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Pathophys Exam 3 > Cases > Flashcards

Cases Flashcards

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1
Q

Prinzmetal angina

A

Variant unstable angina caused by spasm in coronary artery

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2
Q

Contraction bands

A

histological finding of a recent MI that was reperfused afterwards- bright eosinophilic bands of condensed contractile proteins

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3
Q

verrucae

A

formation of vegetations

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4
Q

Aschoff bodies

A

Widely disseminated focal inflammatory lesions characteristic of rheumatic heart disease

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5
Q

Acute rheumatic fever bacteria cause

A

Group A beta-hemolytic streptococci

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6
Q

Aschoff cell or Antischkow cell

A

Plump histiocyte found within Aschoff body in Rheumatic heart disease

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7
Q

Ashoff giant cell

A

Multinucleated cells found in Rheumatic heart disease

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8
Q

Which valves most commonly associated with acute rheumatic fever

A

mitral and aortic valves

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9
Q

hemosiderin-laden macrophages

A

occur from prior alveolar hemorrhage; evidence of CHRONIC severe L heart failure (RBC’s leaked out of vessels into alveoli and taken up by macrophages)

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10
Q

Hemosiderin-laden macrophages in acute or chronic L sided heart failure?

A

chronic, not acute

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11
Q

Bacterial cause of endocarditis

A

S. viridans, staphylococci

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12
Q

conditions that predispose to endocarditis

A

abnormal blood flow (congenital heart shunts, abnormal valves), bacteremia (IV drug abuse, surgery), and abnormal immune response- immunodefiency. So start antibiotic PROPHYLAXIS before procedures likely to produce bacteremia (dental work)

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13
Q

Vegetation

A

intracardiac thrombus, fibrin, inflammatory cells, often form on heart valves

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14
Q

IV drug abusers likely to have what heart problem?

A

Tricuspic valve endocarditis

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15
Q

Arterial nephrosclerosis

A

Granular pattern of scarring in kidney, can result from long standing HTN

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16
Q

Most common causes of secondary HTN

A

Renal and endocrine system abnormalities. Renal diseases include renal artery stenosis, glomerulonephritis, renin-producing renal tumors, polycystic kidney disease. Endocrine diseases- pheochromocytoma, cushing disease, hyperaldosteronism, hyper and hypothyroidism

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17
Q

Hyaline arteriosclerosis seen in what population

A

ppl with HTN, diabetes, and elderly

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18
Q

Elevated afterload has what result in LV?

A

LVH

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19
Q

Aortic dissection is serious complication in which inherited disease?

A

Marfan syndrome- CT disorder

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20
Q

MOI in marfans

A

autosomal dominant, mutation in fibrillin gene

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21
Q

Fibrillin

A

glycoprotein secreted by fibroblasts

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22
Q

Possible causes of sudden death in patient with HTN

A

Ischemic heart disease (fatal arrhythmias) and aortic dissection

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23
Q

Most aortic dissections are..

A

.Type A- proximal, involving the ascending aorta- occur within the first 10cm of proximal aorta- problem associated= can rupture into pericardium- hemopericardium-death

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24
Q

Patient presents with severe, tearing chest pain. Uneven pulses, widened mediastinum. Dx?

