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Cardio Step 1 > Pathology Part 4 > Flashcards

Pathology Part 4 Flashcards

1
Q

Cardiac tamponade is what?

A

Compression of heart by fluid (blood or effusion) in the pericardium

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2
Q

Cardiac tamponade leads to what?

A

Decreased CO

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3
Q

Cardiact tamponade leads to _______ in all 4 chambers.

A

Equilibration of diastolic pressures

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4
Q

What are the findings in cardiac tamponade?

A
  • hypotension
  • increased venous pressure (JVD)
  • Distant heart sounds
  • Increased HR
  • Pulsus Paradoxus
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5
Q

What is pulsus paradoxus?

A

Decrease in amplitude of systolic blood pressure by more than 10 mmHg during inspiration

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6
Q

What is pulsus paradoxus seen in?

A
  • Severe cardiac tamponade
  • Asthma
  • Obstructive sleep apnea
  • Pericarditis
  • Croup
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7
Q

Syphilitic heart disease is caused by what?

A

tertiary syphilis

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8
Q

What does syphilitic heart disease do?

A

Disrupts the vasa vasorum of the aorta

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9
Q

What are the consequences of syphilitic heart disease?

A
  • Atrophy of the vessel wall

- dilation of the aorta and valve ring

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10
Q

What may you see with syphilitic heart disease in the aortic root and ascending aortic arch?

A

Calcifications

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11
Q

What does the aorta look like in syphilitic heart disease?

A

Tree bark

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12
Q

What can result from syphilitic heart disease?

A
  • Aneurysm of the ascending aorta or aortic arch

- Aortic insufficiency

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13
Q

What are the two types of primary cardiac tumors?

A

Myxoma

Rhabdomyoma

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14
Q

Myxomas are the ________ primary cardiac tumor in adults and 90% occur in the _____ (especially the _______)

A

most common, atria, Left atria

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15
Q

Myxomas are usually described as a _______ obstructing the ________

A

ball valve, left atrium

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16
Q

Obstruction of the left atrium by the myxoma leads to what?

A

Multiple syncopal episodes

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17
Q

Rhabdomyomas are the _________ primary cardiac tumor in children and are associated with _______

A

most frequent, tuberous sclerosis

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18
Q

What is the most common heart tumor?

A

Metastasis (from melanoma and lymphoma)

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19
Q

What is kussmaul’s sign?

A

Increase in JVP on inspiration instead of the normal decrease

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20
Q

What is the physiology behind Kussmaul’s sign?

A

Inspiration –> negative intrathoracic pressure not transmitted to the heart –> impaired filling of RV –> blood backs up to the vena cava –> JVD

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21
Q

Kussmaul’s sign may be seen in what disorders?

A
  • Constrictive pericarditis
  • Restrictive cardiomyopathy
  • Right atrial/ventricular tumors
  • Cardiac tamponade
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22
Q

What is Raynaud’s phenomenon and when does it happen?

A

Decreased blood flow to the skin due to arteriolar vasospasm in response to cold temperature or emotional stress.

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23
Q

Where does raynaud’s phenomenon typically occur?

A

Finger and toes

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24
Q

When is raynaud phenomenon called a disease or a syndrome?

