Path Flashcards
(52 cards)
1
Q
Temporal (Giant Cell) Arteritis
A
- Granulomatous Vasculitis often involving Branches of Carotid
- Thickened Tunica Intima
- Destruction of Elastic Lamina
- Presentations
- Headache
- Visual Disturbances
- Jaw Claudication
- Flu-Like Symptoms w/ Joint and Muscle Pain
- Elevated ESR
- Biopsy
- Inflamed Vessel Wall w/ Giant Cells and Intimal Fibrosis
- Negative biopsy DOES NOT r/o disease
- Treatment
- Corticosteroids
2
Q
Takayasu Arteritis
A
- Granulomatous vasculitis often involving aortic arch at branch points
- Presents in younger adults (classically, Asian Females)
- Visual and Neurological Symptoms w/ weak and absent pulse in UE
- Elevated ESR
3
Q
Polyarteritis Nodosa
A
- Necrotizing vasculitis involving multiple organs (Lungs Spared)
- Fibrinoid Necrosis
- Presents in Young Adults as
- Hypertension (Renal Artery Involvement)
- Abdominal pain w/ melena (Mesenteric Artery Involvement)
- Neurologic Disturbances
- Skin Lesions
- Associated w/ Serum HBsAg
4
Q
Kawasaki Disease
A
- Asian children <4 Years of Age
- Coronary Artery Involvment Common and Leads to:
- Risks for Thrombosis w/ MI
- Aneurysm w/ Rupture
- Presents w/
- Fever
- Conjunctivitis
- Erythematous Rash of Palms and Soles
- Enlarged Cervical Lymph Nodes
5
Q
Microscopic Polyangitis
A
- Necrotizing vasculitis involving multiple organs, including lungs and kidney
- Similar to Wegener granulomatosis (granulomatosis w/ polyangitis)
- BUT nasopharyngeal involvement and granulomas absent
- Serum p-ANCA levels correlate w/ disease activity
- Tx = corticosteroids and cyclophosphamide
6
Q
Granulomatosis w/ Polyangitis (Wegener Granulomatosis)
A
- Necrotizing granulomatous vasculitis involving nasopharynx, lungs, and kidneys
- Presents in Middle-Aged Male w/ :
- Sinusitis
- Nasopharyngeal Ulceration
- Hemoptysis w/ bilateral nodular lung infiltrates
- Hematuria due to rapidly progressive glomerulonephritis
- Serum c-ANCA levels correlate w/ disease activity
- Biopsy reveals large necrotizing granulomas w/ adjacent necrotizing vasculitis
7
Q
Buerger Disease
A
- Necrotizing vasculitis involving digits
- Presents w/
- Ulceration
- Gangrene
- Autoamputation of Fingers and Toes
- Raynaud Phenomenon often present
- Highly associated w/ heavy smoking
8
Q
Reagent Test Strip
A
- Advantages
- Evaluate multiple physicochemical aspects of urine
- Results availabe in minutes
- Low complexity
- Disadvantages
- Medications/Other Compounds may interfere w/ test
- If there is discordance b/t clinical suspicion and test strip results microscopic eval is needed as well as backup chemistry tests
9
Q
Hyaline Casts
A
- Hyaline Cast
- Composed of Tamm-Horsfall Protein
- Can be seen in:
- Normal Urine (0-2 Low Power Field)
- Following Strenuous Exercise and Dehydration
- All type of renal disease
10
Q
A
- Cysteine crystals
- Cystinuria Disease
11
Q
A
- Tyrosine Crystals
- Severe Liver Disease
12
Q
A
- Leucine Crystals
- Liver Disease
13
Q
A
- Cholesterol Crystals
- Nephrotic Syndrome
14
Q
A
- Bilirubin Crystals
- Liver Disease
15
Q
Normal Blood Pressure
A
Less than 120/80 mmHg
16
Q
Elevated Blood Pressure
A
Systolic b/t 120-129 and Diastolic less than 80
17
Q
Stage 1 Hypertension
A
Systolic 130-139 and Diastolic 80-89
18
Q
Stage 2 Hypertension
A
Systolic at least 140 or Diastolic at least 90
19
Q
Hypertensive Crisis
A
Systolic Over 180 and/or Diastolic Over 120
20
Q
Monckeberg’s Medial Calcific Sclerosis
A
- Calcific deposits in muscular arteries in people over age 50
- Typically do not involve the lumen
21
Q
Arteriolosclerosis
A
- Disease of small arteries and arterioles associated w/ hypertension and diabetes
22
Q
Atherosclerosis
A
- Arteriosclerosis characterized by fatty and atheromatous plaques w/in arterial lumina
- Most frequent and clinically important pattern of ateriosclerosis
23
Q
Hyaline Arteriolosclerosis
A
- Arteriolar wall is thickened w/ increased plasma protein deposition and narrowed lumen
- Chronic Hypertension
- Diabetes Mellitus
24
Q
Hyperplastic Arteriolosclerosis
A
- Onion-skinning causing lumenal obliteration
- Severe (Malignant) HTN