A

Aortic dissection

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25
Lysolecithin
hydrolytic product of biliary lecithin produced with bile stasis, is toxic to the gallbladder mucosa, can cause acute calculous cholecystitis
26
Rokitansky-Aschoff sinuses
May be seen in cholecystitis- outpouchings of the mucosal epithelium through the muscular wall of the gallbladder
27
Labs in acute pancreatitis
elevated amylase and lipase
28
Complications of cholelithiasis
acute and chronic cholecytitis, choledocholelithiasis, pancreatitis
29
Cholesterolosis
geographic yellow mucosal gallbladder surface caused by excess cholesterol
30
PIgment stones composed of...
calcium bilirubinate
31
Most common causes of pancreatitis
acute- gallstones (cholelithiasis). Chronic- alcohol
32
Complications of acute pancreatitis
Psuedocysts, abscess, neoplasm, duodenal obstruction, chronic pancreatitis
33
Causes of hepatic abscess
Pyogenic abscess (caused by bacteria from ascending cholangitis), amebic abscess (Caused by E. histolytica), and Hydatid cyst (caused by Echinococcus)
34
Most common cause of esophagitis
Reflux of gastric and duodenal contents
35
the presence of intraepithelial eosinophils and neutrophils in esophagus inc. diagnosis of..
reflux esophagitis
36
Barett esophagus
the squamous mucosa is replaced by metaplastic columnar epithelium as a response to prolonged reflux-induced injury in the lower part of the esophagus.
37
Major complications of reflux esophagitis
(1) ulcer, (2) bleeding, (3) development of stricture, and (4) development of Barrett esophagus.
38
What do heaped up margins indicate?
heaped up margins around a tumor are a sign of tumor invasion into adjacent tissue
39
When do adenocarcinomas of barretts esophagus normally present?
in advanced adenocarcinoma stage- this is why its associated with poor prognosis
40
what layers of esophagus do advanced vs. early adenocarcinoma involve?
early involves only mucosa and submucosa. advanced also involves muscularis propria
41
3 patterns seen in SCC of esophagus
protruded, flat, and ulcerated
42
Typical feature of SCC
nests of squamous epithelial cells with lighter-staining keratin in their centers
43
Predisposing factors to cancer of the lower lip
sunlight and pipe smoking
44
prognosis for cancers in lip vs. floor of mouth and base of tongue
good, poor
45
leukoplakia
whitish mucosal patch or plaque caused by epithelial thickening, can be malignant
46
pleomorphic adenoma
benign tumor of salivary glands
47
more than half of pleomorphic adenomas occur in...
parotid gland
48
Most common malignant salivary gland tumor
Mucoepidermoid tumors
49
Do chronic peptic ulcers undergo malignant transformation?
No
50
How to differentiate benign vs. malignatn ulcer
endoscopy and multiple biopsies
51
H. pylori associated with...
peptic ulcers and gastric cancer
52
Maltoma
mucosa-associated lymphoid tissue, low grade gastric lymphoma
53
complications of chronic peptic ulcers
bleeding (so will have to transfuse blood in these patients), perforation, penetration into adjacent viscus, obstruction, intractable pain
54
fibrosis associated with acute or chronic peptic ulcer
chronic
55
Are acute gastric ulcers associated with H. pylori
No- associated in chronic. (peptic ulcer disease)
56
Causes of bowel infarction
mechanical obstruction to blood flow by arterial thrombosis, volvulus, stricture or by reduced perfusion (cardiac failure, shock)
57
What layers of intestine would transmural infarction involve?
all
58
Carcinoid syndrome
associated with flushing of skin, diarrhea, cough, wheezing, systemic fibrosis, and hepatomegaly. result from secretion of serotonin by the tumor cells
59
Carcinoid tumor
type of neuroendocrine tumor
60
endocrine syndromes associated with carcinoid tumors
ZES, insulinoma, and cushing syndrome
61
Markers present in IBD patients
HLA-B27 and ankylosing spondylitis (but etiology is unknown)
62
ankylosing spondylitis
Chronic inflammatory disease of the axial skeleton
63
Pseudopolyp
Bulging mass of inflamed residual mucosa
64
Polyp
any nodule or mass that projects above the level of surrounding mucosa- can by hyperplastic or neoplastic
65
Histological feature in Crohn's not seen in UC
granulomas and transmural inflammation that results in fibrosis and thickening of the bowel wall
66
complications of UC
carcinoma, toxic megacolon, severe diarrhea, electrolyte disturbances, perforation, peritonitis, massive hemorrhage
67
toxic megacolon
severe colonic dilation
68
creeping fat
when the mesenteric fat wraps around the bowel surface, seen in crohn's
69
Risk of colon carcinoma more in crohn's or UC
UC
70
Rhabdomyolysis
skeletal muscle damage

Pathophys Exam 3 (2 decks)

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