Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

* DIT each session > Day 7.1 Cardio > Flashcards

Day 7.1 Cardio Flashcards

1
Q

4 drugs used to treat tinea capitis or pubis

A

Pyrmethrin
Pyrethin
Lindane (but it’s neurotoxic)
Melathium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Organism in animal urine

A 
Leptospira
Hanta virus (rat/mouse urine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Drug w best effect on:
HDL
LDL
TGs

A

Raises HDL: Niacin
Lowers LDL: Statins (HMG coA reductase inhib)
Lowers TGs: Fibrates (2nd- omega3 FA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Murmur: mitral/tricuspid regurg (MR/TR)

A

Heard from S1 all the way to S2.
Holocystic, high-pitched “blowing murmur”

Mitral: loudest at apex, radiates to axilla
Enhanced by things that increase TPR (squatting, hand grip) or by increased LA return (expiration)

Tricuspid: loudest at tricuspid area, radiates to right sternal border
Enhanced by maneuvers that increase RA return (inspiration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the causes of mitral and tricuspid regurg?

A 
MR:
ischemic heart dz
mitral valve prolapse
LV dilation
rheumatic fever
endocarditis

TR:
RV dilation
Endocarditis
Rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Murmur: Aortic stenosis

A

B/t ejection click and S2 (ejection click is shortly after S1)
Crescendo-decrescendo systolic ejection murmur after ejection click. (ED is d/t abrupt halting of valve leaflets)

LV prs&raquo_space; aortic prs during systole
Radiates to carotids/apex
Heard in aortic area
“Pulsus parvus et tardus”- pulses are weak compared to heart sounds. Can lead to syncope.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of aortic stenosis

A

Age-related calcific aortic stenosis

Bicuspid aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Murmur: VSD

A

Heard from S1 all the way to S2
Holocystolic, harsh sounding murmur
Loudest at tricuspid area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Murmur: mitral prolapse

A

From mid-systolic click to S2. (MC is halfway thru S1 and S2)
Late systolic crecendo murmur w midsystolic click. (MC is due to sudden tensing of chordae tendineae)
Most frequent valvular lesion
Loudest at S2 (bc crescendos up to it)
Usu benign
Can predispose to infective endocarditis (only if there is mitral regurg assoc w it. give abx before dental procedures)
Enhanced by maneuvers that increase TPR (squatting, hand grip)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can cause mitral prolapse?

A

Myxomatous degeneration
Rheumatic fever
Chordae rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Murmur: Aortic regurg

A

Starts at S2
Immediate high-pitched “blowing” diastolic murmur
Wide pulse prs when chronic
Can px w bounding pulses and head throbbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cause of aortic regurg

A

Aortic root dilation (syphilis, Marfan’s)
Bicuspid aortic valve (but this is more characteristic of stenosis, not regurg)
Rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Murmur: mitral stenosis

A

After the Opening Snap (which is even after S2)
Follows opening snap (OS d/t tension of chordae tendineae)
Delayed rumbling late diastolic murmur
LA prs&raquo_space; LV prs during diastole
Enhanced by maneuvers that increase LA return- expiration (vs split S2 sound, which is enhanced by INspiration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can cause mitral stenosis?

A

Often secondary to rheumatic fever

Chronic MS can result in LA dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Murmur: PDA

A

Continuous- from S1 to S2 and beyond, but most at S2
Continuous machinery-like murmur
Loudest at S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What murmur can be heard best at the tricuspid area?

A

Pan-systolic:
Tricuspid regurg
VSD

Diastolic:
Tricuspid stenosis
ASD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What murmurs are enhanced when TPR is increased?

A

Mitral regurg

Mitral prolapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What murmur is enhanced when LA return is increased?

A

Mitral regurg

Mitral stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What murmurs can be d/t Rheumatic Fever?

A 
Mitral regurg
Mitral stenosis
Aortic regurg
Aortic stenosis
Tricuspid regurg
Mitral prolapse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What murmurs are loudest at S2?

