaki DZ

What is the Tx?

A

Erythema of conjunctiva, oral mucosa, palms and soles.
Desquamative rash.

IVIg and aspirin.

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14
Q

What are the major targets of Microscopic polyangiitis?

A

Renal glomerulus and lung capillaries

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15
Q

SX of Microscopic polyangiitis

A

Hemoptysis
Hematuria, proteinuria
Cutaneous purpura

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16
Q

Major COD of Churg-Strauss syndrome

What are SX?

A

Cardiomyopathy

Asthma, rhinitis, hypereosinophilia.
Purpura, GI bleed, renal DZ.

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17
Q

Genetic marker of Behcet DZ

A

HLA-B51

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18
Q

What is the major COD for Behcet DZ?

A

Disease mortality related to severe neurological involvement and rupture of aneurysms.

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19
Q

Age group of Granulomatosis w/ polyangiitis

A

M>F, avg. age of 40

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20
Q

SX of Granulomatosis w/ polyangiitis

A

Pneumonitis
Sinusitis
Renal DZ
Nasopharyngeal ulceration

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21
Q

morphology of Granulomatosis w/ polyangiitis

A

URT: granulomas w/ geographic patterns of central necrosis and vasculitis.

LRT: cavitory granulomas.

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22
Q

Major fashions for vascular invasion of infectious vasculitis (2)

A

Local tissue invasion

Hematogenous spread

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23
Q

Primary Raynaud phenomenon

A

Induced by cold or emotion w/ symmetric involvement of digits.
Mostly young women. Benign course.

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24
Q

Secondary Raynaud phenomenon

A

A component of arterial DZ like SLE, scleroderma, thromboangiitis, etc.

Asymmetric involvement of digits. Worsens w/ time.

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25
Q

“Cardiac Raynaud”

A

Excessive vasoconstriction of myocardial aa. or arterioles that may cause ischemia or infarct.

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26
Q

Primary lymphedema

A

Isolated congenital defect leads to Lypmphedema (Milroy DZ)

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27
Q

Secondary lymphedema

A

Blockage of previously normal lymphatic flow. Due to cancer, surgery, radiation, infection, etc.

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28
Q

Markers to check via IHC for vascular malignancies

A

CD31 or von Willebrand factor (vWF)

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29
Q

Telangiectasia

A

Permanent dilation of preexisting small vessels that form red lesions usually in skin or mucous membranes.

These are not true neoplasms.

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30
Q

Sturge-Weber syndrome

A

A special form of nevus flammeus (port wine stain) in the distribution of the trigeminal n.

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31
Q

Capillary hemangioma

A

Thin-walled capillaries tightly packed together (most common).

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32
Q

Cavernous hemangioma

A

Irregular, dilated vascular channels making a lesion w/ indistinct border.
More likely to involve deep tissue or bleed.

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33
Q

Pyogenic granuloma

A

Type of capillary hemangioma.
Grow fast in oral mucosa. May develop from trauma.
Ex: Granuloma gravidarum: gingiva of pregnant women (tumors)

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34
Q

Cavernous lymphangioma

A

Cystic hygroma.
Usually in neck or axilla of kids.
Turner syndrome.

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35
Q

Simple lymphangioma

A

Appear similar to capillary hemangiomas, just no RBC.

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36
Q

What happens morphologically in bacillary angiomatosis?

A

Vascular proliferation to G- Bartonella. Forms capillaries w/ plump endothelial cells.

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37
Q

Who does Bacillary angiomatosis affect?

What kind of lesions form?

What stain is used commonly?

What is a good Tx?

A

Immunocompromised pts.

Red papules.

Warthin-Starry stain.

Macrolide abx.

38
Q

Morphology of Epithelioid hemangioendothelioma

A

neoplastic endothelial cells are cuboidal and resemble epithelium. Vascular channels may be hard to recognize.

39
Q

Most common inducer of Angiosarcoma

Where is the cancer found typically?

A

Radiation

Skin, ST, breast and liver

40
Q

What disease is associated with Berry aneurysms?

A

AD polycystic kidney DZ

41
Q

Renovascular HTN

A

Fibromuscular dysplasia of renal aa.

42
Q

What kinds of HTN are hyaline and hyperplastic arteriosclerosis associated with?

A

Hyaline - chronic HTN

Hyperplastic - severe HTN

43
Q

Nephrosclerosis

A

Chronic HTN leadnig to hyaline arteriosclerosis and impairment of renal blood supply and glomerular scarring

44
Q

Necrotizing arteriolitis

A

Fibrinoid deposits and vessel wall necrosis (usually in kidney) that leads to onion skinning and hyperplastic arteriorsclerosis as a result of malignant HTN.

45
Q

Where does a plaque generally exist?

A

Above the internal elastic lamina (between lamina and inner media).

46
Q

2 “models” used to describe how atherosclerosis develops

A

Hemodynamic model - due to lesions near bifucations.

Circulating lipids - accumulation of choleserol which is metabolized by Mo and a fatty streak is made.

47
Q

False aneurysm

A

Defect thru the wall of a vessel that communicates w/ and extravascular hematoma that communicates with the lumen of the vessel.
Creates a pulsating hematoma.

48
Q

Atherosclerosis causes ischemia of the ______ media

A

Inner

49
Q

HTN causes ischemia of the ______ media

A

Outer

50
Q

What valvular DZ can accompany tertiary syphilis?

A

Aortic regurg

51
Q

Serous pericarditis

A

Produced by non-infectious inflammatory Dzs, like RF, SLE, and scleroderma.

52
Q

Purulent/suppurative pericarditis

A

Active infection caused by microbial invasion of pericardial space.

