Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
67 Cards in this Set
- Front
- Back
|
Monoclonal gammopathy
|
Excess functional immunoglobulins
potential to convert to MM |
|
|
Excessive osteoclast activating factor seen in MM leads to
|
Osteolytic lesions
(IL-6) (IL-1 as well) |
|
|
Bence-Jones protein seen in
|
MM
free monoclonal kappa or gamma chains (light chains) |
|
|
Other things seen in MM
|
-amyloidosis (tissue deposit light chains)
-hypercalcemia -anemia & leukocytopenia -increased susceptibility to infections -M-spike |
|
|
Tests for MM
|
UPEP
SPEP (M-spike on electrophoresis) |
|
|
Pathology in Waldenstrom's disease
|
overproduction of IgM
--> hyperviscosity syndrome (fatigue, weakness, skin & mucosal bleeding, HA, visual, neurologic problems) |
|
|
Histologically seen in Waldenstrom's
|
Flame cells
(eosinophilic neoplastic plasma cells) |
|
|
Virchow's triad
|
-Stasis
-Hypercoagulability -Endothelial cell damage |
|
|
Trousseau's syndrome
|
Migratory venous thrombosis
|
|
|
Path MM
|
excess intact IgG or IgA
excessive light chains |
|
|
Path atherosclerosis
|
high LDL-cholesterol
-foam cell (cholesterol-laden macrophage) -deposition large & medium arteries in intimal layer |
|
|
Atherosclerosis increases risk of
|
CVA
PVD Ischemic HD Mesenteric ischemia Aortic aneurysm |
|
|
Monckeberg's - path & common places
|
Ca deposits in blood vessel media
Common to radial and ulnar a. |
|
|
Cause arteriolosclerosis (hyperplastic)
|
malignant HTN (SBP > 210 or DBP > 150)
|
|
|
What vessels does arteriolsclerosis (hyperplastic) affect?
|
Sm arteries and arterioles
|
|
|
Histological arteriolosclerosis (hyperplastic)
|
Onion skin hyperplasia
(medial hyperplasia --> narrowing of lumen) |
|
|
Cause arteriolosclerosis (hyaline)
|
Inflammation & use
(HTN, aging, DM) |
|
|
Histological arteriolosclerosis (hyaline)
|
BM thickened
(subluminal fibrosis) --> weakening elastic laminae --> media atrophy |
|
|
Vessels affected by arteriolosclerosis (hyaline)
|
Sm arteries & arterioles
Kidney - nephrosclerosis |
|
|
What arteritises are associated w/ Lg vessels
|
Giant cell
Takayasu |
|
|
What diseases are affected by medium vessels arteritis
|
Polyarteritis nodosa
Kawasaki Thromboangiitis obliterans |
|
|
What diseases are affected by small vessel arteritis
|
Wegener's
Henoch-Schonlein Hypersensitivity arteritis Churg-Strauss Microscopic polyangitis Thromboangiitis obliterans |
|
|
What type of hypersensitivity is hypersensitivity arteritis? Where does it affect?
|
Type III
SKIN (mostly) muscles brain kidney |
|
|
Causes of hypersensitivity arteritis
|
Drugs (PEN)
Tumors HCV EBV HIV |
|
|
Ab in hypersensitivity arteritis
|
p-ANCA
|
|
|
S/S hypersensitivity arteritis
|
palpable purpura (+/- macules)
papules (buttocks) Painful pruritic |
|
|
Henoch-Schonlein purpura
|
(variant of hypersensitivity arteritis)
vasculitis of IgA immune complex small vessel walls Mostly kids |
|
|
S/S henoch-schonlein purpura
|
palpable purpura (buttocks esp.)
