Pathoma/ Small Group/ Psych Review

Question 1

• Stable angina: What is most at risk?
• UA: reversible injury?
• Vasospasm: ECG? Reversible injury?
• MI: NG help? TnI to normal? CkMB normal by? Contraction bands? Myocyte death process? (3) Feeds papillary muscles? Transmural leads to? (2)
• Sclerosis: Athero: Thickening of? Vessels affected? Common in?
• Arterio: Vessels affected? What happens? Risk factors? Increase in what?

Answer 1

• Endocardium
• Yes
• ST elevation; yes
• No; 7-10 days; 72 hours; pink dead myocytes; Coag necrosis (day), inflamm (week), fibrosis (month); Right main; preicarditis and Dresslers
• Intima; m/L vessels; pop, coronary, internal car, AA
• Small; proteins leak in; Htx, DM; Smooth muscle

Question 2

• Aortic Dissection: What tears? Flow into? 2 RF’s? What can happen? (2)
• Aneurysm: What is it? Often related to? Can lead to?
• VSD: Common? Type of shunt? What can happen?
• ASD: Common type? patho what? (2)
• PDA: Often related to? Type shunt? Murmur?
• T of F: Type of shunt? Kids often do what? 4 things?
• Coarctation: Jux opposed to? Assoc with? Notching of?

Answer 2

• Intimal tear; medial layer; htx, genetics; rupture or block a branch
• Balloon like dilation from weakness in wall; syphallys; aortic insufficiency
• Most; L –> R; pulm htx and reverse shunt
• ostium secundum; S2 split; para emboli
• Rubella; L–>R; constant
• R–> L; squat to increase arterial resistance; Pulm stenosis; RVH; Over riding aorta (anterior septal defect); VSD
• DA; Turners; bones

Question 3

• What can happen with mitral in MI?
• PVD related to?
• Valvular disease: RF: Valve appearance? Often related to?
• MVP: Fused? Related to? (2)
• PFO? Endocarditis with?
• Arthero vs arteriolo: Location? Effects?
• Who do you see small intra mycyte MI’s with?
• Dilated CM: Genetics? Hypertrophic: Genetics?
• Most common virus? Parasite?
• Pericarditis types? (4) Etiologies? (4)

Answer 3

• Insufficiency
• Virchows triad
• White mixoid appearance from Mucin and fused tendinae; Strep Pyro (group A)
• Valves; CT disorders/ Tall thin women
• Anything that bypasses lungs; Staph or strep
• Arthero = Intimal, lumen calcification
• Arteiolo = Media; elastin replaced with fibrosis
• DM
• 30-40% with cytoskel.; 100% with sarcomeres
• Cocksachie; chagas
• Fibronous = Post MI, Dresslers; Hemmorhagic; Purulent/Serous = Bacteria; Causeus = TB

Question 4

• 8 areas of inquiry?
• 4 parts of interview?
• Psychiatric illness?
• Depression SIG E CAPS?
• Often present with? Risk factors? (5)

Answer 4

• Why here/now? Psych problem? Medical problem? Lethal behav.? Expectation from us? Family/ friends problem? Cultural? Ways of coping?
• Engage (listen to story); Assess; Focus; Plan
• Disrupts persons thinking, feeling, mood
• Sleep, interest, guilt, energy, conc., appet., psychomotor, suicidality
• Somatic complaint; loss, abuse, female, no social support, family hx, stress

Question 5

• Atypical often presents with? Dysthmia?
• Grief vs. Depression? Length? Suicide? Psychosis? Depression? Blame? Supportive therapy?
• 2 possible mechanisms?
• Treatment? (9)
• Look for what? (3)

Answer 5

• hypersomnia and weight gain; chronic low mood
• Depression: > 2 mo; ideation; sustained; pervasive; self; doesn’t help
  1. ) Mono amine defic; Low sera, NE, dopa
  2. ) Stress disrupts hypo-pit-adrenal axis; stress –> environment –> cortisol release –> low BNDF –> neuronal atrophy
• CBT, psychotherapy, ECT, SNRI’s, exercise, fish oil, vitamins, religion, calcium, chamamilla
• hypothyroid, SLE, corticosteroid use