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CR III > Path > Flashcards

Path Flashcards

1
Q

Temporal (Giant Cell) Arteritis

A
  • Granulomatous Vasculitis often involving Branches of Carotid
    • Thickened Tunica Intima
    • Destruction of Elastic Lamina
  • Presentations
    • Headache
    • Visual Disturbances
    • Jaw Claudication
    • Flu-Like Symptoms w/ Joint and Muscle Pain
    • Elevated ESR
  • Biopsy
    • Inflamed Vessel Wall w/ Giant Cells and Intimal Fibrosis
    • Negative biopsy DOES NOT r/o disease
  • Treatment
    • Corticosteroids
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2
Q

Takayasu Arteritis

A
  • Granulomatous vasculitis often involving aortic arch at branch points
  • Presents in younger adults (classically, Asian Females)
    • Visual and Neurological Symptoms w/ weak and absent pulse in UE
    • Elevated ESR
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3
Q

Polyarteritis Nodosa

A
  • Necrotizing vasculitis involving multiple organs (Lungs Spared)
    • Fibrinoid Necrosis
  • Presents in Young Adults as
    • Hypertension (Renal Artery Involvement)
    • Abdominal pain w/ melena (Mesenteric Artery Involvement)
    • Neurologic Disturbances
    • Skin Lesions
    • Associated w/ Serum HBsAg
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4
Q

Kawasaki Disease

A
  • Asian children <4 Years of Age
  • Coronary Artery Involvment Common and Leads to:
    • Risks for Thrombosis w/ MI
    • Aneurysm w/ Rupture
  • Presents w/
    • Fever
    • Conjunctivitis
    • Erythematous Rash of Palms and Soles
    • Enlarged Cervical Lymph Nodes
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5
Q

Microscopic Polyangitis

A
  • Necrotizing vasculitis involving multiple organs, including lungs and kidney
  • Similar to Wegener granulomatosis (granulomatosis w/ polyangitis)
    • BUT nasopharyngeal involvement and granulomas absent
  • Serum p-ANCA levels correlate w/ disease activity
  • Tx = corticosteroids and cyclophosphamide
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6
Q

Granulomatosis w/ Polyangitis (Wegener Granulomatosis)

A
  • Necrotizing granulomatous vasculitis involving nasopharynx, lungs, and kidneys
  • Presents in Middle-Aged Male w/ :
    • Sinusitis
    • Nasopharyngeal Ulceration
    • Hemoptysis w/ bilateral nodular lung infiltrates
    • Hematuria due to rapidly progressive glomerulonephritis
  • Serum c-ANCA levels correlate w/ disease activity
  • Biopsy reveals large necrotizing granulomas w/ adjacent necrotizing vasculitis
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7
Q

Buerger Disease

A
  • Necrotizing vasculitis involving digits
  • Presents w/
    • Ulceration
    • Gangrene
    • Autoamputation of Fingers and Toes
    • Raynaud Phenomenon often present
  • Highly associated w/ heavy smoking
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8
Q

Reagent Test Strip

A
  • Advantages
    • Evaluate multiple physicochemical aspects of urine
    • Results availabe in minutes
    • Low complexity
  • Disadvantages
    • Medications/Other Compounds may interfere w/ test
    • If there is discordance b/t clinical suspicion and test strip results microscopic eval is needed as well as backup chemistry tests
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9
Q

Hyaline Casts

A
  • Hyaline Cast
    • Composed of Tamm-Horsfall Protein
    • Can be seen in:
      • Normal Urine (0-2 Low Power Field)
      • Following Strenuous Exercise and Dehydration
      • All type of renal disease
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10
Q
A
  • Cysteine crystals
    • Cystinuria Disease
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11
Q
A
  • Tyrosine Crystals
    • Severe Liver Disease
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12
Q
A
  • Leucine Crystals
    • Liver Disease
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13
Q
A
  • Cholesterol Crystals
    • Nephrotic Syndrome
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14
Q
A
  • Bilirubin Crystals
    • Liver Disease
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15
Q

Normal Blood Pressure

A

Less than 120/80 mmHg

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16
Q

Elevated Blood Pressure

A

Systolic b/t 120-129 and Diastolic less than 80

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17
Q

Stage 1 Hypertension

A

Systolic 130-139 and Diastolic 80-89

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18
Q

Stage 2 Hypertension

A

Systolic at least 140 or Diastolic at least 90

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19
Q

Hypertensive Crisis

A

Systolic Over 180 and/or Diastolic Over 120

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20
Q

Monckeberg’s Medial Calcific Sclerosis

A
  • Calcific deposits in muscular arteries in people over age 50
    • Typically do not involve the lumen
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21
Q

Arteriolosclerosis

A
  • Disease of small arteries and arterioles associated w/ hypertension and diabetes
22
Q

Atherosclerosis

A
  • Arteriosclerosis characterized by fatty and atheromatous plaques w/in arterial lumina
    • Most frequent and clinically important pattern of ateriosclerosis
23
Q

Hyaline Arteriolosclerosis

A
  • Arteriolar wall is thickened w/ increased plasma protein deposition and narrowed lumen
    • Chronic Hypertension
    • Diabetes Mellitus
24
Q

Hyperplastic Arteriolosclerosis

A
  • Onion-skinning causing lumenal obliteration
    • Severe (Malignant) HTN
  • Laminations composed of smooth muscle cells w/ reduplicated, thickened basement membranes
25
Q

