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66 Cards in this Set
- Front
- Back
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Rheumatic fever
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post group a strep
5-15 yr olds antigen/antibody |
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Major criteria for RF
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Carditis
Erythema marginatum Polyarthritis Sydenham chorea Subcutaneous nodules |
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Minor criteria for RF
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fever
arthalgia c-reactive protein prolonged PR invterval C-3 complement alpha1 anitrypsin ceruloplasmin |
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Chronic RF due to
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1st attack is early in childhood
1st bout of rheumatic fever is severe have recurrent attacks |
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Valvular involvement with RF
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mostly mitral valve
can lead to deformation and scarring--permanent dysfunction--chronic rheumatic heart diseas--CHF |
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Changes secondary to Mitral valve stenosis
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LVH, RVH, CHF
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Gross for RF
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chronic vavle disease
clacification deep in leaflets |
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Micro for RF
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Aschoff nodules
Antischkow myocyte |
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Acute pericarditis forms
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Serous
Fibrinous and serofibrinous Purluent |
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Serous acute pericarditis
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slow accumulation of fluid
secondary to non-bacterial involvement |
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Fibrinous and serofibrinous acute pericarditis
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most common
seen with MI produce friction rub uremia with renal failure |
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Purulent
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secondary to bacteria, fungus, or parasite
gram + staph, strep, and pneumonocci can get constrictive pericarditis |
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Acute pericariditis hemorrhagic
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most often follows cardiac surgery or associated with TB or malignancy
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Caseous AP
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secondary to TB
get fibrocalcific constrictive pericarditis |
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Chronic pericarditis
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healing of acute lesions causes pericardial fibrosis which varies from thick, nonadherent epicardial plaque to thin, delicate adhesions, to massive adhesions
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Adhesive mediastinopericarditis
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pericardial sac is obliterated and the parietal surface is tethered to mediastinal tissue which results in hypertrophy and dilation
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Constrictive pericarditis most common cause
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TB
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Dilated cardiomyopathy
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gradual four chamber hypertrophy and dilation
Slow, progressive CHF |
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Causes for dilated cardiomyopathy
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Unknown
genetic defect alcohl peripartum postviral myocarditis |
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Gross finding of dilated cardiomyopathy
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cardiomegaly
mural thrombi mild to moderate endocardial thickening |
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Micro changes of dilated cardiomyopathy
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some have diffuse mycocyte hypertrophy and intersitial fibrosis
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Hypertrophic cardiomyopathy
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heavy, muscular, hypercontractile heart with poor diatstolic relaxation
young adults at risk for sudden death |
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Gross findings of hypertrophic cardiomyopathy
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thickened basal septum which can lead to valve problems
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Restrictive cardiomyopathy
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restriction of ventricular fillings
decreased cardiac output interstitial fibrosis peripheral eosinophilia |
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Two types of restrictive cardiomyopathy
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hemochromatosis
amyloidosis |
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Gross findings for myocarditis
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resembles dilated cardiomyopathy
flabby ventricles mural thrombi post acute stage has residual dilatation or hypertrophy with small areas of interstitial fibrosis |
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Micros findings of myocarditis
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mysocyte necrosis or degeneration
"Aschoff nodules" lymphoma (indicates viral) |
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Cardiotoxic agents
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produces myofiber swelling, fatty changes and indiviual cell lysis
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Iron overload
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dilated pattern
hemosiderin depostis |
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Amyloidosis
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may be part of systemic disease
isolated arrhythmias or restricitive physiology |
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Catecholamines
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tachycardia
diffuse, patchy ischemic necrosis cocaine may have a similar effect |
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Benign histo
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well formed vascular channels lined with endothelial cells
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Malignant histo
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poorly formed cascular channels with solid, anaplastic endothelial proliferation
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Hemangioma
