DIAGNOSIS
AORTIC STENOSIS
DISCUSS 1 PATHOGENESIS AND THE DIAGNOSIS OF THE CONDITION SHOWN IN THE IMAGE
CHRONIC RHEUMATOID ARTHRITIS
MITRAL STENOSIS
acute chest pain, alleviate when the patient leans forward, ST elevation in all leads.
Acute pericarditis
previously normal patient, new heart murmur and fever
diagnosis and cause?
acute bacterial endocarditis
coag. positive, catalase-positive, gram-positive bacteria
patient with rheumatic heart disease, new heart murmur, and fever
diagnosis and cause?
subacute endocarditis
alpha-hemolytic streptococcus
renin level in higher in left renal vein compared to the right
possible diagnosis
Left renal artery stenosis
the right kidney is smaller than the left kidney
possible diagnosis
right renal artery stenosis
serum sodium -high
serum ph- high
serum potassium- low
possible diagnosis
RAS
Conn syndrome
new hypertension, history of CAD, bruit in the left flank (at L2)
Renal Artery stenosis due to ATH
HTN is aggravated during pregnancy, angiogram showing beading of the Left Renal Artery
histology of the Left Renal Artery?
Collagen 1 deposit in the media
Which heart fails in Acute bacterial endocarditis in IV drug users?
Right
possible cause of the gross appearance?
100% occultation by an embolus from:
IE
MI
Acute gastric ulcer vs ATM of the mesenteric artery
how to differentiate?
ask if the patient has a history of CAD or has atherosclerosis risk factors
mention 4 risk factors
immobilization
pancreatic cancer
factor V Leiden
Smoking+ OCP use
1 risk factor
1 cause
1 risk factor- smoking
1 cause- hypertension
large heart, thick walls, and narrow left ventricular chamber
cause?
Hypertension
large vascular channels, calcification, location in the liver
diagnosis?
cavernous hemangioma
Think VHL
JVP raised suddenly after 5 days after MI, heart sound muffled
diagnosis?
rupture of the left wall in the MI
biopsy of renal arterioles
diagnosis?
benign long stanging HTN
biopsy of the renal arteriole
diagnosis?
malignant HTN
Area of perfusion in LAD, RCA?
LAD- LEFT LATERAL WALL AND ANT. 2/3 OF IVS
RCA: INFERIOR
VASCULITIS WITH FIBRNOID NECROSIS
PAN
VASULITIS WITH BLINDNESS
TEMPORAL ARTERITIS
VASCULITIS WITH LOSS OF PERIPHERAL PULSE (UPPER LIMB)
Takayasu
groups of small capillaries under the skin disappeared after a few years of birth
- diagnosis*
- cell of origin*
Capillary Hemangioma
Endothelium
Mention 2 pathogenesis
CRHD
Papillary muscle rupture- MI after 3-7 days
diagnosis?
Pathophysiology (cause)?
AS
- If the senile patient- dystrophic calcification on a tricuspid valve
- In a younger patient- dystrophic calcification on a bi-cuspid valve
head-bobbing?
Likely AR
what is the histology of the area of the rupture?
rbc, coagulative necrosis, and early granulation tissue
(remember rupture happens between 3-7 days
MVP: recall changes in the tissue in Marfan syndrome
MVP- narrate the murmur
Myxoid bluish elastic tissue (ballooning degeneration).
MVP- early systolic click and late systolic murmur
diagnosis of the histology of the heart?
Possible time?
coagulative necrosis
1-3 hours
histology of heart in MI?
timing?
plenty neutrophils and coagulative necrosis
2-3 days
discuss the histology of heart in MI
timing?
new capillaries, inflammatory cells (+ collagen)
10-21 days
histology of the lesion: haphazard blood vessels composed of od thick and thin-walled blood vessels.
stool occult blood becomes positive when the patient’s intraabdominal pressure
Angiodysplasia
How to differentiate AS murmur vs HCM murmur
Valsalva maneuver
AS murmur- will reduce
HCM murmur- increase in intensity
Cause of Hypertrophic Cardiomyopathy?
genetics (beta myosin mutation)
