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23 Cards in this Set
- Front
- Back
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Is monoclonal gammopathy benign or malignant?
What can it evolve into? |
Benign excess of Ig
Can convert to Multiple Myeloma |
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What malignancy do Bence-Jones proteins and an M-spike indicate?
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Multiple Myeloma
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What are Bence-Jones proteins?
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free monoclonal kappa or lambda light chains that CANNOT be identified on urinalysis
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What is Waldenstrom's macroglobulinemia?
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Hyperviscosity syndrome d/t overproduction of IgM (a huge pentamer molecule that thickens the blood)
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What is Trousseau's syndrome?
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Migratory venous thrombosis that is more commonly seen in those with any of the Virchow's triad
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In what layer does LDL deposit?
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Intima
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What is Monckeberg's atherosclerosis and what layer of the vessel does it effect?
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Calcium deposits in the tunica media layer
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If a pt's small arteries and arterioles had the appearance of an onion skin, what would you dx?
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Hyperplastic Arteriolosclerosis d/t malignant HTN (SBP >210 or DBP >150)
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How can hyaline arteriolosclerosis cause an aneurysm?
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Thickening of the arterial basement membrane over time leads to atrophy of the tunica media allowing for luminal widening which can weaken further as an aneurysm - especially in pts with HTN.
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What diseases cause small vessel arteritis?
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Wegener's
Henoch-Schonlein Hypersensitivity arteritis Churg-Strauss Microscopic polyangiitis Thromboangiitis obliterans |
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What type of symptoms and signs does Henoch-Schonlein purpura cause?
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Palpable purpura (esp on butt)
arthralgias bloody diarrhea +/- glomerulonephritis |
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What disease is frequently linked to polyarteritis nodosa?
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Hepatitis B - up to 30% are +
HBV, HCV, and Hairy Cell Leukemia area all assoc. |
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A pt presents with palpable purpura, hemoptysis, hematuria, and glomerulonephritis. What condition do you expect they have? And what likely started this process?
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Microscopic polyangiitis
Penicillin or clopidogrel |
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A 29yo Jewish male smoker presents to your office complaining of leg and arm pain. What arteritis are you most concerned about?
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Thromboangiitis obliterans (Buerger's dz)
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A 60yo female presents to your office with terrible temporal headaches, fever, and fatigue. You order an ESR but decide to go ahead and put her on a course of steroids until a confirmatory biopsy can be done. What dz are you presumptively treating this patient for?
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Giant cell arteritis d/t the high risk of sudden monocular blindness from occlusion of the opthalmic branch of the internal jugular artery
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What is the systemic manifestation of Giant cell arteritis?
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Polymyalgia rheumatica
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What is Churg-Strauss dz?
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Allergic angiitis featuring granulomas and PAN-like features with massive EOSINOPHIL invasion of vessel wall AND surrounding tissues
Affects small vessels (skin/nn/mm/LUNG/HEART) and creates asthma like symptoms |
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Who is most likely to develop Takayasu arteritis?
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15-40 yo women of Asian descent
(night sweats, chest pain, weak/absent peripheral pulses esp in UE d/t granulomatous vasculitis) |
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What disease is often misdiagnosed as herpes (oral or genital) that is especially severe in men?
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Behcet's PHLEBITIS (veins not arteritis) which causes painful oral/genital ulcers
+/-uveitis/iritis +/- arthritis of knee and can cause life threatening brain and GI damage or DVT/PEs |
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How are syphilitis aka leutic aneurysms described?
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Tree-barking of the intima
(d/t obliterative endarteritis of vasa vasorum leading to ischemia/atrophy of media that causes it to shrink leaving behind the unsupported intima) |
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What causes mycotic aneurysms?
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Infection of the vessel wall, usually by bacteria
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What are the 3 major effects a luminal plaque can have?
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1 luminal narrowing
2 atrophy of media leading to weakening of the wall 3 disruption increases risk of occlusion d/t clot |
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What is the pathophysiology of Kawasaki diease?
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Unknown but suspect it is triggered by viral infection. Resembles Polyarteritis Nodosa and can cause coronary artery aneurysm!!
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