Nichols- Vasculitis & Complications of MI Flashcards
Vasculitis is obviously the inflammation of blood vessels. What is the most common cause?
Autoimmune
What are the two divisions of vasculitis?
- Non-infectious (primary)
2. Infectious
Common fungal cause of infectious vasculitis?
Aspergillus
Common bacterial cause of infectious vasculitis?
Pseudomonas
Common viral cause of infectious vasculitis?
Cytomegalovirus
Primary vasculitis is mediated by what cells?
T cell mediated immune response to vascular antigens –> recruit macrophages that “chew up” the elastic lamina of the vessel –> inflammation –> antibody mediated attack
Main sign of a vasculitis?
Palpable purpura
This vasculitis is an acute necrotizing inflammatory disease of the smallest vessels (arterioles, capillaries, venules)
Hypersensitivity angiitis
Hypersensitivity angiitis on the skin is called?
Leudocytoclastic vasculitis
Hypersensitivity angiitis on the internal organs is called?
Microscopic polyangiitis
Describe the pathogenesis of Hypersensitivity angiitis
infiltration of blood vessels by neutrophils –> breakdown of vessels (leukocytoclasia) –> dispersed nuclear dust
A good bit of the time, Hypersensitivity angiitis can come from?
Side effects of a drug
This vasculitis is a granulomatous inflammatory disease of medium/large arteries (especially in the head)
Temporal (giant cell) arteritis
Presentation of Temporal (giant cell) arteritis?
Old white women
Pathology of Temporal (giant cell) arteritis?
Chronic granulomatous inflammation with multinucleated giant cells that destroy the internal elastic lamina –> intimal thickening –> cell proliferation & luminal stenosis
Signs/symptoms of Temporal giant cell arteritis?
Headache, vision probs, jaw claudication
Temporal giant cell arteritis is assc with?
Polymyalgia rheumatica, a chronic inflammatory disease of muscles
Temporal giant cell arteritis major complication?
Blindness
How do you diagnose Temporal giant cell arteritis?
ESR & biopsy
How do you treat temporal giant cell arteritis?
aspirin & steroids
This vasculitis presents in young Asian children. It is a primary vasculitis of the coronary arteries with 20% aneurysm formation
Kawasaki disease
Pathogenesis of Kawasaki?
Immune reaction to ubiquitous RNA virus
Pathology of Kawasaki?
Endothelial necrosis with transmural inflammation
Signs/symptoms of Kawasaki?
Persistent high fever, conjunctivitis, skin erythema, cervical lymphadenopathy, STRAWBERRY TONGUE
There are 7 complications that can result from MI. What the fudge are they?
- Arrhythmia
- Heart Failure
- Mural thrombus formation
- Cardiac rupture
- Pericarditis
- Aneurysm
- Papillary muscle
How common are cardiac arrhythmias in MI?
Very very common.. almost always happen
Dyspnea, crackles, and a third heart sound would lead you to believe that ______ is assc with MI
heart failure
If over 40% of the LV is infarcted, what will patient present with?
Cardiogenic shock
Where does a mural thrombus usually embolize to?
Brain or kidney
Cardiac rupture of the free wall of the heart leads to?
Cardiac tamponade
Cardiac rupture of the IV septum leads to?
left –> right shunt
What day post MI is cardiac rupture most likely to happen?
5 days post MI
How long post MI does pericarditis occur?
2-4 days
Its been 6 weeks since Mr. Jone’s MI. He presents with an autoimmune disease against his pericardium. Whats the diagnosis?
Dressler syndrome
Why can ventricular aneurysms happen post MI?
Because the scar tissue is thinner than the previous heart tissue was.. this happens months post MI
Ruptured papillary muscle post MI leads to?
Mitral regurgitation