A

Mitral prolapse

PDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the diastolic murmurs? (After S2)

A

Aortic regurg
Mitral stenosis (late, after OS)
PDA is continuous, so can hear in both diastole and systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the systolic murmurs? (B/t S1 and S2)

A 
Mitral regurg
Tricuspid regurg
VSD
PDA (continuous)
Aortic stenosis (after EC)
Mitral prolapse (late, after MC)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What sounds are d/t sudden tensing of chordae tendineae?

A 
Midsystolic click (systole)
Opening snap (diastole)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What do S1 and S2 heart sounds represent?

A

S1 = Mitral valve closure
S2 = Aortic valve closure
Between them is systole (contraction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What murmurs can be best heard at the aortic area?

A

Systolic murmurs:
Aortic stenosis
Flow murmur
Aortic valve sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What murmurs can be best heard at the Left Sternal Border?

A 
Diastolic murmur:
Aortic regurg
Pulmonic regurg
Systolic murmur:
Hypertrophic cardiomyopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What murmurs can be best heard at the pulmonic area?

A

Systolic ejection murmur:
Pulmonic stenosis
Flow murmur (eg ASD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What murmurs can be best heard at the mitral area?

A

Systolic: mitral regurg
Diastolic: mitral stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Systolic murmur at left sternal border

A

Hypertrophic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Systolic ejection murmur at pulmonic area

A 
Pulmonic stenosis
Flow murmur (ASD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Diastolic murmur at tricuspid area

A

Tricuspid stenosis

ASD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Diastolic murmur at mitral area

A

Mitral stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Systolic murmur at aortic area

A

Aortic stenosis
Flow murmur
Aortic valve sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Diastolic murmur at left sternal border

A

Aortic regurg

Pulmonic regurg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Pansystolic murmur at tricuspid area

A

Tricuspid regurg

VSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Systolic murmur at mitral area

A

Mitral regurg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Px of ASD murmur

A

Commonly presents as pulmonary flow murmur (increased flow thru pulm valve) plus a diastolic rumble (d/t increased flow across tricuspid).
Blood flow across the actual ASD does NOT cause a murmur bc there is no prs gradient.
The murmur later progresses to a louder diastolic murmur of pulmonic regurg, from dilation of the pulmonary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What valves should be open during diastole?

A

Diastolic filling- so mitral and tricuspid should be open. Therefore stenosis of these valves will make a diastolic murmur.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What valves should be closed during diastole?

A

Diastolic filling- aortic and pulm valves should be closed. If there is aortic or pulm regurg, will hear a murmur.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What valve should be open during systole?

A

Systolic contraction: aortic and pulmonic valves should be open (at the end of systole)
So aortic or pulm stenosis will cause a systolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What valves should be closed during systole?

A

Mitral and Tricuspid. So if have mitral or tricuspid regurg, will cause a systolic murmur.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

When are all of the valves closed?

A 
Isovolumetric contraction (Early systole)
Isovolumetric relaxation (Early diastole)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Best heard w pt in left lateral decubitous position (on left side)?

A

Mitral regurg
Mitral stenosis
Left-sided S3 and S4 heart sounds.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Most common causes of aortic stenosis

A

Congenital bicuspid valve (doesn’t px until >40yo)
Senile calcification
Chronic rheumatic valve dz

Less common, but still causes:
Congenital unicuspid valve
Syphilis (tree-barking of aorta- can cause stenosis or regurg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

VSD and tricuspid regurg sound the same. In what pts is it likely to be VSD? to be tricuspid regurg?

A

VSD: newborns

IV drug user: tricuspid regurg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What does holosystolic mean?

A

Blood is flowing through valves during all of systole (S1 to S2), including during isovolumetric contraction at the beginning (when there should be no flow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How do you open/close a PDA?

