Pathology 2 Flashcards by Emily W

Where does LDL build up in atherosclerosis?

Tunica intima

How well did you know this?

Not at all

Perfectly

Which arteries are most prone to atherosclerosis?

Abdominal aorta
Coronary arteries
Popliteal arteries
Thoracic aorta
Internal carotids

How well did you know this?

Not at all

Perfectly

90% of ischemic heart disease is due to _________

Atherosclerosis

How well did you know this?

Not at all

Perfectly

What is “critical stenosis”?

> 75% reduction in the diameter of the artery

Leads to compensatory vasodilation

How well did you know this?

Not at all

Perfectly

When can an MI be seen histologically and macroscopically?

Histologically from 4 hours

Macroscopically from 12 hours

How well did you know this?

Not at all

Perfectly

What are the potential complications of MI?

Arrhythmias
Cardiac arrest
Ventricular aneurysm
Pedicarditis
Papillary muscle dysfunction
Myocardial rupture
Heart failure

How well did you know this?

Not at all

Perfectly

What is diastolic heart failure?

Reduced filling due to increased resistance

How well did you know this?

Not at all

Perfectly

What are the causes of diastolic heart failure?

LV hypertrophy
Aortic stenosis
Hypertension

How well did you know this?

Not at all

Perfectly

What are the causes of systolic heart failure?

IHD
MI
Cardiomyopathy

How well did you know this?

Not at all

Perfectly

How does systemic hypertension affect the left ventricle?

LV hypertrophy
Without dilation
Impaired filling

How well did you know this?

Not at all

Perfectly

What is the most common type of valvular heart disease?

Mitral regurgitation

due to a floppy mitral valve

How well did you know this?

Not at all

Perfectly

What is functional regurgitation?

When a valve becomes incompetent due the dilation of a ventricle

How well did you know this?

Not at all

Perfectly

What is the main causative organism of rheumatic fever?

Strep pyogenes

How well did you know this?

Not at all

Perfectly

What are the signs and symptoms of rheumatic fever?

Fever
Painful joints
Involuntary muscle movements
Non itchy rash- erythema marginatum

How well did you know this?

Not at all

Perfectly

Which factors predispose to infective endocarditis?

Artificial valve
Bicuspid aortic valve
Floppy mitral valve
Stenosis
Immunosuppression
Diabetes
Alcohol
IVDU
Dental work

How well did you know this?

Not at all

Perfectly

Which 3 organisms most commonly cause ACUTE endocarditis?

Highly virulent organisms-

S. aureus
Pneumococcus
S.pyogenes

How well did you know this?

Not at all

Perfectly

Which 2 organisms most commonly cause SUBACUTE endocarditis?

Low virulence organisms- 1. Strep viridans

2. Enterococci

How well did you know this?

Not at all

Perfectly

What type of endocarditis is more common in replacement valves?

Subacute

How well did you know this?

Not at all

Perfectly

What is the most common type of cardiomyopathy?

Dilated cardiomyopathy

How well did you know this?

Not at all

Perfectly

What can cause dilated cardiomyopathy?

Alcohol
Genetics
Chronic anaemia

How well did you know this?

Not at all

Perfectly

What is the pathophysiology of heart muscle in hypertrophic cardiomyopathy?

NO dilation of chambers
Hypertrophic fibres
Cardiac wall thickened
Decreased chamber size

How well did you know this?

Not at all

Perfectly

What is the pathophysiology of heart muscle in restrictive cardiomyopathy?

Both atria dilated

Normal sized ventricles, but decreased ventricular compliance

How well did you know this?

Not at all

Perfectly

What is the main cause of myocarditis?

Viruses

How well did you know this?

Not at all

Perfectly

What can cause pericarditis?

Infection
Immune mediated eg. SLE, Rheumatic fever
Trauma
Radiation

How well did you know this?

Not at all

Perfectly

What are the causes of right to left cardiac shunts?

1. Tetralogy of Fallot 2. Transposition of great arteries 3. Perisitent truncus arteriosus 4. Tricuspid atresia (right ventricle underdeveloped)

What are the causes of left to right shunts?

ASD VSD Can lead to pulmonary hypertension

Which sinus is susceptible to sinusitis due to dental infection?

Maxillary sinus

What us GPA/ Wegener's?

