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

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2
Q

Organism in animal urine

A
Leptospira
Hanta virus (rat/mouse urine)
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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)

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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)

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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

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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.

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7
Q

Causes of aortic stenosis

A

Age-related calcific aortic stenosis

Bicuspid aortic valve

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8
Q

Murmur: VSD

A

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

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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)

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10
Q

What can cause mitral prolapse?

A

Myxomatous degeneration
Rheumatic fever
Chordae rupture

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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

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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

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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)

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14
Q

What can cause mitral stenosis?

A

Often secondary to rheumatic fever

Chronic MS can result in LA dilation

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15
Q

Murmur: PDA

A

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

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16
Q

What murmur can be heard best at the tricuspid area?

A

Pan-systolic:
Tricuspid regurg
VSD

Diastolic:
Tricuspid stenosis
ASD

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17
Q

What murmurs are enhanced when TPR is increased?

A

Mitral regurg

Mitral prolapse

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18
Q

What murmur is enhanced when LA return is increased?

A

Mitral regurg

Mitral stenosis

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19
Q

What murmurs can be d/t Rheumatic Fever?

A
Mitral regurg
Mitral stenosis
Aortic regurg
Aortic stenosis
Tricuspid regurg
Mitral prolapse
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20
Q

What murmurs are loudest at S2?

A

Mitral prolapse

PDA

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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

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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)
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23
Q

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

A
Midsystolic click (systole)
Opening snap (diastole)
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24
Q

What do S1 and S2 heart sounds represent?