A

Open: prostaglandins
Close: NSAIDs (indomethicin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Signs of R-sided heart failure

A

Peripheral / lower extremity edema

Hepatosplenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Signs of L-sided heart failure

A

Pulmonic congestion / edema
Dyspnea on exertion
Orthopnea
Paroxysmal nocturnal dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Signs/sympt of bacterial endocarditis

A

Fever (most common sympt)
Roth’s spots (round white spots on retina surrounded by hemorrhage)
Osler’s nodes (tender raised lesions on finger/toe pads)
New murmur (caused by valvular dmg)
Janeway lesions (sml erythematous lesions on palm or sole)
Anemia
Spinter hemorrhages on nail bed

Bacterial FROM JANE:
Fever
Roth's spots
Osler's nodes
Murmur
Janeway lesions
Anemia
Nail-bed hemorrhages (splinter)
Emboli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What valves are usu involved in bacterial endocarditis?

A

Mitral valve most frequently

Tricuspid valve in IV drug users (don’t tri drugs)- assoc w S. aureus, Pseudomonas, Candida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Complications of bacterial endocarditis

A 
chordae rupture
glomerulonephritis
suppurative pericarditis
R-sided (tricuspid) emboli -->PE
L-sided (mitral) emboli --> Stroke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Organisms causing bacterial endocarditis

A

Acute is caused by S. aureus (high virulence)
See lg vegetations on valves that were fine before. Rapid onset.

Subacute is caused by viridans strep (low virulence)
Smlr vegetations, seen on congentially abn or diseased valves (not good valves). More insidious onset. Can occur after dental procedures- so give abx before!

Enterococci (VRE esp bad, bc can’t give vanco)

Coag-neg Staph (S. epidermiditis)

IV drug users: S. aureus, Pseudomonas, Candida, S. epidermiditis
Colon cancer pts: S. bovis
Pts w prosthetic valves: S. epidermitidis
Culture-neg: HACEK organisms

54
Q

Non-bacterial endocarditis

A

Occurs secondary to malignancy or hyper-coag state (marantic / thrombolyic endocarditis)

55
Q

How to dx bacterial endocarditis

A

multiple blood cultures

56
Q

What are the HACEK organisms?

A 
Hemophilus
Actinobacillus
Cardiobacterium hominis
Eikenella corrodens
Kingella

These cause culture-negative endocarditis

57
Q

What is Libman-Sacks endocarditis?

A

Verrucous (wart-like), sterile vegetations
Non-infective
Occur on both sides of valve.
Most often benign; can be assoc w mitral regurg and (less common) mitral stenosis

The most common heart manefestation of SLE!
SLE causes LSE

58
Q

What is endocarditis?

A

Inflammation of the inner layer of the heart- the endocardium
Usu involves the valves
Can also involve other structures- IV septum, chordae tendonae, mural endocardium, intracardiac devices

59
Q

What are vegetations?

A

Mass of platelets, fibrin, microcolonies of microorganisms, and inflammatory cells

Subacute (viridians) vegetations can also have a center of granulomatous tsu which can calcify/fibrose.

60
Q

Which lesions of endocarditis are painful? non-painful?

A 
Painful = Osler's nodes on finger/toe pads
Non-painful = Janeway lesions on palms/soles
61
Q

What are the features of Hypovolemic/Cardiogenic shock?

Septic shock?

A

Hypovol/Cardiogenic = LOW-output failure
Increased TPR (afterload)
Low CO
Cold, clammy pt

Septic = HIGH-output failure
Decreased TPR (decreased afterload)
Dilated arterioles, high mixed venous prs
Hot pt

62
Q

SVR & CO, plus Rx in Hypovolemic shock

A

SVR and CO both increase

Rx = IV fluid and blood

63
Q

Causes of hypovolemic shock

A

Blood loss d/t trauma (gunshot, MVA, stabbing)

Severe burns

64
Q

SVR & CO plus Rx in Heart failure (cardiogenic shock)