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common seen often in kids
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Capillary hemangioma
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small, seen mostly in skin or mucous membranes some in vicera
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Juvenile capillary hemangioma
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aka strawberry, present at birth, rapidly grow for a few months, then regress and disappear around 7yr
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Cavernous hemangioma
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1-2cm found in skin, mucou membranes, liver, CNS and other vicera
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Pyogenic granuloma hemangioma
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often secondary to trauma, seen in gingiva in pregnant women and regress after delivery
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Glomus tumor
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benign, but extremely painful, tumor of smooth muscle cells, found beneath nail beds, very tiny
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Nevus flammeus
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birth mark, aka port wine if on face or neck
grows with child but most regress with age |
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Vascular ectasia
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abnormally prominent capillaries, venules, and arterioles in skin or mucous membranes
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Nevus flammeus
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birth mark, port wine if on face or neck, grows with child but most regress with age
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Sturge-Weber syndrome
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facial port-wine lesion, with associated leptomeningeal angiomatous masses, metal retardation, seizures, hemiplegia, and skull radiopacities
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Spider telangiectasis
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minute focal subcutaneous arterioles found in hyper estrogenic states such as pregnancy and cirrhosis
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Hereditary hemorrhagic telangiectasia
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rare, presents with epistaxis, hempotysis, GI or GU bleeding and gets worse with age
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Bacillary angiomatosis
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potenially fatal infectious disease secondary to rickettsia-like bacteria.
Bad news for immunocompromised like AIDS |
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Simple lyphangioma
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head, neck, axillary subcutaneous tissue, 1-2 cm nodules, histo looks like hemangioma but NO BLOOD CELLS
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Cystic hygroma
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hard to resect, as large as 15cm, hist looks like cavernous hemagnioma but NO BLOOD CELLS
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Hemangoendothelioma
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Hard to excise, recur can look like metastatic carcinoma, melanom, or sarcoma
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Kaposi Sarcoma
chronic/classic/European |
elderly men of eastern European or mediterranean descent, with red to pruple plaques and nodules on LE, rarely leads to death
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Kaposi Sarcoma
Lyphadenopahtic/African |
younger men, red to pruple plaques and nodules mainly in lymph nodes, aggressisve
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Kaposi Sarcoma
Transplant |
red to pruple plaques and nodules in patients on immunosuppressive thereapy, goes away when therapy is over
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Kaposi Sarcoma
AIDS associated |
more common in homosexuals, lesions occur in skin, mucous membranes, lymph nodes, GI tract, and vicscera (big deal)
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Angiosarcoma (Hemangio-or Lymphangio)
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most aggressive of vascular tumors, metastasizes widely, hepatic lesions, skin, soft tissue, breast, spleen, may arise in areas of lymphedema 10 yrs post radical mastectomy
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Hemangiopericytoma
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rare, LE and retoperitoneum (so can grow a long time before it is noticed), 50% metastatasize to lung, bone, or liver
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Heart tumors
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primary tumors are rare
secondary tumors occur more frequently from lung, melanoma, or breast, can involve the pericardium or penetrate the mycardium |
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Myxomas
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most common primary tumor of the heart, more common in adults, can damage valves and create peripheral emboli
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Lipomas
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most are tiny, often subendocardial, LV, RA, septum
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Papillary fibroelastomas
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can emboli but usually not found till autopsy, found in right sided valves in kids and left in adults
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Rhabdomyomas
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most common primary tumor of the heart in kids
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Rhabdomyocarcomas
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rare, malignant
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Angiosarcoma
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most common malignant tumor of the heart
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Direct consequences of heart tumors
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pericardial and myocardial metastases, large vessel obstruction, and pulmanory tumor emboli
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Indirect consequences of heart tumors
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nonbacterial thrombotic endocarditis
carcinoid heart diesase (via chemicals from tumors) pheochromocytoma associated heart disease myeloma associated amyloidosis |
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Effects of tumor therapy
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chemotherapy
radiation therapy--can cause heart tethering |
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Myxomas histo
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very bland
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