Pathology Flashcards
Tetralogy of Fallot’s most important characteristic to determine prognosis
Pulmonary infundibular stenosis
Most common congenital left-to-right shunt
Ventricular septal defect (VSD), membranous type
Most common type of atrial septal defects
Ostium secundum defects
Most common location for coarctation of the aorta
Postductal coarctation (adult type)
Definition of hypertensive urgency
Severe (more than 180/ more than 120) hypertension without acute end-organ damage
Definition of hypertensive emergency
Severe hypertension with evidence of acute end-organ damage
Type of arteriolosclerosis with proliferation of smooth muscle cells and “onion skinning” appearance
Hyperplastic arteriolosclerosis
Pathogenesis of Mönckeberg sclerosis (medial calcific sclerosis)
Calcification of internal elastic lamina and media of arteries that affects medium-sized arteries
Classic description of Mönckeberg sclerosis (medial calcific sclerosis) on x-ray
“Pipestem” appearance
Most common sites of atherosclerosis to develop
- Abdominal aorta
- Coronary artery
- Popliteal artery
- Carotid artery
Type of aortic aneurysm associated with tertiary syphilis (endarteritis obliterans)
Thoracic
Most common site for traumatic aortic rupture
Aortic isthmus (proximal descending aorta just distal to the origin of left subclavian artery)
Type of angina for which smoking is a risk factor, but hypertension and hypercholesterolemia are not
Prinzmetal angina
ECG manifestations of Prinzmetal angina
Transient ST elevation
Prinzmetal angina treatment
- Calcium channel blockers
- Nitrates
- Smoking cessation
Most important risk factor for stable angina
Age (45 yo in men, 55 yo in women)
ECG and laboratory characteristics of unstable angina
+/- ST depression and/or T-wave inversion on ECG but no cardiac biomarker elevation (unlike NSTEMI)
Principle behind pharmacologic stress test with coronary vasodilators
Based on the coronary steal syndrome
*Administration of vasodilators dilate snormal vessels and shunts blood toward well-perfused areas, diverting flow away from vessels that are stenosed
Definition of sudden cardiac death
Death from cardiac causes within 1 hour of onset of symptoms
Drugs used for symptomatic relief in heart failure
Thiazides and loop diuretics
What are Roth spots and in which pathology can they be found
They are round white spots on th retina surrounded by hemorrhage, found in bacterial endocarditis
What are Osler nodes and in which pathology can they be found
Tender, raised lesions on finger or toe pads due to immune complex deposition, found in bacterial endocarditis
Organisms associated to tricuspid valve endocarditis due to IV drugs
- S. aureus
- Pseudomonas
- Candida
Early and late cardiac lesions seen in rheumatic fever
- Early: mitral valve regurgitation
* Late: mitral valve stenosis
What are Aschoff bodies and in which pathology can they be found
They are granulomas with giant cells, found in rheumatic fever
What are Anitschkow cells and in which pathology can they be found
They are enlarged macrophages with ovoid, wavy, rod-like nucleus, found in rheumatic fever
Rheumatic fever is an example of which type of hypersensitivity
Type 2 hypersensitivity
*Antibodies to M protein corss-react with self antigens (molecular mimicry)
ECG changes seen in acute pericarditis
Widespread ST-segment elevation and/or PR depression
Components of Beck’s triad
- Hypotension
- Distended neck veins
- Distant heart sounds
Characteristic type of pulse seen in cardiac tamponade
Pulsus paradoxus
Definition of pulsus paradoxus
Decrease in amplitude of SBP by more than 10 mmHg during inspiration
Definition of the Kussmaul sign
Increase in JVP on inspiration instad of a normal decrease
Disease associated to giant cell arteritis
Polymyalgia rheumatica
Most common affected arteries in giant cell arteritis
Branches of the carotid artery (usually superficial temporal and ophthalmic)
Histopathologic characterstic of giant cell arteritis
Focal granulomatous inflammation
Treatment that should be given to a patient with giant cell arteritis before a temporal artery biopsy to prevent blindness
High-dose corticosteroids
Histopathologic characteristic of Takayasu arteritis
Granulomatous thickening and narrowing of the aortic arch and proximal great vessels
Hepatitis B seropositivity is seen in which vasculitis
Polyarteritis nodosa
Vessels affected in polyarteritis nodosa
Renal and visceral vessels
Histopathologic characteristic of polyarteritis nodosa
Transmural inflammation of the arterial wall with fibrinous necrosis
Vasculitis that shows coexistance of different stages of inflammation in different vessels
Polyarteritis nodosa
Signs and symptoms of Kawasaki disease
“CRASH and burn”
- Conjunctival injection
- Rash
- Adenopathy
- Strawberry tongue
- Hand-foot changes
- Fever
Aneurysms of which arteries are seen in Kawasaki disease
Coronary artery aneurysms
Most common etiology of sudden cardiac death
Acute ischemia
Congenital cardiac defect associated with fetal alcohol syndrome
Ventricular septal defect
Most common type of atrial septal defect
Ostium secundum defects
Ostium primum type of atrial septal defects is associated with what pathology
Down syndrome
Type of coarctation of the aorta that is associated with PDA
Infantile type
Laboratory finding that needs to be present in addition to major or minor criteria for the diagnosis of acute rheumatic fever
- Elevated ASO
* Anti-DNase B titers
Most common cause of death during the acute phase of rheumatic fever
Myocarditis
What are thrombotic vegetations made of
Platelets and fibrin
Histologic findings in hypertrophic cardiomyopathy
Myofiber hypertrophy with disarray
Radiographic finding in aortic dissection
Wide mediastinum
Main energy source of the heart
Fatty acid oxidation (more than 60%)
Most common type of cancer that leads to developing of marantic/thrombotic endocarditis
Pancreatic cancer
Essential hypertension and malignant hypertension are associated with which types of arteriosclerosis
Hyaline and hyperplastic, respectively
First histologic change following a MI
Contraction bands
HLA that is associated with rheumatic fever
HLA-DR7
Myocyte enlarging after an MI is cuased by accumulation of what electrolyte
Calcium
What does “tree barking” refer to in patients with syphilitic aortitis
Intimal wrinkling
Spared arteries in polyarteritis nodosa (PAN)
Pulmonary arteries
Growth factor that triggers smooth muscle cell (SMC) migration from the media and proliferation of the intimia in an atheroma
Platelet-derived growth factor (PDGF)
Type of cell that promotes atherosclerotic plaque stability by synthesizing collagen
Smooth muscle cells (SMC)
Congenital long QT syndrome that also presents with sensorineural deafness
Jervell and Lange-Nielsen syndrome