A 
CO is decreased bc heart is failing, so have a compensatory increase in SVR
Rx = LMNOPP
Loop/Lasix
Morphine
Nitrates
O2
Pressors
Positioning
65
Q

SVR & CO plus Rx in sepsis/anaphylaxis

A

Massive vasodilation - decreased SVR
Compensatory increase in CO
Rx Abx, IV fluids (plus NE if needed)

66
Q

SVR & CO plus Rx in neurogenic shock

A

E.g. Spinal cord injury, TBI
This means there is not good communication b/t body and brain, so nothing works:
SVR and CO are both decreased
Rx IV fluids. For SC injury give high dose corticosteroids

67
Q

Causes of cardiogenic shock

A 
Heart failure
MI
Arrhythmias (V-tach, esp V-fib)
Tamponade
Pulm embolism
Tension pneumothorax
Cardiac contusion
68
Q

Sympt of Rheumatic heart dz

A 
FEVERSS:
Fever
Erythema marginatum
Valve dmg (vegetation and fibrosis)
ESR increased
Red-hot joints (migratory polyarthritis
Subcutaneous nodules (Aschoff bodies)
St. Vitus' dance (chorea)

OR
JONES (O = s cells (activiated histiocytes)
Elevated ASO titers
Aschoff body - granuloma w giant cells

69
Q

What is Rheumatic heart dz?

A

Pharyngeal infection w S. pyogenes Gp A strep (beta-hemolytic), which leads to dz
Early deaths are d/t myocarditis
Late results: rheumatic heart dz (affects heart valves mitral > aortic&raquo_space; tricuspid)
Early lesion - mitral valve prolapse
Late lesion- mitral stenosis

NOT bacterial. It is immune-mediated (type II HPS). There are Ab to M protein.

70
Q

Aschoff body

A

Pathognomonic for rheumatic heart dz!
It’s a granuloma w giant cells in the middle of myocyte cells (heart muscle).
Area of fibrinous necrosis, surrounded by mono-nuclear lymphocytes and multinucleated giant cells.

71
Q

T/F Rheumatic dz of the heart is d/t bacterial infection.

A

False. It’s auto-immune

But: It is the consequence of S. pyogenes infection.

72
Q

Cardiac tamponade

A

Compression of heart by fluid in pericardium (eg blood, effusion), which squeezes the heart and t/f causes decreased CO.
Bc there is prs from the outside all around, all 4 chambers equalize in prs (the diastolic prs)

73
Q

Findings in cardiac tamponade

A

hypotension
increased venous prs (JVD)
distant heart sounds (have to hear them through the fluid)
increased HR (to make up for the decreased CO)
Pulsus paradoxus
EKG: electrical alternans (QRS has beat-to-beat variations in amplitude- sometimes tall, sometimes short, medium, etc)

74
Q

What is pulsus paradoxis?

A

Exaggerated decrease in amplitude (loudness) of pulse during inspiration.
So when pt breaths in, systolic BP drops a lot (>10mmHg).
Seen in severe cardiac tamponade, asthma, obstructive sleep apnea, croup (things w exaggerated inspiration)

75
Q

What are the types of pericarditis?

A

Serious (SLE, Rheum Arthritis, viral infection, uremia)
Fibrinous (Uremia, MI-dressler’s synd, Rheum Fever)
Hemorrhagic (TB, malignancy-melanoma)

76
Q

What are the findings in pericarditis?

A 
Pericaridal pain
Friction rub
Pulsus paradoxus
Distant heart sounds
EKG chgs- ST segmt elevation in MULTIPLE leads (vs MI- only in a few specific leads, dep on MI location)
Kussmaul's sign (JVD w inspiration)

It can get better w/o scarring, or it can cause chronic adhesive or chronic constrictive pericarditis

77
Q

Heart dz caused by syphilis

A

Tertiary (3) syphilis dmgs the vaso vasorum of the aorta, causing dilation of the aorta and the valve ring (root of the aorta)
Tree-barking: can see calcification of aortic root and ascending aortic arch.

