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Block 4 > Path > Flashcards

Path Flashcards

1
Q

how are MPO/PR3 autoab bad?

A

ligate target to plasma mem of leuks & cross link w/ Fc receptors –> resp burst, release proteolytic granules, cytok –> alternative C’ –> rolling neu

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2
Q

ranges of nml vs elevated bp vs stage 1 HTN vs stage 2 HTN vs hypertensive crisis

A

<120/80 vs <130/80 vs <140 or 90 vs >/=140 or 90 vs >/=180/120

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3
Q

risk factors of HTN

A

black, age, obese/wt gain, alc, psychosocial stress, sedentary

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4
Q

does inc in cardiomyocyte size/hypertrophy inc vasc density?

A

no –> O2 & nutrients = less in hypertophied heart

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5
Q

forward vs backward failure

A

heart can’t pump blood forward to meet body’s metab demands vs inc pulm or systemic venous pressure -> fluid moves from capillaries to interstitium -> pulm and/or periph edema

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6
Q

HTN crisis: neuro vs cardiac vs renal vs ocular vs microangiopathic hemolytic anemia

A

HTN enceph vs LV fail, coronary syndrome, aortic dissection vs high BUN/Cr, hematuria vs HTN retinopathy, retinal hem, yellow exudates, papilledema vs fibrinoid necrotizing arteriolitis -> destroyed RBCs -> occlusion w/ schistocytes

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7
Q

L (cause; clin pres) vs R (cause) HTN/cor pulmonale heart dz

A

diastolic dysfxn, CHF, IHD; LV concentric w/ perivasc interstitial fibrosis, EKG showing lg V, afib showing lg A, eccentric, pulm edema vs RV overload, pulm HTN

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8
Q

causes and clin pres of AsD vs VsD

A

defect in interatrial septum -> L to R shunt -> R heart overload -> systemic edema. asx/murmur/sOB; CXR shows lg R heart vs defect in interventricular septum -> L heart overload. asx/murmur; pulm HTN, shunt reversal, Eisenmenger

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9
Q

coarct of aorta. clin pres for neonatal vs adult?

A

narrowing of abd aorta either proximal/preductal or distal/postductal to to L subclavian a & ductus arteriosus. CHF, shock vs UE HTN, dec LE pulse, aortic aneurysm, systolic murmur, CXR shows figure 3 config

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10
Q

PFO

A

failed postnatal fusion of septum primum & secundum -> no flap b/w RA & LA at fossa ovalis -> LAP > RAP to keep PFO closed but if RAP > LAP -> paradoxical embol (clot goes R to L to brain) -> cryptogenic stroke, migraines w/ aura

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11
Q

TOF. complications?

A

defect in conotruncal septum -> pulm valve/a stenosis, lg VSD, overriding aorta over VSD instead LV, RVH -> R to L shunt -> cyanosis, tet spells, squatting -> inc resistance -> more bloodflow to pulm circ. arterial thrombosis -> ischemic stroke

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12
Q

Eisenmenger syndrome. clin pres?

A

untxed L to R shunt  inc pulm blood flow  pulm vasc obstructive dz & vasc resistance  pulm a HTN RV hypertrophy & failure. Fatigue, dyspnea, cyanosis, erythrocytosis; CXR shows enlarged RV & dilated pulm a

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13
Q

tricuspid atresia

A

no tricuspid valve & hypoplastic RV -> blood from RA to LA to LV (ASD) -> no blood to lungs -> cyanosis, CHF, digital club, fail to thrive

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14
Q

Ebstein anomaly

A

downward/apical displacement of tricuspid valve into RV -> incompetent tricuspid valve, shortened RV, enlarged RA -> R to L shunt

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15
Q

truncus arteriosus

A

arterial vessel from heart overrides vent septum -> supplies systemic & pulm circ from proximal ascending vessel -> cyanosis, polycythemia, finger clubbing, CHF, fail to thrive, recurrent resp infxns

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16
Q

TGA. D v L TGA

A

failed conotruncal septum to spiral & divide TA to pulm aa & aorta -> aorta = ant on RV, pulm a on LV. pulm & systemic circs in parallel not nml series -> incompatible w/ life w/o mixing circs vs nml circs but L/RV switched -> deO2 blood go to RA to LV to pulm aa, O2 blood go to pulm vv to LA to RV to aorta

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17
Q

general idea of L to R shunt vs R to L shunt

A

blood from L to R -> dec CO -> dec O2 to tissue -> Qp/Qs > 1.5:1-> R heart overload, inc pulm pressure/resistance, edema vs blood from R to L -> Qp/Qs < 1:1 -> L heart overload

18
Q

Anomalous coronary a from pulm a

A

L>R coronary a -> LV perfused by desaturated blood under low pressure -> myocardial ischemia -> CP, syncope, sudden cardiac death, MI

19
Q

xanthoma?
* Xanthelasma =
* Tuberous =
* Tendinous =
* Eruptive =

A

deposited lipid laden macs in skin or tendon. most common; soft & yellow vs extensors knees/elbows/butt d/t hyperchol & high LDL vs subq nodules on extensors hands/feet/Achilles vs pruritic red-yellow papules on extensors/butt/shoulders d/t hyperTG x/ IV; Can spont resolve in weeks

20
Q

concentric vs eccentric hypertrophy

A

high overload -> new sarcomeres in parallel w/ long axes of cardiomyocytes vs vol-overload hypertrophy/aortic regurg -> vent dil -> new sarcomeres in series w/ existing sarcomeres

21
Q

superficial vs DVT affects which vv? causes vs clin pres of DVT?

