Cv System - Rheumatic Heart Disease, Pericarditis, Tumors By Leech

Front 1

What is rheumatic heart disease?

Back 1

it's secondary rheumatic fever which is acute, recurrent inflamm. disease that develops 1-5 weeks after group A strep infection.

need 2 major jones or 1 major and 2 minors plus evidence of strep.

Front 2

the major criteria

Back 2

-erhythema marginatum
-sydenham chorea
-carditis
-subcutaneous nodules
-migratory large joint polyarthritis

Front 3

the minor criteria

Back 3

-fever
-arthralgia

-upper acute phase reactants
-c reactive
-cerulaplasmin
-alpha 1 antitrypsin
-C 3 complement
-prolonged PR interval

Front 4

When do you most likely have chronic RHD?

Back 4

most likely when 1st attack is early in childhood

1st bout of rheumatic fever is severe

you have recurrent attacks

Front 5

Physical changes are...

Back 5

secondary to mitral stenosis. this includes LAH and enlargement, chronic congestive changes in lungs, RVH, and CHF

Front 6

what do you see in chronic RHD

Back 6

fibrous thickening of leaflets

bridging fibrosis across commissures

thickened, fused and shortened mitral valve chordae

Front 7

Name the three types of acute pericarditis

Back 7

1. Serous
2. Fibrinous & Serofibrinous
3. Purulent

Front 8

serous pericarditis

Back 8

slowly accumulating fluid secondary to nonbacterial involvements. not sure how it starts.

Front 9

Fibrinous & Serofibrinous

Back 9

MOST COMMON

seen with MI and produces the friction rub. usually completely resolves without problem

Front 10

Purulent

Back 10

secondary to bacterial, fungal, parasitic infectoin which has reached the pericardium by direct extension

Front 11

most common causative agents of purulent pericarditis?

Back 11

gram + stap, strep and pneumococci

Front 12

describe hemorrhagic pericarditis

Back 12

most often follows cardiac surgery or ass'd with TB or malignancy.

has fibrin and hemorrhage.

Front 13

describe caseous pericarditis

Back 13

secondary to TB and usually direct extension from lymph nodes. leads to fibrocalcific constrictive pericarditis

Front 14

Chronic pericarditis.

Back 14

may heal without problem at all. maybe just some plaque.

Front 15

Describe Adhesive Mediastinopericarditis

Back 15

the pericardial sac is obliterated and the parietal surface is tethered to mediastinal tissue. Results in hypertrophy and dilation.

Front 16

Whats the most common cause of constrictive (chronic) pericarditis?

Back 16

TB is the most common cause. this is because of the thick, dense fibrous obliteration of the pericardial sac- often calcification- limits diastolic expansion and restricts output.

Front 17

Hemangioma is

Back 17

a benign lesion most commonly seen in kids. in skin or mucous membrane, goes away as kid grows (the 1-2 mm ones). they also may be on the viscera.

Front 18

Which are the bigger hemangiomas?

Back 18

cavernous- 1-2cm. common in the liver, CNS and other viscera.

Front 19

Von Hippel-Lindau disease is

Back 19

a cavernous h. of the cerebellum, brainstem, or eye grounds assd with cystic lesions in the pancreas, liver, kidney

Front 20

Pyogenic granuloma is

Back 20

ulcerated polypoid variant of capillary h. often secondary to trauma.

Front 21

Glomus Tumor is

Back 21

a benign tumor. Smooth muscle cell tumor from the glomus body. found in the distal fingers, beneath nailbeds. very small.

Front 22

Vascular Ectasia is

Back 22

abnormally prominent capillaries, venules and arterioles in skin or mucous membranes

Front 23

Nevus Flammeus

Back 23

birth mark. port wine stain on face/neck.

Front 24

Spider Telangiectasis

Back 24

subq arterioles like a web. often above waist and from hyper estrogenic states in pregenancy and cirrhosis.

Front 25

Bacillary Angiomatosis is

Back 25

potentially fatal infectious disease secondary to ricketts bacteria. people with immunocomprises like AIDS.

Front 26

Simple Lymphangioma is

Back 26

not a big issue. just lymph pushing out of a lesion

Front 27

Cystic Hygroma

Back 27

often large in kids. on neck or axilla. need to remove them, but some come back. poor margins and hard to deal with.

Front 28

What is hemangioendothelioma?

Back 28

it's an intermediate grade tumor, most often cured by excision. some recur. looks like metastatic carcinoma, melanoma, sarcoma.

Front 29

4 types of Kaposi Sarcoma (intermediate)

Back 29

1. chronic/classic/europe- purple plaque
2. lyphadenopathic/african- lymph nodes
3. transplant- immunocompromised b/c of docs
4. AIDS-associated

Front 30

Name a malignant tumor

Back 30

1. angiosarcoma
2. hemangiopericytoma

Front 31

Describe angiosarcomas

Back 31

hemangio- or lymphangio-

most aggressive of vascular tumors, often fatal.

seen in older folks that worked with pesticides. sites are skin, soft tissue, breast, and spleen.

may arise in areas of lymphedema.

Front 32

Hemangiopericytoma

Back 32

is rare. metastasize quickly and goes to lung, bone and liver.

Front 33

Are tumors of the heart rare?

Back 33

yeah.

metastatic lesions are more frequent.

Front 34

What is the most common primary tumor of the heart in adults?

Back 34

Myxomas. most often in the fossa ovale of the atria. this damages the valve in a wrecking ball manner from the peripheral embolization fragments. the biggest problem is the obstruction of the valve.

Front 35

Lipomas

Back 35

circumscribed by poorly encapsulated

Front 36

papillary fibroelastomas

Back 36

may emboli.

Front 37

the most common primary heart tumor in kids is

Back 37

rhabdomyomas. they infiltrate the ventricle.

Front 38

most common malignant

Back 38

angiosarcoma