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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
Q

What could Raynaud’s syndrome be caused by?

A

Mixed connective tissue disease
SLE
CREST syndrome (limited systemic sclerosis)

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26
Q

What are the types of large-vessel vasculitis?

A

Temporal (giant Cell) arteritis

Takayasu’s arteritis

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27
Q

Temporal arteritis is generally seen in _________ and presents as ________ and _______

A

elderly females
unilateral headache (temporal artery)
Jaw claudication

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28
Q

Temporal arteritis may lead to

A

Irreversible blindness due to opthalmic artery occlusion

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29
Q

Temporal arteritis is associated with what?

A

polymyalgia rheumatica

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30
Q

What artery is most commonly affected in temporal arteritis?

A

Branches of carotid artery

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31
Q

What kind of inflammation is seen in temporal arteritis?

A

Focal granulomatous inflammation (Increased ESR)

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32
Q

How do you treat temporal arteritis?

A

High-dose corticosteroids

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33
Q

Takayasu’s arteritis is seen in ________ less than ______ of age

A

Asian females, 40

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34
Q

Takayasu’s arteritis can be described as a ______ disease because of _________

A

pulseless, weak upper extremity pulses

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35
Q

TAkayasu’s arteritis presents as what?

A
  • Weak upper extremity pulses
  • Fever
  • Night sweats
  • Arthiritis
  • myalgias
  • skin nodules
  • ocular disturbances
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36
Q

What kind of inflammation is seen in takayasu’s arteritis?

A

Granulomatous thickening (increase in ESR)

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37
Q

What arteries are most commonly affected by Takayasu’s arteritis?

A

Aortic arch

Proximal great vessels

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38
Q

How is Takayasu’s arteritis treated?

A

Corticosteroids

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39
Q

What are the medium-vessel vasculitis?

A
  • Polyarteritis Nodosa
  • Kawasaki Disease
  • Buerger’s disease (thromboangiitis obliterans)
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40
Q

Who usually gets polyarteritis nodosa?

A

Young adults

41
Q

What disease is seropositive in 30% of patients with polyarteritis nodosa?

A

Hepatitis B

42
Q

What symptoms occur in polyarteritis nodosa?

A 
Fever
Weight Loss
Malaise
Headache
Hypertension
Neurologic dysfunction
Cutaneous eruptions
Renal damage
GI
43
Q

What GI symptoms are seen in polyarteritis nodosa?

A

Abdominal pain

Melena

44
Q

What vessels are usually involved in polyarteritis nodosa, and which are not?

A

renal and visceral vessels are and pulmonary arteries are not

45
Q

Polyarteritis nodosa is a __________ mediated disease

A

Immune-complex

46
Q

Polyarteritis nodosa results in what?

A

Transmural inflmmation of the arterial wall with fibrinoid necrosis

47
Q

Lesions in polyarteritis nodosa are of _____ and on arteriogram one can see many ____ and _____

A

different ages, aneurysms, constrictions

48
Q

How do you treat polyarteritis nodosa?

A

Corticosteroids, cyclophosphamide

49
Q

Who gets Kawasaki’s disease?

A

Asian children less than 4 years old

50
Q

What are the symptoms of kawasaki disease?

A 
Fever
Cervical lymphadenitis
Conjuctival infection
Changes in lips/oral mucosa (strawberry tongue)
Hand-foot erythema
Desquamating rash
51
Q

What may you develop with kawasaki disease?

A

Coronary aneurysm leading to MI

Rupture

52
Q

How do you treat kawasaki disease?

A

IVIG + aspirin

53
Q

Who gets Buerger’s disease?

A

Heavy smokers

Males less than 40 years of age

54
Q

What are happens in buerger’s disease?

A

Intermittent claudication

Segmental thrombosing vasculitis

55
Q

What may buerger’s disease lead to?

A

Gangrene
autoamputation of digits
superficial nodular phlebitis

56
Q

What phenomenon is often present in Buerger’s disease?

A

Raynaud’s

57
Q

How do you treat Buerger’s disease?

A

Smoking cessation

58
Q

What are the small-vessel vasculitis?

A

Microscopic Polyangiitis
Wegener’s granulomatosis
Churg-Strauss syndrome
Henoch-Schonlein purpura

59
Q

What is microscopic polyangitis and where does it present?

A

Necrotizing vasculitis involving lung, kidney and skin with pauci-immune glomerulonephritis and palpable purpura

60
Q

Microscopic polyanittis is associated with no_____ and _______

A

granulomas, p-ANCA

61
Q

How do you treat microscopic polyangiitis?