A

great/less saph vv vs iliac, fem, popliteal, tibial vv. immobile, cig smoke, obese, ocp, hormone replace, preg, surg/trauma, antiphospholipid ab, Factor V Leiden, prothrombin mutation vs pulm thromboembolism

22
Q

cause vs clin pres vs complications of thrombophlebitis?

A

staph aureus, S. epidermidis, K. pneu, E. coli, Pseudomonas; IV cath, venipuncture for phlebotomy & IV injections vs fever/chills, limb swelling, tender vs sepsis, infective endocarditis

23
Q
  • Migratory thrombophlebitis/Trousseau
A

recurrent venous thrombosis preceding or concomitant w/ occult visceral malig from ca procoagulant or tissue factor

24
Q

Cause of venous thrombosis?

A

Virchow’s triad: vessel wall injury; venous stasis from immobility; change in blood composition from factor V Leiden, lupus anticoag, protein C/S defic, antithrombin defic, malig

25
Q

risk factors vs clin pres of varicose vv of LE

A

fhx, age, female, multipara; obese, occupation vs Chronic insufficiency of LE, Pitting edema; Venous stasis, ulcer; Superficial thrombophlebitis

26
Q

primary vs secondary lymphedema

A

in children; Milroy dz: auto dom VEGFR3 -> dec lymp vessel -> can’t absorb lymph fluid -> painless chronic LE lymphedema vs in adults; Brca, rads therapy, extensive skin resect, extreme obese

27
Q

varicose vv of LE. primary vs secondary?

A

subq dil vessels in LE esp great/less saph vv -> inc venous pressure, dec venous return. downreg P2X1 receptors -> lose ctxile cells -> can’t vasoconstrict, just dil -> secondary valve dz vs inflam & destruction of vessel wall -> inc venous pressure -> more inflam & venous destruction

28
Q

examples of complicated plaques

A

calcification in lipid core; superficial v deep rupture; chol crystal in small/med aa esp abd aorta -> livedo reticularis, blue toe syndrome, LE pain; plaque hem from rupture of newly formed capillaries

29
Q

non vs modifiable factors of atherosclerosis

A

fhx, age, gender vs HLD, DM, HTN; homocysteine, metab d/o; cig smoke; inflam/infxn

30
Q

tunica intima vs media vs adventitia

A

simple sq endothel cells vs symph circular sm mm cells, have lumen that shrinks when cells constrict vs merges w/ surrounding tissue

31
Q

elastic aa. vasa vasorum?

A

largest aa containing cirumferential & fenestrated sheets of elastic fibers in tunic media, in/external lamina –> stretches heart in systole. blood vessels in tunica media

32
Q

muscular/distributing aa

A

branches off elastic aa to supply organs & extremities. constrict/dil to ctrl blood flow to specific organs. respond to neural, hormonal, & local metab stimuli

33
Q

arterioles -> metarterioles -> capillaries

A

smooth cell mm layer = still continuous, ctrls blood flow/pressure vs scatter sm mm cells, ctrls blood flow thru capillaries vs not continuous, 1 cell thick for diffusion, contains pericytes

34
Q

cont vs fenest vs sinusoid capillaries

A

most common, no defects vs pores -> more permeable; GI, endocrine glands, kid, choroid plexus vs bigger pores -> WBC pass thru, highly fenestrated basal lamina; liver, spleen, bone marrow, some endocrine glands

35
Q

post capillary vs collecting vs muscular venules

A

receive blood from capillaries, have pericytes, WBC migration vs mult layers of pericytes, tunica media vs smooth mm fibers instead of pericytes, tunica media

36
Q

lymph vessels

A

run parallel to capillary & vv; move lymph via muscle compression; have valves to prevent backflow; low pressure vs endothel cells not tightly joined -> edges loosely overlap & have minivalves to prevent backflow; fibers anchor endothel cells -> expose slits & keep vessels from collapsing

37
Q

what do cardiac cells vs Purkinje look like histo?

A

central nuclei, striations, lots of capillaries, intercalated discs (desmosomes/adherent jxns/gap jxns); no regen -> fibrosis/scar vs must fine tune microscope -> bigger cells w/ frothy central cyto w/ few peripheral striations

38
Q

endo vs myo vs epicardium

A

simple sq vs thickest; atria has lowest pressure -> thinnest myocardium, LV has highest pressure -> thickest myocardium vs simple sq w/ adipose

39
Q

papillary mm vs chordae tendinae vs heart valves

A

collagen fibers providing tension for chordae tendinae vs collagen & elastic thata prevent prolapse of AV valves vs prevent backflow; lamina fibrosa = central cartil plate, covered by endocardium

40
Q

sA & AV nodes vs Purkinje

A

irreg twirl of small fibers lacking intercalated discs embedded in collagen connective tissue vs binucleated bigger myocytes w/ less myofibrils = terminal branches of condxn in ventricles, lg glycogen stores -> clear halo around nucleus

Block 4 (18 decks)

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