Cadiovasc NMBE Flashcards
(48 cards)
What are the types of large vessel vasculitis?
-Giant cell (temporal) Arteritis
-Takayasu Arteritis
How can you distinguish between the different large vessel vasculitis?
Giant cell
-“old women with jaw pain and vision loss”
-Unilateral headache
- Inc. ESR associated with polymyalgia rheumatica (joint and muscle pain/stiffness)
- Granulomatous thickening of carotids
Takayasu
-“young asian women with WEAK PULSES”
-Pulseless disease
-Granulomatous thickening of aortic arch
What are the types of medium vessel vasculitis?
-Polyarteritis Nodosa
-Kawasaki disease
What are some ways to distinguish medium vessel vasculitis?
Polyarteritis Nodosa
-PAN = HepB + renal prob + neuro prob
- Hepatitis B patient with renal and neuro problems
- SPARES lungs
- Fibrinoid necrosis–> String of pearls
-corticosteroids, cyclophosphamide
Kawasaki Disease
-CRASH and Burn;
-Conjunctivitis, Rash, Adenopathy (cervical), Strawberry tongue, Hand/foot edema, Burn (fever)
- Coronary vasculitis–> risk of aneurysm
- Aspirin and IVIG treatment
What kind of vasculitis is Buerger disease?
Medium vasculitis
Whats another word for buerger disease?
Thromboangiitis Obliterans
What are the types of small vessel vasculitis?
-Granulomatosis with polyangiitis
-Microscopic polyangiitis
-Eosinophilic granulomatosis with polyangiitis
- Henoch- Schönlein Purpura
Whats another name for granulomatosis with polyangiitis?
Wegeners disease
Whats another name for eosinophilic granulomatosis with polyangiitis?
Churg- Strauss
Whats another name for Henoch-Schonlein Purpura?
IgA vasculitis
What are some ways I can distinguish small vessel vasculitis?
Wegeners
-C-shaped symptoms
-C-ANCA
-C- shaped organs; nasopharynx, lungs, kidneys
-Hemoptysis, hematuria
-Necrotizing granulomas
-cyclophosphamide and steriods
Microscopic Polyangiitis
- Like wegeners but no granulomas or NO upper airway involvement
-P-ANCA
-cyclophosphamide and steriods
Churg-Strauss
-P-ANCA + eosinophilia
- History of asthma/allergies
-necrotizing granulomas
- cyclophosphamide and steroids
IgA Vasculitis
- IgA= Skin, GI, Kidneys
-PALPABLE purpura, arthritis, abdominal pain
-IgA nephropathy (hematuria)
-Often follows URI
What type of vasculitis present with recurrent oral and genital ulcers, uveitis and POSITIVE pathergy test?
Behcets syndrome
What are the main 4 types of shock
Cardiogenic Shock
Distributive shock
Hypovolemic shock
Obstructive shock
What is the main cause of cardiogenic shock?
Heart failure due to MI, arrhythmias, cardiomyopathy, valvular diseases (mitral regurg)
What is the pathophys of cardiogenic shock?
-Decreased CO due to pump failure
-increased afterload due to body compensating (RAAS and SNS)
What clinical features are associated with cardiogenic shock?
-Hypotension, tachy, cool extremities, pul. edema (dyspnea, crackles)
-JVD due to increased CVP (right atrial pressure)
-Low CO w/ high PCWP (due sucky ass left ventricle)
-increased TPR (body compensation)
What are the main causes of hypovolemic shock?
Decreased blood volume due to hemorrhage, fluid loss (vomitting, diarrhea, burns), or dehydration
What is the pathophys for hypovolemic shock?
-Decreased preload, leads to low CO
-Body compensates by activating RAAS, SNS, ADH secretion to preserve blood volume
What are the clinical features of hypovolemic shock?
-hypotension, tachy, cool extremities, reduced urine output
-Dry mucous membranes (dehydration)
-Low central venous pressure (CVP)
-Low PCWP
What are the big causes of distributive shock?
Systemic vasodilation due to…
-sepsis
-anaphylaxis
- neurogenic shock (spinal cord injury–> less SNS input)
-toxic shock syndrome
What is the pathophysiology of distributive shock?
-MASSIVE vasodilation –> Decreased TPR—> shitty ass organ perfussion
-Decreased preload
-high/low CO depending on stage
What are the clinical features of distributive shock?
-Warm skin (in sepsis and anaphylactic shock), due to vasodilation
-Hypotension
-Hyperdynamic circulation with bounding pulses (due to compensation) in sepsis and anaphylaxis
- Tachy
-elevated lactate levels (in septic shock due to tissue hypoxia)
What are the main causes of obstructive shock?
Physical obstruction of blood flow due to PE, cardiac tamponade, tension pneumo
What is the pathophys of obstructive shock?
-Decreased CO due to impaired blood flow
-increased afterload or pressure overload on the heart due to obstruction
