Endocrine

Question 1

Conn Disease

Answer 1

Primary aldosterone elevation

Question 2

Monckeberg Medial Sclerosis

Answer 2

• is degenerative calcification of the media of large-to-medium-size muscular arteries
• usually in the extremities of older persons, or in advanced chronic kidney disease
• osseous metaplasia may be seen, but usually no clinical impairment

Question 3

Fibromuscular dysplasia

Answer 3

• is a rare, noninflammatory thickening of large-to-medium-size arteries (NO INFLAMM OR NECROSIS)

• -women of reproductive age mostly
• -can lead to renal artery stenosis

Question 4

Fusiform anurysm

Answer 4

along axis of vessel. usually abdominal are fusiform.

Question 5

Types of DVT

Answer 5

• deep venous thrombosis refers to both phlebothrombosis and thrombophlebitis
• thrombophlebitis - inflammation and secondary thrombosis of smaller veins, often as a reaction to bacterial infection
• phlebothrombosis - venous thrombosis not caused by infection or inflammation
• usually associated with prolonged best rest or reduced cardiac output
• anticoagulant (ex. protein C, antithrombin) deficiencies also increase risk
• major problem is pulmonary embolism

Question 6

Hemangiomas

Answer 6

common, benign vascular channel tumors. Look like birthmarks (capillary hemangiomas are birthmarks). Cherry red spots.

Question 7

Juvenile / Strawberry Hemangioma

Answer 7

• congenital lesions that grow rapidly in newborns and then regress by 3-5 years
• have packed masses of capillaries that are usually filled with blood and separated by connective tissue stroma

Question 8

Hemangioendothelioma

Answer 8

is a vascular tumor of endothelial cells

• intermediate between benign hemangiomas and malignant angiosarcomas

Question 9

Angiosarcoma

Answer 9

a rare, highly malignant tumor of endothelial cells
• small, painless, demarcated red nodules —> larger, fleshy, unencapsulated, pale gray masses —> central necrosis, softening, and hemorrhage
–stains for CD31

Question 10

Cystic lymphangioma

Answer 10

benign, soft, large, spongy, pink lesion in the neck and axilla

Question 11

Marantic endocarditis

Answer 11

Non-bacterial endocarditis

• associated with cancer, DIC, or nonneoplastic wasting diseases

Question 12

Rheumatic heart disease

Answer 12

Group A strep (pyrogenes)

Mitral valve tropism – fusing of leaflets (commissural fusing)

Question 13

Carcinoid syndrome

Answer 13

uniquely affects right-sided valves
• arises in patients with carcinoid tumors, usually of the small intestine, that have metastasized to the liver
• hypothesized cause: too much serotonin and other vasoactive amine and peptides, which travel through the R. heart before they can be metabolized in the lung
• non-inflammatory plaques of dense, fibrous gray tissue —> leaflet deformation and shrinkage —> tricuspid regurgitation or stenosis, pulmonary stenosis

Question 14

Myxoma

Answer 14

is the most common primary cardiac tumor
• glistening, gelatinous, polypoid masses mostly in the L. atrium
• causes mitral valve dysfunction, embolization to the brain

Question 15

AV Canal

Answer 15

ASD and VSD often in Down’s syndrome

Question 16

Patent ductus arteriosus

Answer 16

Rubella and premature infants

If want to close it give PDE inhibitors –> idomethecin

Question 17

Hypoplastic left heart

Answer 17

• very small L. ventricle and ascending aorta
• like a type of aortic stenosis
• blood flows from pulmonary artery/right ventricle to the systemic circulation via a PDA
• blood from pulmonary veins flows through ASD to right atrium

Question 18

Tricuspid atresia

Answer 18

congenital absence of the tricuspid valve —> obligate R-to-L shunt through the patent foramen ovale
• often with a VSD, which allows blood access back into the pulmonary arteries
• small right ventricle and cyanosis seen

Question 19

Ebstein malformation

Answer 19

downward displacement of an abnormal tricuspid valve into an underdeveloped right ventricle
• upper/inflow/proximal region of the R. ventricle is “atrialized,” only the distal part is functional
• leads to HF, R. atrial dilation, arrhythmias, palpitations, tachycardia, sudden death

Question 20

High output HF

Answer 20

Hyperthyrodisum, Low Thiamine/B12 (Beriberi)

Question 21

Constrictive Pericarditis

Answer 21

• chronic, fibrosing disease that fuses the visceral and parietal layers, obliterating the pericardial space and restricting flow into the heart
• due to excessive healing after an injury, esp. radiation, cardiac surgery, or TB
• high venous pressure, low CO, small pulse pressure, ascites and peripheral edema
• treat with total pericardiectomy

Question 22

Chronic vascular rejection of heart transplant

Answer 22

a.k.a accelerated coronary artery dx
affects epicardial coronary arteries and branches more than 1 year after transplantation
• concentric intimal proliferation and lumen narrowing —> occlusion, MI
–most common is acute cellular rejection

Question 23

Bronchiogenic Cyst

Answer 23

discrete, extrapulmonary, fluid-filled mass lined by respiratory epithelium, mucle, and cartilage; often found in the middle medisatinum
• can compress the airway, get infected, hemorrhage, perforate, or be asymptomatic

Question 24

Viral pneumonia causes what type of disease pattern

Answer 24

DAD –> @ first interstitial inflamm and hyline membrane (necrotic debris and infiltrate) then fibrosis and scaring after a week or so.

Question 25

MAI Pneumonia

Answer 25

lots of macrophages.
form epitheloid granulomas
loose aggregates of foamy macrophages
symp like TB

Question 26

airspace industry

Answer 26

berylliosis

Question 27

shipyard

Answer 27

asbestosis

construction and plumbing

Question 28

silicosis

Answer 28

sandblasters

Question 29

Loeffler syndrome

Answer 29

Eosinophilic pneumonia in response to a parasite

endomyocardial fibrosis with prominent eosinphilic infiltrate causing restrictive cardiomyopathy

Question 30

Bronchopulmonary dysplasia

Answer 30

Congenital weakness of the supporting structures of the bronchial wall

Question 31

Arrythmogenic RV cardiomyopathy

Answer 31

degeneration of cardiac myocytes and replacement with fat and fibrous tissue. disease of the desmosomes.
most common cause of sudden death in mediterranean and italy