USMLE 1 Path CV
Terms
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- MC arteries affected by Monckenberg arteriosclerosis
- Radial and Ulnar arteries
-
Definition:
Hyaline thickening of small arteries in Essential HTN and DM - Arteriolosclerosis
-
Dx:
"Onionskin" thickening of the arteriolar walls -
Hyperplastic Arteriolosclerosis
(Malignant HTN) -
Definition:
Dx specific to an aneurysm of the Ascending Aorta
where does it exert its effect?
what heart problem can it lead to? -
Syphillic (Leutic) Anneurysm
effects: Vaso Vasorum
leads to: Aortic valve incompetence - what may be confused w/ a MI if it wasn't for the normal serum enzymes?
- Dissecting Aneurysm
-
Definition:
dilated small vessel surrounded by radiating fine channels and associated w/ hyperestrinism - Spider Telangiectasia
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Dx:
Port-wine stain birthmark - Hemangioma
-
Dx:
Hemangioblastomas of the retina, cerebellum and medulla.
What can it lead to?
what genetics? gene? -
Von Hippel-Lindau Dz
can lead to: Bilateral Renal Cell CA
genetics:
Auto Dominant;
deletion on VHL gene on chrom 3
(chrom 3 = 3 words in name VHL) - Malignant vascular tumor caused by Arsenic exposure
- Hemangiosarcoma
-
Dx:
fever, weight loss, abd pain, HTN, cutaneous eruptions, arthralgia, vasculitis in arterioles and glomeruli of kidney
What is possible predisposing virus? -
Polyarteritis Nodosa
(P-ANCA)
virus: HBV -
Dx:
granulomatous vasculitis w/ eosinophilia and asthma; prominent in pulmonary vasculature - Churg-Strauss syndrome
-
Dx:
child w/ previous URI gets hemorrhagic urticaria of extensor surfaces, arthralgia, abd pain, melena - Henoch-Schonlein purpura
-
Dx:
necrotizing granulomatous vasculitis in lung and upper airway and necrotizing glomerulonephritis -
Wegener's Glanulomatosis
(C-ANCA) -
Dx:
unilateral HA, visual impairment, polymyalgia rheumatica (muscle pain), increased ESR -
Temporal arteritis
(Giant cell arteritis) -
Dx:
fever, arthritis, night sweats, myalgia, skin nodules, ocular disturbances, weak pulse in upper extremities, elevated ESR - Takayasu's Arteritis
-
Dx:
child w/ fever, congested conjuctiva, changes in lips/oral mucosa, lymphadenitis - Kawasaki Dz
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Dx:
intermittent claudication, nodular phlebitis, cold sensitivity, heavy smoker -
Buerger's Dz
(Tx: quit smoking) -
Dx:
marked increase in diastolic BP, retinal hemorrhages, papilledema, "flea-bitten" kidney - Malignant HTN
-
Definition:
focal interstitial myocardial inflammation w/ fragmented collagen and fibrinoid material and some mulitnucleated giant cells; seen in Rheumatic fever -
Aschoff Body
(w/ Anitschkow's cells) - MC coronary artery for MI
- LAD
-
Definition:
Autoimmune phenomenon resulting in fibrinous pericarditis post-MI - Dressler's syndrome
- what lab is elevated in Rheumatic Heart Dz?
- elevated ASO titer
-
Dx:
fever, erythema marginatum, valvular damage, elevated ESR, polyarthritis, Sub-q nodules, chorea -
Rheumatic Heart Dz
(mitral = MC valve) - MCC of Subacute Endocarditis
- Strep Viridians
- MCC of Acute Endocarditis
- Staph Aureus
-
Definiton:
Endocarditis secondary to metastasis or renal failure -
Marantic endocarditis
(can result in peripheral emboli) - (3) congenital Right -> Left shunts
-
3 Ts:
Tetralogy of Fallot;
Transposition of great vessels;
Truncus Arteriosus -
Dx:
Fixed S2 split - ASD
-
Definition:
uncorrected VSD, ASD, or PDA leads to progressive pulmonary HTN. With Inc pulm resistance, shunt reverses from L -> R to
R -> L, causing late cyanosis, clubbing and polycythemia - Eisenmenger's syndrome
- which congenital heart defect is not compatable with life unless a shunt is present?
- Transposition of great vessels
-
Dx:
notching of ribs, HTN in upper extremities and weak pulses in lower extremities - Coarctation of Aorta
-
Dx:
continuous "machine-like" murmur - PDA
- what is given to close a PDA?
- Indomethacin
- what is given to keep a PDA open?
-
Prostaglandins
[PROp it open] -
Congenital defect with:
Congenital Rubella
(2) -
Septal defect;
PDA -
Congenital defect with:
Marfan's syndrome - Aortic insufficiency
-
Congenital defect with:
offspring of Diabetic mother - Transposition of Great vessels
-
Murmur:
systolic High-pitched "blowing" - Mitral Regurg
-
Murmur:
Midsystolic Click - Mitral Prolapse
-
Murmur:
Wide pulse-pressure - Aortic Regurg
- MC heart tumor in children
-
Rhabdomyoma
(w/ Tuberous Sclerosis) - which type of emboli can lead to DIC?
- Amniotic fluid embloi
-
Dx:
low CO, equilibrium of pressures in all 4 chambers, JVD, pulsus paradoxus - Cardiac tamponade
- (4) causes of Serous Pericarditis
-
SLE;
RA;
Infection;
Uremia - (3)* causes of Fibrinous pericarditis
-
Fiber in your RUM:
Rheumatic fever;
Uremia;
MI - (4) signs of Tetralogy of Fallot
-
PROVe:
Pulmonary stenosis;
RVH;
Overriding Aorta;
VSD - developmental cause of Tetralogy of Fallot?
- Anterosuperior displacement of Infundibular septum
-
Definition:
passage of emboli from the venous circulation into the arterial circulation via a R -> L shunt - Paradoxic Emboli