Path - Pulm Vasc Dz

Question 1

what is the study of choice for suspected PE?

Answer 1

contrast-enhanced CT scan (often paired with angiogram now)

Question 2

what is the purpose of a plain CXR with suspected PE?

Answer 2

rule out mimics: pneumonia, pneumothorax

Question 3

what % of PEs cause wedge infarcts?

Answer 3

15-20%

Question 4

pulm infarcts generally lead to?

Answer 4

hemorrhage

Question 5

what is the order of pathology in PAH?

Answer 5

medial hypertrophy –> intimal proliferation (usually endothelial hyperplasia) –> intimal fibrosis –> plexiform lesions

Question 6

clinical sx of wegener’s

Answer 6

cough, hemoptysis, pleuritis

Question 7

why is it important to detect wegener’s?

Answer 7

easily treatable with chemo + steroids (otherwise can/will kill you)

Question 8

radiology of wegener’s

Answer 8

multifocal nodular infiltrates

Question 9

pathology of wegener’s

Answer 9

multisystem necrotizing granulomatis vasculitis

Question 10

detection of wegener’s

Answer 10

elevated C-ANCA in >85% of patients (can’t rule out without it); positive for PR3 antigen

Question 11

what is unique about the necrotizing granulomata found in wegener’s?

Answer 11

the necrosis is on the OUTSIDE, granuloma surrounds vessel

Question 12

what type of stain would show the vascular injury seen in wegener’s

Answer 12

elastin stain (due to elastica disruption)

Question 13

hemosiderin-laden macrophages are a sign of?

Answer 13

prior hemorrhage