- Laminations composed of smooth muscle cells w/ reduplicated, thickened basement membranes
25
Most frequent causes of aortic stenosis
1. Wear and Tear
2. RHD
26
Most frequent cause of aortic insufficiency
1. Dilation of Aortic Arch (Due to Hypertension and Aging)
2. RHD
27
Most frequent cause of mitral stenosis
1. Post-Inflammatory Scarring of RHD
28
Most frequent cause of mitral insuffiency
1. Myxomatous Degeneration
2. RHD
29
Congenital Bicuspid Aortic Valve
* 1.4% of Live Births
* Asymptomatic Early
* Predisposes to Early Calcific Stenosis
* Often Diagnosed in Young Adulthood
* _Larger Cusp Often has Midline Raphe_
30
* Proteoglycans Deposited in Spongiosa
* Collagen and Elastin Loose and Disorganized
Mitral Valve Prolapse (Myxomatous Valve)
* Midsystolic Click
* Ballooning/Parachute-Like Leaflets
\*More common in women than men\*
31
Bread and Butter Pericarditis
Acute Rheumatic Heart Disease
32
Most Common of All Valvular Diseases
Aortic Stenosis
33
1. Angina
2. Syncope During Exertion
3. Congestive Heart Failure
4. Heart Palpitations
5. Sudden Cardiac Death from Arryhthmia
Aortic Stenosis
34
1. Dyspnea on Exertion
2. Fatigue
3. Decreased Exercise Tolerance
4. Sensation of Forceful Heartbeat w/ HBP
Aortic Regurgitation/Insufficiency
35
1. Dyspnea w/ Exertion at First and at Rest Later (With increased severity)
2. Fatigue
3. Pulmonary Hypertension
4. Right Sided Heart Failure
Mitral Stenosis
36
Use of Fen-Phen
Mitral Regurgitation
37
Anitschkow Cells "Caterpillar Cells"
Rheumatic Heart Disease
38
What valve disease is pretty much universal in Chronic Rheumatic Heart Disease?
Mitral Stenosis
39
Acute Infective Endocarditis
* Explosive, Rapidly Progressive Illness
* High Fever
* Shaking Chills
* Staph aureus commonly
* Often arises in previously normal heart valves
40
Subacute Infective Endocarditis
* Low-Grade Fever, often w/ nonspecific constitutional symptoms
* Strep viridans most common w/ native valves
* Epidermidis most common w/ prosthetic valves
* Typically arise in damaged/congenitally abnormal heart valves
41
* Intravenous Drug Abuse
* May be complicated by pulmonary emboli and infarcts
* Pneumonia
* Lung abscesses
* May result in CHF
Right-Sided Endocarditis
42
* Sterile, small vegetations of platelets and fibrin, loosely adherent to valve leaflets along closure lines w/o significant inflammation or valve damage
* Setting of cancer of prolonged chronic illnesses
Non-Bacterial Thrombotic Endocarditis
43
* Systemic Lupus Erythematosus and Antiphospholipid Antibody Syndrome
* Valve Scarring
* Small/Medium-Sized Fibrinous, Sterile Vegetations on Either or Both Sides of the Valve Leaflets
Libman-Sachs Disease
44
Fusion of Commisure of Aortic Valve
Post-Rheumatic Heart Disease
45
* Occur in Skin, Subcutaneous Tissues, Mucous Membranes, Liver, Spleen, and Kidneys
* Bright Red to Blue, Vary from a few millimeters to several centimeters in size
* Microscopically are unencapsulated aggregates of closely packed, thin walled capillaries
* Vessels separated by scant connective tissue stroma
Capillary Hemangioma
46
* Composed of larger vessels than seen in capillary hemangiomas
Cavernous Hemangioma
47
* Rapidly growing pedunculated red nodule on the skin of mucus membrane
* Bleeds easily, often ulcerated
* Usually reach 1-2 cm in size within a few weeks
* May develop after trauma
* Microscopically are composed of closely packed small capillaries in a lobular configuration w/ stromal edema
Lobular Capillary Hemangioma
48
* Predominantly in head and neck region, and axillary subcutaneous tissues
* Look like hemangioma, except vessels do not contain blood
Simple Capillary Lymphangioma
49
* Typically found in head and neck region or axilla of children
* May be enormous, up to 15 cm
* Not encapsulated. Composed of large, dilated vessels, w/o blood in the lumen
Cavernous Lymphangioma
50
Malignant Primary Cardiac Tumors
* Angiosarcoma
* Rhabdomyosarcoma
* Leiomyosarcoma
* Kaposi Sarcoma
* Fibrosarcoma
* Lymphoma
51
Most Common Metastatic tumors to Heart
* Melanoma
* Breast Carcinoma
* Lung Carcinoma
* Renal Cell Carcinoma
* Germ Cells Tumors
* Childhood Rhabdomyosarcoma
52