Vasculitis of small and medium vessels | Affects upper respiratory tract, kidneys, lungs

What are the signs/ symptoms of Wegner's Granulomatosus?

``` Nose bleeds/ sores Ulcers Subglottic stenosis -> hoarseness Chronic ear infections Haemoptysis Haematuria ```

Which antibodies will be present in Wegner's Granulomatosus?

ANCA

What age patients does Wegner's Granulomatosus usually affect?

30-50years

How can Wegner's Granulomatosus be treated?

Steroids Cyclophosphamide Methotrexate Surgery

What are the potential complications of Wegner's Granulomatosus?

Nasal septum perforation Airway stenosis Respiratory or renal failure

What is an inverted papilloma?

Nasal tumour in mucous membrane Grows into underlying bone Usually benign May be caused by smoking, pollution, allergens

What is Samter's triad?

1. Asthma 2. Nasal polyps 3. Aspirin hypersensitivity

How can a nasal papilloma be treated?

Endoscopy

What is the main cancer of the larynx/ nose/ sinuses?

Squamous cell carcinoma

Who is affected by juvenile nasal angiofibroma?

Males | Aged <20 years

What are the symptoms of Juvenile Nasal Angiofibroma?

Nasal obstruction Bleeding hearing loss headache

What is nasopharnygeal carcinoma?

Rare undifferentiated cancer Affects the nasopharynx Can cause otitis media (glue ear)

Which factors increase the risk of nasopharyngeal carcinoma?

EBV Nitrosamines in diet HLA

_____________ is caused by Corynebacterium diphtheria and can cause a "pseudomembrane" seen histologically

Diphtheria

What epithelial cell type is found in the oesophagus and anus?

Squamous

What epithelial cell type is found in the stomach, duodenum and colon?

Columnar

What is the main cause of oesophagitis?

GORD

Gastritis is often associated with which type of infection?

H.pylori

What can be detected in breath if H.pylori infection is present?

Urease

What is the triple therapy for H.pylori infection?

1. PPI 2. Clarithromycin 3. Amoxicillin/ Metronidazole

What is the histological appearance of coeliac disease?

Crypt hyperplasia Villous atrophy Intra epithelial lymphocytosis Lamina propria rich in plasma cells

What is the HLA association in coeliac?

HLA DQ2/ HLA DQ8

What are the potential complications of coeliac disease?

Anaemia Oesteoporosis Dermatitis herpetiformis Increased risk of malignancy

In which part of the bowel is diverticular disease most common?

Sigmoid colon

What are the complications of diverticular disease?

``` Bowel perforation Haemorrhage Fistula Obstruction Superinfection with CMV/ C.Diff ```

What conditions is ulcerative collitis associated with?

Primary sclerosing cholangitis | Ankylosing spondolytis

What are the histological features of UC?

``` Mucin depletion Pseudopolyps Punctuate ulcers Inflammation Basal plasmocytosis Crypt abscess Haemorrhagic mucosa ```

How can UC be managed medically?

1. 5-ASA Eg. Mesalazine 2. Oral prednisolone 3. IV hydrocortisone and fluids 4. Anti TNF eg. Infliximab

What is the histological appearance of Crohn's?

Granulomas Fat wrapping Transmural lymphoid aggregates

What is microscopic collitis?

Condition typically in middle aged women Longstanding diarrhoea Normal colonoscopy

What are the 2 types of oesophageal carcinoma?

1. Squamous cell carcinoma | 2. Adenocarcinoma- develops from Barrett's mucosa

What are the risk factors for squamous cell carcinoma of the oesophagus?

``` Smoking Alcohol Low protein diet HPV infection Family history in Iran ```

What are the risk factors for oesophageal adenocarcinoma?

``` GORD Smoking Alcohol Obesity NSAIDs ```

What type of cancer has "signet ring" appearance histologically?

Gastric adenocarcinoma

What is achalasia?

Lower oesophageal sphincter fails to relax Due to degeneration of myenteric plexus Leads to dysphagia, regurgitation and weight loss

What are the causes of dysphagia?

1. Mechanical blockage: Malignancy, stricture, mediastinal mass, retrosternal goitre, pharyngeal pouch 2. Motility disorder- Achalasia, oesophageal spasm, Bulbar palsy 3. Oesophagitis