Can result in aneurysm of the ascending aorta or the aortic arch; aortic valve incompetence

78
Q

What is Kussmaul’s sign/pulse?

A

JVD with inspiration
Caused by decreased capacity of RIGHT ventricle
Common in constrictive pericarditis (not v much in tamponade)

79
Q

How is pulsus paradoxus different from Kussmaul’s?

A

PParadox has to do w decreased systolic BP on inspiration. It is decreased capacity of LV (vs Kussmaul’s which is RV)
And it occurs in cardiac tamponade (vs Kussmauls, which occurs in pericarditis).

80
Q

Myxoma

A

Most common primary cardiac tumor in adults
90% are in atria (mostly LA)
HUGE BALL.
Ball-valve obstruction in LA assoc w multiple syncopal episodes.

81
Q

Rhabdomyoma

A

Most freq primary cardiac tumor in kids

Assoc w tuberous sclerosis

82
Q

Most common heart tumor

A

Metastases - melanoma, lymphoma

83
Q

Chest pain, dyspnea, tachycardia, tachypnea in..
IV drug user
MVA pt
Post-op pt

A

IVDU: Bacterial endocarditis (maybe bacterial embolism –> PE)
MVA pt: Tension pneumothorax
Post-op: Pulm embolism (esp if pt is also confused)

84
Q

Immediate Rx for bacterial endocarditis

A

Get culture
give IV vanco
then later give specific Abx dep on what culture shows

85
Q

Diffuse myocardial inflam w necrosis and mononuclear cells

A

Myocarditis

86
Q

Chest pain + course rubbing heart sounds in pt w Creatinine 5.0

A

Uremic pericarditis

87
Q

ST elevations in all EKG leads

A

Pericarditis

88
Q

Disordered growth of myocytes

A

Hypertrophic cardiomyopathy

89
Q

EKG shows electrical alternans

A

Cardiac tamponade

90
Q

Raynaud’s dz

A

Decrsd blood flow to skin d/t arteriolar vasospasm
Caused by cold temp, emotional distress
Fingers and toes turn blue/white
Sml vessel dz

Can be secondary to:
MCTD (mixed CT dz)
SLE
CREST scleroderma
Buerger's dz
91
Q

Rx for Raynaud’s

A

Aspirin
Dihydropyridine CCBs
Sildenafil (ED- but great vasodilator)

92
Q

Renal dz + lung dz

A

Wegener’s granulomatosis or Goodpasture’s syndrome

Differentiate bc Wegener’s has upper airway dz, Goodpasture’s doesn’t

93
Q

Perforation of nasal septum- cause

A

Cocaine abuse

Wegener’s granulomatousis

94
Q

Triad for Wegener’s granulomatosis

A

Focal necrotizing vasculitis (sml vessles)
Necrotizing granulomas in lung/upper airway (hard palate, soft palate, oropharynx, nasopharynx)
Necrotizing glomerulonephritis

So basically a lot of inflam that necrotizes.

95
Q

Symptoms of Wegener’s granulomatosis

A 
Hemoptysis
Hematuria
Perf of nasal septum
Chronic sinusitis
Otitis media
Mastoiditis
Cough, Dyspnea
96
Q

Lab findings in Wegener’s granulomatosis

A

c-ANCA (!!!)

CXR might show lg nodular densities
Hematuria and red cell casts

97
Q

Rx for Wegener’s granulomatosis

A

Cyclophosphamide and corticosteroids

this is also the Rx for polyarteritis nodosa

98
Q

What 3 things are p-ANCA positive?

A

Microscopic poly angitis
Primary pauci-immune crescentic glomerular nephritis
Churg-Strauss syndrome.

99
Q

What is microscopic polyangitis?

A 
Like Wegeners (inflam, necrosis- lungs, kidneys), but does NOT have granulomas.
p-ANCA
100
Q

What is primary pauci-immune crescentic glomerulonephritis?