Arthralgias Bloody diarrhea +/- glomerulonephritis |
|
|
Polyarteritis nodosa (PAN)
|
transmural necrotizing inflammation arterial walls
-WBC invade blood vessel walls --> inflam. damage |
|
|
PAN secondary to
|
HBV
HCV Hairy cell leukemia |
|
|
S/S PAN
|
Fever
Abd. pain & melana Renal dz (w/o glomerulonephritis) HTN neuritis of motor neurons diffuse myalgia ***FATAL if untx |
|
|
Microscopic polyangiitis
|
Small blood vessels
Transmural necrotizing inflam. arterial wall p-ANCA |
|
|
Cause of microscopic polyangiitis
|
Drugs (PEN)
|
|
|
S/S microscopic polyangiitis
|
palpable purpura, hemoptysis, hematuria, myalgia
|
|
|
Microscopic polyangiitis leads to
|
Severe glomerulonephritis (-->Rapidly progressive glomerulonephritis)
Pulmonary capillaritis |
|
|
Thromboangiitis obliterans
|
(Buerger's disease)
hypersens. to tobacco (< 35 yo jewish male) |
|
|
Path thromboangiitis obliterans
|
Tibial & radial arteries
Neutrophils surrounded by granulomas form in vessel wall |
|
|
Thromboangiitis obliterans leads to
|
blood vessel destruction
severe pain distal limb --> progessive to gangrene |
|
|
Giant cell arteritis
|
granulomatous inflammation of vessel wall
(affect aorta, carotid, vertebral a., temporal a.) Female > 50 yo |
|
|
Temporal arteritis
|
Giant cell arteritis in temporal a.
Tetrad - fever, fatigue, temporal HA, high ESR, jaw claudication |
|
|
What is systemic manifestation of giant cell arteritis
|
Polymyalgia rheumatica
|
|
|
S/S polymyalgia rheumatica
|
Flu-like
arthralgia & myalgia fever, high ESR |
|
|
Wegener's granulomatosis
|
granulomatous development in small vessels
|
|
|
Ab Wegener's granulomatosis
|
c-ANCA
|
|
|
Clinical Wegener's granulomatosis
|
Sinusitis (sinus polyps)
Glomerulonephritis Lung lesions |
|
|
Takaysau arteritis
|
thickening aortic arch w/ huge granulomas
|
|
|
Peak age & characteristics of pt w/ takaysau arteritis
|
15-40 yo
Female Asian |
|
|
S/S Takaysau arteritis
|
Night sweats
CP Weak or absent peripheral pulse |
|
|
Kawasaki disease path? trigger?
|
(mucocutaneous LN syndrome)
similar to PAN - transmural necrotizing Viral trigger |
|
|
S/S Kawasaki
|
Fever
Conjunctivitis Maculopapular rash (hands & soles) Coronary a. aneurysms Oral mucosal erythema Cervical LN enlargement |
|
|
Typical pt w/ Kawasaki disease
|
usually < 4 yo
Japanese |
|
|
First line tx Kawasaki disease
|
IV immunoglobulins
ASA (even though pt typically children) |
|
|
Churg-Strauss path?
|
Granulomas
PAN-like histologic features massive eosinophil invasion |
|
|
Ab Churg-Strauss
|
p-ANCA
|
|
|
Churg-Strauss - Affects blood vessels where
|
Skin
Nerves Muscle LUNG HEART |
|
|
S/S Churg-Strauss
|
severe, recurrent asthma-like
lung infiltrates coronary vessel destruction +/- myocarditis (death) typically pt w/ hx asthma |
|
|
Behcet's syndrome path? Ab?
|
vaculitis v. and venules
Ab - anti-human oral mucosa Ab |
|
|
S/S Behcet's syndrome
|
recurrent painful oral and genital ulceration (looks like herpes)
+/- uveitis/iritis, artheritis knee |
|
|
Outcome Behcet's syndrome
|
life-threatening brain & GI damage
high risk DVTs & PEs |
|
|
Population affected by Behcet's syndrome
|
Mediterranean
Middle east Far east |
|
|
Aneurysm that occurs w/ syphilis
|
(luetic)
endarteritis of vasa vasorum Thoracic aorta --> ischemia & atrophy media --> media shrinks --> intima buckles ("tree-barking") Can lead to aortic regurg |
|
|
Aneurysm of circle of willis? associated w/ ___ dz?
|
Berry
adult Polycystic Kidney disease Rupture = subarachnoid hemorrhage |
|
|
Aortic dissection risk factors
|
HTN
Marfans |
|
|
Path aortic dissection
|
intima tears --> split b/t laminar planes of media
blood collects w/i aortic wall |
|
|
Micro aneurysm
|
Cerebral - HTN
Retinal - DM |
|
|
Mycotic aneurysm
|
d/t infections of vessel wall
--> damage media |
|
|
Aneurysms of aortic arch can cause
|
-dyspnea (compression resp. structures)
-recurrent, persistent cough (pressure on recurrent laryngeal n.) -HF (aortic regurg) -rupture & death |