A

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

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25
What murmurs can be best heard at the aortic area?
Systolic murmurs: Aortic stenosis Flow murmur Aortic valve sclerosis
26
What murmurs can be best heard at the Left Sternal Border?
``` Diastolic murmur: Aortic regurg Pulmonic regurg Systolic murmur: Hypertrophic cardiomyopathy ```
27
What murmurs can be best heard at the pulmonic area?
Systolic ejection murmur: Pulmonic stenosis Flow murmur (eg ASD)
28
What murmurs can be best heard at the mitral area?
Systolic: mitral regurg Diastolic: mitral stenosis
29
Systolic murmur at left sternal border
Hypertrophic cardiomyopathy
30
Systolic ejection murmur at pulmonic area
``` Pulmonic stenosis Flow murmur (ASD) ```
31
Diastolic murmur at tricuspid area
Tricuspid stenosis | ASD
32
Diastolic murmur at mitral area
Mitral stenosis
33
Systolic murmur at aortic area
Aortic stenosis Flow murmur Aortic valve sclerosis
34
Diastolic murmur at left sternal border
Aortic regurg | Pulmonic regurg
35
Pansystolic murmur at tricuspid area
Tricuspid regurg | VSD
36
Systolic murmur at mitral area
Mitral regurg
37
Px of ASD murmur
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
38
What valves should be open during diastole?
Diastolic filling- so mitral and tricuspid should be open. Therefore stenosis of these valves will make a diastolic murmur.
39
What valves should be closed during diastole?
Diastolic filling- aortic and pulm valves should be closed. If there is aortic or pulm regurg, will hear a murmur.
40
What valve should be open during systole?
Systolic contraction: aortic and pulmonic valves should be open (at the end of systole) So aortic or pulm stenosis will cause a systolic murmur
41
What valves should be closed during systole?
Mitral and Tricuspid. So if have mitral or tricuspid regurg, will cause a systolic murmur.
42
When are all of the valves closed?
``` Isovolumetric contraction (Early systole) Isovolumetric relaxation (Early diastole) ```
43
Best heard w pt in left lateral decubitous position (on left side)?
Mitral regurg Mitral stenosis Left-sided S3 and S4 heart sounds.
44
Most common causes of aortic stenosis
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)
45
VSD and tricuspid regurg sound the same. In what pts is it likely to be VSD? to be tricuspid regurg?
VSD: newborns | IV drug user: tricuspid regurg
46
What does holosystolic mean?
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)
47
How do you open/close a PDA?
Open: prostaglandins Close: NSAIDs (indomethicin)
48
Signs of R-sided heart failure
Peripheral / lower extremity edema | Hepatosplenomegaly
49
Signs of L-sided heart failure
Pulmonic congestion / edema Dyspnea on exertion Orthopnea Paroxysmal nocturnal dyspnea
50
Signs/sympt of bacterial endocarditis
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 ```
51
What valves are usu involved in bacterial endocarditis?
Mitral valve most frequently | Tricuspid valve in IV drug users (don't tri drugs)- assoc w S. aureus, Pseudomonas, Candida
52
Complications of bacterial endocarditis
``` chordae rupture glomerulonephritis suppurative pericarditis R-sided (tricuspid) emboli -->PE L-sided (mitral) emboli --> Stroke ```
53
Organisms causing bacterial endocarditis
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
Non-bacterial endocarditis
Occurs secondary to malignancy or hyper-coag state (marantic / thrombolyic endocarditis)
55
How to dx bacterial endocarditis
multiple blood cultures
56
What are the HACEK organisms?
``` Hemophilus Actinobacillus Cardiobacterium hominis Eikenella corrodens Kingella ``` These cause culture-negative endocarditis
57
What is Libman-Sacks endocarditis?
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
What is endocarditis?
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
What are vegetations?
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
Which lesions of endocarditis are painful? non-painful?
``` Painful = Osler's nodes on finger/toe pads Non-painful = Janeway lesions on palms/soles ```
61
What are the features of Hypovolemic/Cardiogenic shock? | Septic shock?
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
SVR & CO, plus Rx in Hypovolemic shock
SVR and CO both increase | Rx = IV fluid and blood
63
Causes of hypovolemic shock
Blood loss d/t trauma (gunshot, MVA, stabbing) | Severe burns
64
SVR & CO plus Rx in Heart failure (cardiogenic shock)
``` CO is decreased bc heart is failing, so have a compensatory increase in SVR Rx = LMNOPP Loop/Lasix Morphine Nitrates O2 Pressors Positioning ```
65
SVR & CO plus Rx in sepsis/anaphylaxis
Massive vasodilation - decreased SVR Compensatory increase in CO Rx Abx, IV fluids (plus NE if needed)
66
SVR & CO plus Rx in neurogenic shock
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
Causes of cardiogenic shock
``` Heart failure MI Arrhythmias (V-tach, esp V-fib) Tamponade Pulm embolism Tension pneumothorax Cardiac contusion ```
68
Sympt of Rheumatic heart dz
``` 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
What is Rheumatic heart dz?
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 >> 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
Aschoff body
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
T/F Rheumatic dz of the heart is d/t bacterial infection.
False. It's auto-immune | But: It is the consequence of S. pyogenes infection.
72
Cardiac tamponade
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
Findings in cardiac tamponade
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
What is pulsus paradoxis?
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
What are the types of pericarditis?
Serious (SLE, Rheum Arthritis, viral infection, uremia) Fibrinous (Uremia, MI-dressler's synd, Rheum Fever) Hemorrhagic (TB, malignancy-melanoma)
76
What are the findings in pericarditis?
``` 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
Heart dz caused by syphilis
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
What is Kussmaul's sign/pulse?