A

Vasculitis limited to kidney
Pauce-immune = paucity of Ab
p-ANCA
mpo-ANCA

101
Q

What is Churgg-Strauss syndrome?

A

Granulomatous vasculitis w eosinophilia(!)
Px: asthma, sinusitis, skin lesions, and peripheral neuropathy (foot/wrist drop)
Can also involve heart, GI, kidneys
p-ANCA
“vasculitis in a young asthmatic”

102
Q

Things that cause eosinophilia

A 
Atopy (predisposition to HPS rxns)
Asthma
Allergies
Parasites
Churg-Strauss
103
Q

Sturge-Weber dz

A

Congenital vascular disorder that affects capillaries. (sml vessels)
Causes port wine stain (nevus fammeus) at opthalmic division of trigeminal nerve on face;
Ipsilateral angiomatosis (intracerebral AVM)
Seizures
Early-onset glaucoma
MR
Hemiplegia

104
Q

Henoch-Schonlein purpura

A

Lower extremity palpable purpura (butt and legs)
Arthralgia (knees esp)
Abd pain (intestinal hemorrhage, melena)
Recent URI

Most commone form of childhood systemic vasculitis.
IgA immune complexes
Assoc w IgA nephropathy (nephrotic, nephritic synd)
Self-limiting

105
Q

Buerger’s dz

A

aka thromboangiitis obliterans
Heavy smoker(!) with
idiopathic, segmental, thrombosing vasculitis of sml and medium periph arteries and veins

Sympt: intermittent claudication, superficial nodular phlebitis, cold sensitivity (reynaud’s phenomenon), severe pain in affected part
Can lead to gangrene and auto-amputation of digits
RX: stop smoking!

106
Q

T/F medium-vessel dz causes thrombosis/infarction of arteries

A

True

107
Q

Kawasaki dz

A

aka mucocutaneous lymph node syndrome
Asian infants/children w acute, self-limiting necrotizing vasculitis

Sympt: fever, conjunctivitis, chg in lips/oral mucosa (strawberry tongue, lips cracking), lymphadenitis, peeling palms/fingers/toes (desquamative skin rash)
May develop coronary aneurysms- really dangerous bc a) can rupture and heart won’t be perfused or b) the widening pools blood and causes thrombosis- so heart won’t be perfused.
Affects sml and medium vessels

108
Q

Rx for Kawasaki dz

A 
IV immunoglobulin (pooled Ab from population)
High dose aspirin- this is the only time you give it to kids (Reye's!)
109
Q

Polyarteritis nodosa

A

Transmural vasculitis w fibrinoid necrosis.
Is immune-mediated.

HBV+ pt (30%) w non-specific sympt: fever, weight loss, malaise, abd pain, melena, headache, myalgia, HTN, neurologic dysfn, cutaneous eruptions

110
Q

Findings and Rx for Polyarteritis nodosa

A

HBV +
See multiple aneurysms and constricitons on arteriogram. (Lesions are of different ages)
Sml and med-vessel dz
Usu renal and visceral vessels (NOT pulm arteries)

Rx: corticosteroids and cyclophosphamide (same rx as wegener’s, but wegener’s is p-ANCA positive, this is not.)

111
Q

Takayasu’s arteritis

A

pulseless dz- weak pulses in upper extremities.

Asian 40+ yo Female w granulomatous thickening of aortic arch and/or proximal great vessels. Assoc w increased ESR.
medium and large vessel dz.

Sympt: fever, arthritis, night sweats, myalgia, skin nodules, ocular disturbances, weak pulse in upper extremity.

112
Q

Temporal arteritis (giant cell arteritis)

A

Most common vasculitis affecting med and lg arteries, usu branches of carotid artery.

Elderly females w focal, granulomatous inflam.

Sympt:
unilateral headache
jaw claudication
impaired vision (occlusion of opthalimic artery- can lead to irrev blindness.