53
Q

Hemorrhagic pericarditis

A

Exudate composed of blood mixed w/ a fibrous or suppurative effusion.

*most commonly caused by malignancy.

54
Q

Caseous pericarditis

A

From tuberculosis. Rarely can be from fungi.

55
Q

Constrictive pericarditis

A

Heart becomes encased in a dense, fibrous or fibrocalcific scar that limits diastolic expansion and CO (mimics restrictive CM).

56
Q

Cardiac lipoma

A

Localized, well-circumscribed benign tumors composed of mature fat cells; occurs in eubendocsrdium, subepicardium or myocardium.

57
Q

Papillary fibroelastoma

A

Usually incidental, sea-aneomone-like lesions, mostly found on autopsy. 80% found on valves.
-Resemble Lambl excrescences.

58
Q

50% of Rhabdomyomas are associated w/ what DZ?

What are the mutations?

A

Tuberous sclerosis

TSC1 (Hamartin) or TSC2 (Tuberin)

59
Q

How are primary arrhythmic DOs detected?

A

Genetic testing

60
Q

How does the heart morphology of Cor Pulmonale (RSHD) change in chronic vs. acute presentations?

A

Chronically - RV hypertrophy

Acute - usually from a PE. Marked dilation of RV w/o hypertrophy

61
Q

What valvular DZ is most commonly caused by chronic RHD?

A

Mitral stenosis, as well as chordae thickening and cusp fusion

62
Q

In what settings is functional mitral valve regurg clinically important?

A

IHD

DCM

63
Q

Most common causes (2) of mitral regurg

A

Abnormalities of leaflets and commissures

MV prolapse

64
Q

Most common cause of aortic stenosis

A

Calcification of congenitally deformed valve

65
Q

Most common causes (3) of aortic regurg

A

Aortic insufficiency
Syphilitic aortitis
Marfan’s syndrome

66
Q

Age group for calcific aortic stenosis

SX of calcific aortic stenosis

Tx?

A

Increases w/ age usually from 60-80 y/o

Angina, CHF, syncope, pulm. edema

Surgical repair

67
Q

Doxyrubicin chemotherapy is associated w/:

A

DCM

68
Q

Hereditary hemochromatosis is associated w/:

A

DCM

69
Q

Mitral annular calcification is usually ASX, but in some cases it can cause:

A

Arrhythmias
Regurg
Stenosis

70
Q

What marker is elevated first in an MI?

A

Myoglobin > CK-MB > Troponin

71
Q

What is myxomatous degeneration? And what valvular DZ is it associated w/?

A

Proteoglycan deposits and elastic fiber disruption of the valve leaflets. They become thickened and rubbery.

MVP

72
Q

What malformation is associated w/ “nothing” of ribs?

A

Coarctation of aorta w/ PDA

73
Q

When does acute RF occur post infection?

A

10 days to 6 wks

74
Q

RF SX

A

Pancarditis
Migratory polyarthritis
Erythema marginatum
Syndenham chorea

75
Q

Chronic RHD leads to which valvular abnormality?

What happens to the heart structurally as a result?

A

MV stenosis due to leaflet thickening, commissure fusion, and thickening of cords.

LA enlargment
RHF/pulm congestion -> RV hypertrophy
IE

76
Q

3 major associations to DCM

A

EtOH
Genetics
Hemochromatosis

77
Q

Anitschkow “caterpillar” cells

A

Immune cells that clump to form Aschoff bodies in pandcarditis due to *acute RF.

78
Q

Cardiac features of Acute RF (3)

A

Pancarditis

Fibrinoid necrosis of endocardium and left-sided valves

Verrucae

79
Q

Acute IE infects a ____ valve

Chronic IE infects a ____ valve

A

Normal valve

Abn. valve

80
Q

IE usually affects which sided lesions?

A

Left-sided

81
Q

Carcinoid heart DZ usually affects which sided lesions?

A

Right-sided, as the pulm vascular bed degrades mediators.

Usually liver catabolizes mediators before they affect the heart, so there is a huge hepatic burden.

82
Q

Titin is associated w/ what 2 disease processes?

A

DCM

Myocarditis

83
Q

What exists within fatty streaks early on?

In a plaque?

A

Foam cells and T cells

Cholesterol clefts and Mo

84
Q

Fibrillin deficiency is associated w/:

A

Marfan syndrome

85
Q

Familial syndromes associated w/ myxomas have activating mutations in the ______ gene or null mutations in ______. Which 2 diseases/complexes are associated w/ each mutation?

A

GNAS1 - McCune-Albright syndrome

PRKAR1A - Carney complex

86
Q

3 Left-to-right shunts

A

ASD
VSD
PDA

87
Q

Secundum ASD

Primum anomalie ASD

Sinus venosa ASD

A

Secundum ASD - most common, at center of septum

Primum anomalie ASD - 5%, adjacent to AV valves

Sinus venosa ASD - 5%, near entrance on SVC

88
Q

Explain what changes take place to the heart 3-4 days post MI, 7-10 days and 10 days

A

3-4 days: PMNs

7-10 days: Mo

10 days+: granulation

89
Q

When does cTnT peak?

When does cTnI peak?

A

cTnT: 12-48 hrs

cTnI: 24 hrs

Both begin to rise approx 3-12 hrs post MI

90
Q

When does cTnT peak?

When does cTnI peak?

When does CK-MB peak?

A

cTnT: 12-48 hrs

cTnI: 24 hrs

CK-MB: 24 hrs

All begin to rise approx 3-12 hrs post MI

CPR II Exam #1 (30 decks)

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