Vascular Disease Patho

Question 1

radiology of PE

Answer 1

CXR can be normal, need to rule out pneumonia and pneumothorzx\

contrast CT and V/Q scan preferred

Question 2

occasional gross patho PE finding

Answer 2

wedge infarct downstream of occlusion

Question 3

describe the progession of pathological changes in PH, 4 stages

Answer 3

• medial hypertrophy
• intimal proliferation
• intimal fibrosis
• plexiform vascular lesions

Question 4

describe intimal fibrosis

Answer 4

concenctric fibrosis w/ fibroblasts, can look like onion skinning

Question 5

describe appearance of plexiform lesions

Answer 5

recanalization w/i fibrosed lumen

Question 6

3 alveolar hemorrhage syndromes and their corresponding mechanism

Answer 6

goodpastures-linear antibody deposition

acute lupus pneumonitis- immune complexes

GPA- pauci immune, ANCA mediated

all target basement membrane

Question 7

histology of good pastures

Answer 7

RBCs filling alveolar space

Question 8

radiology of goodpastures, most common pts

Answer 8

young adults, more in men

diffuse alveolar pattern (hemorrhage)

Question 9

pathophys of goodpasture

Answer 9

anti BM IgG damage pulm and renal BMs

Question 10

detection of goodpastures

Answer 10

linear IgG and complement deposition visible by immunofluorescence

anti GBM IgG detectable in serum

Question 11

affected by acute lupus pneumo

Answer 11

component of SLE, kids and adults more women

Question 12

radiology of acute lupus pneumo

Answer 12

diffuse alveolar pattern

Question 13

patho of acute lupus pneumo

Answer 13

necrotizing capillaritis from immune complexes

Question 14

detection of acute lupus pneumo

Answer 14

granular IgG/C’ deposition by IF

ANA or anti dsDNA Ab in serum

Question 15

GPA sx

Answer 15

cough, hemoptysis, pleuritis

Question 16

GPA tx

Answer 16

steroids and cyclophosphamide

Question 17

radiolody of GPA

Answer 17

multifocal nodular infiltrates (makes sense, granulomatous inflammation)

Question 18

patho of GPA

Answer 18

multi system necrotizing* granulomatous* vasculitis*- will see all three

can see hemosiderin laden macros indicating a prior hemorrhage

Question 19

detection of GPA

Answer 19

elevated c-ANCA in most pts, PR3 antigen associated