TEMPoral arteritis has signs near TEMPles.

Can also hv hyperpigmt of temples, pronounced temporal artery, muscle wasting over temples, and poor perfusion of scalp

113
Q

Findings and Rx in Temporal arteritis

A

Assoc w increased ESR
Half of pts have systemic involvement and polymyalgia rheumatica

Rx: high dose steriods (for over a year)

114
Q

Polymyalgia rhematica

A

Pain and stiffness in shoulders, hips
Often w fever, malaise, weight loss
Does NOT cause muscular weakness- joints just hurt.
Pts 50+ years
Assoc w temporal arteritis (giant cell arteritis)

Findings: increased ESR, normal CK (not muscular)
Rx: Prednisone

115
Q

Differential Dx for red lesions

A 
Strawberry hemangioma
Cherry hemangioma
Pyogenic granuloma
Cystic hygroma
Glomus tumor
Bacillary angiomatosis
Angiosarcoma
Lymphangiosarcoma
Kaposi's sarcoma
116
Q

Strawberry hemangioma

A

Benign capillary hemangioma in infancy

Grows w child initially, then spontaneously regresses.

117
Q

Cherry hemangioma

A

Benign capillary hemangioma in elderly
Does not regress
Freq increases w age

118
Q

Pyrogenic granuloma

A

Polypoid capillary hemangioma that can ulcerate and bleed.

Assoc w trauma and pregnancy

119
Q

Hemangioma

A

Benign tumor

Abn buildup of bld vessels in skin or organs

120
Q

Cystic hygroma

A

Cavernous lymphangioma of the neck.

Assoc w Turner’s 45XO

121
Q

Glomus tumor

A

Benign but painful, red-blue tumor under fingernails.

Arises from modified smooth musc cells of glomus body

122
Q

Bacillary angiomatosis

A

Benign capillary skin papules found in AIDS pts.
Caused by Bartonella henselae infection
Freq mistaken as Kaposi’s sarcoma

123
Q

Angiosarcoma

A

Highly lethal malignancy of the liver

Assoc w exposure to vinyl chloride, arsenic, and ThO2 (thorotrast) exposure

124
Q

Lymphangiosarcoma

A

Lymphatic malignancy assoc w persistent lymphadema (e.g post- radical mastectomy)

125
Q

Kaposi’s sarcoma

A

Endothelial malignancy of the skin assoc w HHV-8 and HIV

Freq mistaken as bacillary angiomatosis.

126
Q

Which vasculitis has…
Weak upper extremity pulses?
Occlusion of the opthalmic artery, which can cause blindness?
Perforation of the nasal septum?

A

Weak pulse = Takayasu
Opthal artery occlusion = Temporal arteritis
Nasal septum = Wegener’s gran.

127
Q

Which vasculitis features
Necrotizing granulomas of lung, and necrotizing glomerulonephritis?
Unlateral headache and jaw claudication?
Necrotizing immune-coomplex inflam of visceral/renal vessels?

A

Necrotizing lung, nephritis = Wegener’s
Uni headache/Jaw = Temporal arteritis
Imm-complx in renal vessles = Polyarteritis Nodosa

128
Q 
Which vasculitis is common in...
Young male smokers?
Young asian women?
Asian babies?
Young asthmatics?
A

M smoker = Buerger’s
Asian F = Takayasu
Asian baby = Kawasaki
Asthmatic = Churg-Strauss

129
Q

Vasculitis in…
HBV+ pts?
Infants/kids, w coronary problems?
Most common?

A

HBV = Polyarteritis nodosa
Coronary prob = Kawasaki
Most common = temporal arteritis

130
Q

Most common brain tumor in adults?

A

Gliobastoma multiforme (also most deadly)

131
Q

Pregnant woman has normal BP but when lying down it drops. Why?

A

Compression of IVC
less preload, so less SV
If prego should lie on side.

* DIT each session (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions