PATH - General Flashcards
Wolff-Parkinson-White syndrome
Most common type of ventricular pre-excitation
syndrome
Abnormal fast accessory
conduction pathway from atria to ventricle (*bundle of Kent) bypasses the rate-slowing
AV node
**delta wave with widened QRS complex and shortened PR
interval
May result in *reentry circuit–>supraventricular tachycardia
Xanthomas
Plaques or nodules composed of lipid-laden *histiocytes in skin, especially the eyelids
(xanthelasma).
Tendinous xanthoma
Lipid deposit in tendon, especially Achilles
Corneal arcus
Lipid deposit in cornea.
Common in elderly (*arcus senilis), but appears earlier in life in hypercholesterolemia
Arteriosclerosis
Hardening of arteries, with arterial wall thickening and loss of elasticity.
Arteriolosclerosis
Affects small arteries and arterioles
Common
Two types:
- hyaline (thickening of vessel walls in essential hypertension or diabetes mellitus)
- hyperplastic (“onion skinning” in severe hypertension with proliferation of smooth muscle cells)
Mönckeberg sclerosis
medial calcific sclerosis
Affects medium-sized arteries
Uncommon
Calcification of internal elastic lamina and media of arteries–>vascular stiffening without obstruction.
“Pipestem” appearance on x-ray
Does not obstruct blood flow; intima not involved.
Atherosclerosis
Disease of elastic arteries and large- and medium-sized muscular arteries; a form of
arteriosclerosis caused by buildup of cholesterol plaques
Very common
Abdominal aorta > coronary artery > popliteal artery > carotid artery
SX
Angina, claudication, but can be asymptomatic
COMP
Aneurysms, ischemia, infarcts, peripheral vascular disease, thrombus, emboli.
PHYS
Inflammation important in pathogenesis: endothelial cell dysfunction–>macrophage and LDL accumulation–>foam cell formation–>fatty streaks–>smooth muscle cell migration (involves PDGF and FGF), proliferation, and extracellular matrix deposition–>fibrous plaque–>complex atheromas
Congestive Heart Failure
Clinical syndrome of cardiac pump dysfunction–>congestion and low perfusion
SX
dyspnea, orthopnea, fatigue; signs include rales, jugular venous distention (JVD), pitting
edema
Right HF most often results from left HF.
Cor pulmonale refers to isolated right HF due to
pulmonary cause
Congestive Heart Failure
Systolic dysfunction
DEC EF
INC EDV
DEC contractility often 2° to ischemia/MI or dilated
cardiomyopathy.
Congestive Heart Failure
Diastolic dysfunction
preserved EF
normal EDV
DEC compliance often 2° to myocardial hypertrophy.
Left heart failure
Orthopnea
Paroxysmal nocturnal dyspnea
Pulmonary edema
Right heart failure
Hepatomegaly (nutmeg liver)
Jugular venous distention
Peripheral edema
Bacterial endocarditis
Acute—S aureus (high virulence).
- Large vegetations on previously normalvalves.
- Rapid onset.
Subacute—viridans streptococci (low virulence).
-Smaller vegetations on
congenitally abnormal or diseased valves.
-Sequela of dental procedures. -Gradual onset
Mitral valve is most frequently involved.
Tricuspid valve endocarditis is associated with IV drug abuse (don’t “tri” drugs)
♥ Bacteria FROM JANE ♥: -Fever (most common symptom) -Roth spots (round white spots on retina surrounded by hemorrhage) -Osler nodes (tender raised lesions on finger or toe pads) -Murmur -Janeway lesions (small, painless, erythematous lesions on palm or sole) -Anemia -Nail-bed hemorrhage -Emboli
Rheumatic Fever
A consequence of pharyngeal infection with group A β-hemolytic streptococci (S. pyogenes)
Late sequelae include rheumatic heart disease, which affects heart valves—mitral > aortic»_space;tricuspid
Early lesion is mitral valve regurgitation
Late lesion is mitral stenosis
*type II hypersensitivity
*Aschoff bodies (granuloma with giant cells)
*Anitschkow cells (enlarged macrophages with ovoid, wavy,
rod-like nucleus)
J♥NES (major criteria): Joint (migratory polyarthritis) ♥ (carditis) Nodules in skin (subcutaneous) Erythema marginatum Sydenham chorea
INC ASO titers