A

Disease: primary (idiopathic)
Syndrome: secondary to a disease process

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25
What could Raynaud's syndrome be caused by?
Mixed connective tissue disease SLE CREST syndrome (limited systemic sclerosis)
26
What are the types of large-vessel vasculitis?
Temporal (giant Cell) arteritis | Takayasu's arteritis
27
Temporal arteritis is generally seen in _________ and presents as ________ and _______
elderly females unilateral headache (temporal artery) Jaw claudication
28
Temporal arteritis may lead to
Irreversible blindness due to opthalmic artery occlusion
29
Temporal arteritis is associated with what?
polymyalgia rheumatica
30
What artery is most commonly affected in temporal arteritis?
Branches of carotid artery
31
What kind of inflammation is seen in temporal arteritis?
Focal granulomatous inflammation (Increased ESR)
32
How do you treat temporal arteritis?
High-dose corticosteroids
33
Takayasu's arteritis is seen in ________ less than ______ of age
Asian females, 40
34
Takayasu's arteritis can be described as a ______ disease because of _________
pulseless, weak upper extremity pulses
35
TAkayasu's arteritis presents as what?
- Weak upper extremity pulses - Fever - Night sweats - Arthiritis - myalgias - skin nodules - ocular disturbances
36
What kind of inflammation is seen in takayasu's arteritis?
Granulomatous thickening (increase in ESR)
37
What arteries are most commonly affected by Takayasu's arteritis?
Aortic arch | Proximal great vessels
38
How is Takayasu's arteritis treated?
Corticosteroids
39
What are the medium-vessel vasculitis?
- Polyarteritis Nodosa - Kawasaki Disease - Buerger's disease (thromboangiitis obliterans)
40
Who usually gets polyarteritis nodosa?
Young adults
41
What disease is seropositive in 30% of patients with polyarteritis nodosa?
Hepatitis B
42
What symptoms occur in polyarteritis nodosa?
``` Fever Weight Loss Malaise Headache Hypertension Neurologic dysfunction Cutaneous eruptions Renal damage GI ```
43
What GI symptoms are seen in polyarteritis nodosa?
Abdominal pain | Melena
44
What vessels are usually involved in polyarteritis nodosa, and which are not?
renal and visceral vessels are and pulmonary arteries are not
45
Polyarteritis nodosa is a __________ mediated disease
Immune-complex
46
Polyarteritis nodosa results in what?
Transmural inflmmation of the arterial wall with fibrinoid necrosis
47
Lesions in polyarteritis nodosa are of _____ and on arteriogram one can see many ____ and _____
different ages, aneurysms, constrictions
48
How do you treat polyarteritis nodosa?
Corticosteroids, cyclophosphamide
49
Who gets Kawasaki's disease?
Asian children less than 4 years old
50
What are the symptoms of kawasaki disease?
``` Fever Cervical lymphadenitis Conjuctival infection Changes in lips/oral mucosa (strawberry tongue) Hand-foot erythema Desquamating rash ```
51
What may you develop with kawasaki disease?
Coronary aneurysm leading to MI | Rupture
52
How do you treat kawasaki disease?
IVIG + aspirin
53
Who gets Buerger's disease?
Heavy smokers | Males less than 40 years of age
54
What are happens in buerger's disease?
Intermittent claudication | Segmental thrombosing vasculitis
55
What may buerger's disease lead to?
Gangrene autoamputation of digits superficial nodular phlebitis
56
What phenomenon is often present in Buerger's disease?
Raynaud's
57
How do you treat Buerger's disease?
Smoking cessation
58
What are the small-vessel vasculitis?
Microscopic Polyangiitis Wegener's granulomatosis Churg-Strauss syndrome Henoch-Schonlein purpura
59
What is microscopic polyangitis and where does it present?
Necrotizing vasculitis involving lung, kidney and skin with pauci-immune glomerulonephritis and palpable purpura
60
Microscopic polyanittis is associated with no_____ and _______
granulomas, p-ANCA
61
How do you treat microscopic polyangiitis?
Cyclophosphamide | Corticosteroids
62
What are the URT manifestations of wegeners granulomatosis?
Perforation of nasal septum chronic sinusitis otitis media mastoiditis
63
What are the LRT manifestations of wegener's granulomatosis?
Hemoptysis Cough Dyspnea
64
What are the renal manifestations of wegener's granulomatosis?
Hematuria | Red cell casts
65
What is the triad of wegener's granulomatosis?
1. Focal necrotizing vasculitis 2. Necrotizing granulomas in the lung and upper airway 3. Necrotizing glomerulonephritis
66
Wegener's granulomatosis is associated with _____
c-ANCA
67
What does the chest xray of wegener's granulomatosis show?
large nodular densities
68
How do you treat wegener's granulomatosis?
Cyclophosphamide | Corticosteroids
69
What symptoms are present with Churg-Strauss syndrome?
Asthma Sinusitis Palpable purpura Peripheral neuropathy (foot/wrist drop)
70
What other organs can churg-strauss syndrome involve?
Heart GI Kidneys (pauci-immune glomerulonephritis)
71
What does churg-strauss syndrome look like?
Granulomatous, necrotizing vasculitis with eosinophilia
72
Churg Strauss syndrome presents with ______ and elevated ______ level
p-ANCA, IgE
73
Henoch-Schonlein purpura is the most common _______ systemic vasculitis and follows _______ often
Childhood, URI
74
What is the classic triad of henoch-schonlein purpura?
1. Skin: palpable purpura on butt/legs 2. Arthralgia 3. GI: Ab pain, melena, multiple lesions of same age
75
Henoch-Schnonlein purpura is a vasculitis secondary to ______ deposition and associated with ______ .
IgA complex, IgA nephropathy
76
Strawberry hemangioma is what?
Benign capillary hemangioma of infancy
77
Strawberry hemangiomas appear when?
First few weeks of life
78
Strawberry hemangiomas grow _______ and _________ at _______ years of age
rapidly, regress spontaneously, 5-8
79
Cherry hemangioma is what?
Benign capillary hemangioma of elderly
80
Cherry hemangioma does not ____ and the frequency _____ with age
regress, increases
81
Pyogenic granuloma is what?
Polypoid capillary hemangioma that can ulcerate and bleed
82
Pogenic granuloma is assocated with what?
trauma, pregnancy
83
Cystic hygroma is what?
Cavernous lymphangioma of the neck
84
Cystic hygroma is associated with what?
Turner's syndrome
85
Glomous tumor is what?
Benign, painful, red-blue tumor under fingernails
86
Glomous tumor arises fromw hat/
Modified smooth muscle cells of the glomus body
87
Bacillary angiomatosis is what?
Benign capillary skin papules found in AIDS patients
88
What are bacillary angiomatosis caused by?
Bartonella henselae infections
89
Bacillary angiomatosis is frequently mistaken for what?
Kaposis sarcoma
90
What is angiosarcoma?
Rare blood vessel malignancy typically occuring in the head, neck, and breast areas
91
What is angiosarcoma associated with?
Ppl receiving radiation therapy, esp for breast cancer and hodgkins lymphoma
92
Angiosarcoma is ________ and difficult to ______ due to delay in diagnosis
very aggressive, resect
93
Lymphangiosarcoma is what?
Lymphatic malignancy associated with persistent lymphedema (eg. post-radical masectomy)
94
Kaposi's sarcoma is what?
Endothelial malignancy most common in the skin, but also in mouth, GI tract, and respiratory tract
95
Kaposi's sarcoma is associated with what two viruses and frequently mistaken for what?
HHV-8 and HIV | Bacillary angiomatosis
96
Sturge Weber disease is what?
Congenital vascular disorder that affects capillary sized blood vessels
97
How does Sturge-Weber disease manifest?
- Port-wine stain (nevus flammeus) on face - ipsilateral leptomeningeal antiomatosis (intracerebral AVM) - Seizures - Early onset Glaucoma
98
Sturge-Weber affects ____ vessels
small

Cardio Step 1 (14 decks)

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