A

Cyclophosphamide

Corticosteroids

62
Q

What are the URT manifestations of wegeners granulomatosis?

A

Perforation of nasal septum
chronic sinusitis
otitis media
mastoiditis

63
Q

What are the LRT manifestations of wegener’s granulomatosis?

A

Hemoptysis
Cough
Dyspnea

64
Q

What are the renal manifestations of wegener’s granulomatosis?

A

Hematuria

Red cell casts

65
Q

What is the triad of wegener’s granulomatosis?

A
  1. Focal necrotizing vasculitis
  2. Necrotizing granulomas in the lung and upper airway
  3. Necrotizing glomerulonephritis
66
Q

Wegener’s granulomatosis is associated with _____

A

c-ANCA

67
Q

What does the chest xray of wegener’s granulomatosis show?

A

large nodular densities

68
Q

How do you treat wegener’s granulomatosis?

A

Cyclophosphamide

Corticosteroids

69
Q

What symptoms are present with Churg-Strauss syndrome?

A

Asthma
Sinusitis
Palpable purpura
Peripheral neuropathy (foot/wrist drop)

70
Q

What other organs can churg-strauss syndrome involve?

A

Heart
GI
Kidneys (pauci-immune glomerulonephritis)

71
Q

What does churg-strauss syndrome look like?

A

Granulomatous, necrotizing vasculitis with eosinophilia

72
Q

Churg Strauss syndrome presents with ______ and elevated ______ level

A

p-ANCA, IgE

73
Q

Henoch-Schonlein purpura is the most common _______ systemic vasculitis and follows _______ often

A

Childhood, URI

74
Q

What is the classic triad of henoch-schonlein purpura?

A
  1. Skin: palpable purpura on butt/legs
  2. Arthralgia
  3. GI: Ab pain, melena, multiple lesions of same age
75
Q

Henoch-Schnonlein purpura is a vasculitis secondary to ______ deposition and associated with ______ .

A

IgA complex, IgA nephropathy

76
Q

Strawberry hemangioma is what?

A

Benign capillary hemangioma of infancy

77
Q

Strawberry hemangiomas appear when?

A

First few weeks of life

78
Q

Strawberry hemangiomas grow _______ and _________ at _______ years of age

A

rapidly, regress spontaneously, 5-8

79
Q

Cherry hemangioma is what?

A

Benign capillary hemangioma of elderly

80
Q

Cherry hemangioma does not ____ and the frequency _____ with age

A

regress, increases

81
Q

Pyogenic granuloma is what?

A

Polypoid capillary hemangioma that can ulcerate and bleed

82
Q

Pogenic granuloma is assocated with what?

A

trauma, pregnancy

83
Q

Cystic hygroma is what?

A

Cavernous lymphangioma of the neck

84
Q

Cystic hygroma is associated with what?

A

Turner’s syndrome

85
Q

Glomous tumor is what?

A

Benign, painful, red-blue tumor under fingernails

86
Q

Glomous tumor arises fromw hat/

A

Modified smooth muscle cells of the glomus body

87
Q

Bacillary angiomatosis is what?

A

Benign capillary skin papules found in AIDS patients

88
Q

What are bacillary angiomatosis caused by?

A

Bartonella henselae infections

89
Q

Bacillary angiomatosis is frequently mistaken for what?

A

Kaposis sarcoma

90
Q

What is angiosarcoma?

A

Rare blood vessel malignancy typically occuring in the head, neck, and breast areas

91
Q

What is angiosarcoma associated with?

A

Ppl receiving radiation therapy, esp for breast cancer and hodgkins lymphoma

92
Q

Angiosarcoma is ________ and difficult to ______ due to delay in diagnosis

A

very aggressive, resect

93
Q

Lymphangiosarcoma is what?

A

Lymphatic malignancy associated with persistent lymphedema (eg. post-radical masectomy)

94
Q

Kaposi’s sarcoma is what?

A

Endothelial malignancy most common in the skin, but also in mouth, GI tract, and respiratory tract

95
Q

Kaposi’s sarcoma is associated with what two viruses and frequently mistaken for what?

A

HHV-8 and HIV

Bacillary angiomatosis

96
Q

Sturge Weber disease is what?

A

Congenital vascular disorder that affects capillary sized blood vessels

97
Q

How does Sturge-Weber disease manifest?

A
  • Port-wine stain (nevus flammeus) on face
  • ipsilateral leptomeningeal antiomatosis (intracerebral AVM)
  • Seizures
  • Early onset Glaucoma
98
Q

Sturge-Weber affects ____ vessels

A

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Cardio Step 1 (14 decks)

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