Most frequent causes of aortic stenosis

A
  1. Wear and Tear
  2. RHD
26
Q

Most frequent cause of aortic insufficiency

A
  1. Dilation of Aortic Arch (Due to Hypertension and Aging)
  2. RHD
27
Q

Most frequent cause of mitral stenosis

A
  1. Post-Inflammatory Scarring of RHD
28
Q

Most frequent cause of mitral insuffiency

A
  1. Myxomatous Degeneration
  2. RHD
29
Q

Congenital Bicuspid Aortic Valve

A
  • 1.4% of Live Births
  • Asymptomatic Early
  • Predisposes to Early Calcific Stenosis
  • Often Diagnosed in Young Adulthood
  • Larger Cusp Often has Midline Raphe
30
Q
  • Proteoglycans Deposited in Spongiosa
    • Collagen and Elastin Loose and Disorganized
A

Mitral Valve Prolapse (Myxomatous Valve)

  • Midsystolic Click
  • Ballooning/Parachute-Like Leaflets

*More common in women than men*

31
Q

Bread and Butter Pericarditis

A

Acute Rheumatic Heart Disease

32
Q

Most Common of All Valvular Diseases

A

Aortic Stenosis

33
Q
  1. Angina
  2. Syncope During Exertion
  3. Congestive Heart Failure
  4. Heart Palpitations
  5. Sudden Cardiac Death from Arryhthmia
A

Aortic Stenosis

34
Q
  1. Dyspnea on Exertion
  2. Fatigue
  3. Decreased Exercise Tolerance
  4. Sensation of Forceful Heartbeat w/ HBP
A

Aortic Regurgitation/Insufficiency

35
Q
  1. Dyspnea w/ Exertion at First and at Rest Later (With increased severity)
  2. Fatigue
  3. Pulmonary Hypertension
  4. Right Sided Heart Failure
A

Mitral Stenosis

36
Q

Use of Fen-Phen

A

Mitral Regurgitation

37
Q

Anitschkow Cells “Caterpillar Cells”

A

Rheumatic Heart Disease

38
Q

What valve disease is pretty much universal in Chronic Rheumatic Heart Disease?

A

Mitral Stenosis

39
Q

Acute Infective Endocarditis

A
  • Explosive, Rapidly Progressive Illness
    • High Fever
    • Shaking Chills
  • Staph aureus commonly
  • Often arises in previously normal heart valves
40
Q

Subacute Infective Endocarditis

A
  • Low-Grade Fever, often w/ nonspecific constitutional symptoms
  • Strep viridans most common w/ native valves
  • Epidermidis most common w/ prosthetic valves
  • Typically arise in damaged/congenitally abnormal heart valves
41
Q
  • Intravenous Drug Abuse
  • May be complicated by pulmonary emboli and infarcts
    • Pneumonia
    • Lung abscesses
  • May result in CHF
A

Right-Sided Endocarditis

42
Q
  • Sterile, small vegetations of platelets and fibrin, loosely adherent to valve leaflets along closure lines w/o significant inflammation or valve damage
  • Setting of cancer of prolonged chronic illnesses
A

Non-Bacterial Thrombotic Endocarditis

43
Q
  • Systemic Lupus Erythematosus and Antiphospholipid Antibody Syndrome
  • Valve Scarring
  • Small/Medium-Sized Fibrinous, Sterile Vegetations on Either or Both Sides of the Valve Leaflets
A

Libman-Sachs Disease

44
Q

Fusion of Commisure of Aortic Valve

A

Post-Rheumatic Heart Disease

45
Q
  • Occur in Skin, Subcutaneous Tissues, Mucous Membranes, Liver, Spleen, and Kidneys
  • Bright Red to Blue, Vary from a few millimeters to several centimeters in size
  • Microscopically are unencapsulated aggregates of closely packed, thin walled capillaries
    • Vessels separated by scant connective tissue stroma
A

Capillary Hemangioma

46
Q
  • Composed of larger vessels than seen in capillary hemangiomas
A

Cavernous Hemangioma

47
Q
  • Rapidly growing pedunculated red nodule on the skin of mucus membrane
  • Bleeds easily, often ulcerated
  • Usually reach 1-2 cm in size within a few weeks
  • May develop after trauma
  • Microscopically are composed of closely packed small capillaries in a lobular configuration w/ stromal edema
A

Lobular Capillary Hemangioma

48
Q
  • Predominantly in head and neck region, and axillary subcutaneous tissues
  • Look like hemangioma, except vessels do not contain blood
A

Simple Capillary Lymphangioma

49
Q
  • Typically found in head and neck region or axilla of children
  • May be enormous, up to 15 cm
  • Not encapsulated. Composed of large, dilated vessels, w/o blood in the lumen
A

Cavernous Lymphangioma

50
Q

Malignant Primary Cardiac Tumors

A
  • Angiosarcoma
  • Rhabdomyosarcoma
  • Leiomyosarcoma
  • Kaposi Sarcoma
  • Fibrosarcoma
  • Lymphoma
51
Q

Most Common Metastatic tumors to Heart

A
  • Melanoma
  • Breast Carcinoma
  • Lung Carcinoma
  • Renal Cell Carcinoma
  • Germ Cells Tumors
  • Childhood Rhabdomyosarcoma
52
Q
A

CR III (4 decks)

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