JVD with inspiration Caused by decreased capacity of RIGHT ventricle Common in constrictive pericarditis (not v much in tamponade)
79
How is pulsus paradoxus different from Kussmaul's?
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
Myxoma
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
Rhabdomyoma
Most freq primary cardiac tumor in kids | Assoc w tuberous sclerosis
82
Most common heart tumor
Metastases - melanoma, lymphoma
83
Chest pain, dyspnea, tachycardia, tachypnea in.. IV drug user MVA pt Post-op pt
IVDU: Bacterial endocarditis (maybe bacterial embolism --> PE) MVA pt: Tension pneumothorax Post-op: Pulm embolism (esp if pt is also confused)
84
Immediate Rx for bacterial endocarditis
Get culture give IV vanco then later give specific Abx dep on what culture shows
85
Diffuse myocardial inflam w necrosis and mononuclear cells
Myocarditis
86
Chest pain + course rubbing heart sounds in pt w Creatinine 5.0
Uremic pericarditis
87
ST elevations in all EKG leads
Pericarditis
88
Disordered growth of myocytes
Hypertrophic cardiomyopathy
89
EKG shows electrical alternans
Cardiac tamponade
90
Raynaud's dz
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
Rx for Raynaud's
Aspirin Dihydropyridine CCBs Sildenafil (ED- but great vasodilator)
92
Renal dz + lung dz
Wegener's granulomatosis or Goodpasture's syndrome | Differentiate bc Wegener's has upper airway dz, Goodpasture's doesn't
93
Perforation of nasal septum- cause
Cocaine abuse | Wegener's granulomatousis
94
Triad for Wegener's granulomatosis
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
Symptoms of Wegener's granulomatosis
``` Hemoptysis Hematuria Perf of nasal septum Chronic sinusitis Otitis media Mastoiditis Cough, Dyspnea ```
96
Lab findings in Wegener's granulomatosis
c-ANCA (!!!) CXR might show lg nodular densities Hematuria and red cell casts
97
Rx for Wegener's granulomatosis
Cyclophosphamide and corticosteroids | this is also the Rx for polyarteritis nodosa
98
What 3 things are p-ANCA positive?
Microscopic poly angitis Primary pauci-immune crescentic glomerular nephritis Churg-Strauss syndrome.
99
What is microscopic polyangitis?
``` Like Wegeners (inflam, necrosis- lungs, kidneys), but does NOT have granulomas. p-ANCA ```
100
What is primary pauci-immune crescentic glomerulonephritis?
Vasculitis limited to kidney Pauce-immune = paucity of Ab p-ANCA mpo-ANCA
101
What is Churgg-Strauss syndrome?
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
Things that cause eosinophilia
``` Atopy (predisposition to HPS rxns) Asthma Allergies Parasites Churg-Strauss ```
103
Sturge-Weber dz
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
Henoch-Schonlein purpura
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
Buerger's dz
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
T/F medium-vessel dz causes thrombosis/infarction of arteries
True
107
Kawasaki dz
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
Rx for Kawasaki dz
``` IV immunoglobulin (pooled Ab from population) High dose aspirin- this is the only time you give it to kids (Reye's!) ```
109
Polyarteritis nodosa
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
Findings and Rx for Polyarteritis nodosa
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
Takayasu's arteritis
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
Temporal arteritis (giant cell arteritis)
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
Findings and Rx in Temporal arteritis
Assoc w increased ESR Half of pts have systemic involvement and polymyalgia rheumatica Rx: high dose steriods (for over a year)
114
Polymyalgia rhematica
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
Differential Dx for red lesions
``` Strawberry hemangioma Cherry hemangioma Pyogenic granuloma Cystic hygroma Glomus tumor Bacillary angiomatosis Angiosarcoma Lymphangiosarcoma Kaposi's sarcoma ```
116
Strawberry hemangioma
Benign capillary hemangioma in infancy | Grows w child initially, then spontaneously regresses.
117
Cherry hemangioma
Benign capillary hemangioma in elderly Does not regress Freq increases w age
118
Pyrogenic granuloma
Polypoid capillary hemangioma that can ulcerate and bleed. | Assoc w trauma and pregnancy
119
Hemangioma
Benign tumor | Abn buildup of bld vessels in skin or organs
120
Cystic hygroma
Cavernous lymphangioma of the neck. | Assoc w Turner's 45XO
121
Glomus tumor
Benign but painful, red-blue tumor under fingernails. | Arises from modified smooth musc cells of glomus body
122
Bacillary angiomatosis
Benign capillary skin papules found in AIDS pts. Caused by Bartonella henselae infection Freq mistaken as Kaposi's sarcoma
123
Angiosarcoma
Highly lethal malignancy of the liver | Assoc w exposure to vinyl chloride, arsenic, and ThO2 (thorotrast) exposure
124
Lymphangiosarcoma
Lymphatic malignancy assoc w persistent lymphadema (e.g post- radical mastectomy)
125
Kaposi's sarcoma
Endothelial malignancy of the skin assoc w HHV-8 and HIV | Freq mistaken as bacillary angiomatosis.
126
Which vasculitis has... Weak upper extremity pulses? Occlusion of the opthalmic artery, which can cause blindness? Perforation of the nasal septum?
Weak pulse = Takayasu Opthal artery occlusion = Temporal arteritis Nasal septum = Wegener's gran.
127
Which vasculitis features Necrotizing granulomas of lung, and necrotizing glomerulonephritis? Unlateral headache and jaw claudication? Necrotizing immune-coomplex inflam of visceral/renal vessels?
Necrotizing lung, nephritis = Wegener's Uni headache/Jaw = Temporal arteritis Imm-complx in renal vessles = Polyarteritis Nodosa
128
``` Which vasculitis is common in... Young male smokers? Young asian women? Asian babies? Young asthmatics? ```
M smoker = Buerger's Asian F = Takayasu Asian baby = Kawasaki Asthmatic = Churg-Strauss
129
Vasculitis in... HBV+ pts? Infants/kids, w coronary problems? Most common?
HBV = Polyarteritis nodosa Coronary prob = Kawasaki Most common = temporal arteritis
130
Most common brain tumor in adults?
Gliobastoma multiforme (also most deadly)
131
Pregnant woman has normal BP but when lying down it drops. Why?
Compression of IVC less preload, so less SV If prego should lie on side.