CV- PATHOMA Flashcards
polyarthritis nodosa is associated with what infection?
HepB
Main complication of Kawasaki disease?
coronary artery aneurysm
What abnormality in renal vasculature can cause hypertension? explain pathophysiology
renal artery stenosis -> decreased GFR -> increased renin -> peripheral vasoconstriction + more Na+ retention
Define atherosclerosis
INTIMAL plaque that obstructs blood flow
- more than 70% occlusion is needed to be symptomatic
4 modifiable causes of atherosclerosis
it is important to memorize each of this
- smoking
- hypercholesterolemia
- diabetes
- hypertension (more shearing force, easy to damage endothelium)
Describe the mechanism of atherosclerosis formation
endothelium damage
- > LDL deposited in INTIMA
- > LDL oxidation -> oxidized LDL is consumed by macrphage, forming foam cell
- > Foam cell becomes fatty streak, which attracts vascular SMOOTH MUSCLE CELL ( with PDGF and FGF)
- > smooth muscle cell synthesizes extracellular matrix proteins (collagen, elastin) that form FIBROUS CAP
Atherosclerosis vs. Arteriolosclerorsis- what is key difference?
atherosclerosis- medium sized vessels
arteriolosclersis: ARTERIOLo- , thus small arterioles
Arteriolosclerosis: what are two types? what is cause of each type? histologic finding in each type?
- hyaline arteriolosclerosis
: caused by long standing BENIGN HTN or diabetes
: hyalinosis of vascular wall - hyperplastic arteriolosclerosis
: caused by SEVERE MALIGNANT HTN
: hyperplasia of SMOOTH MUSCLE, onion-skin appearance on histology
Explain how hypertension results in weakening of intima, predisposing condition for dissection / aneurysm
hypertension
- > hyaline arteriosclerosis of the vasa vasorum
- > atrophy of media
Is unstable angina due to complete or incomplete occlusion?
incomplete occlusion
=> this may explain ST depression
vs. MI is complete occlusion => ST elevation
What are two possible consequences of fibrinolysis in MI?
- reperfusion injury: introduction of radicals that damage myocytes
- contraction band necrosis: introduction of Ca2+ into myocytes, resulting hypercontraction of myofibrils
What is heart failure cells? They are associated with what cardiac pathology?
- hemosiderin laiden macrophages in alveolar sac
- left sided hear failure -> pulmonary congestion
most common cause of right sided HF?
left sided HF
Explain two types of ASD. which type is more common? which type is associated with Down syndrome?
osteum secundum: incomplete fusion of septum secundum and septum primum, majority of cases
osteum primum: opening of bottom part of septum primum, less common, associated with DOWN SYNDROME
Explain why tetralogy of Fellot is considered as R->L shunt
RV hypertrophy and overriding aorta.
RV can eject deoxygenated blood to aorta
- this is why squatting helps. Squatting increases afterload, limiting blood going into aorta from RV (instead, it will enter pulmonary circulation)
