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18 Cards in this Set
- Front
- Back
The mechanism of aortic valve regurgitation (3)
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1) Valve cusp destruction endocarditis
2) Myxomatous degeneration 3) Dilation of the aortic root |
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Fever, heart murmur, fatigue, anemia, arthralgia, myalgia, and Roth spots (retinal hemorrhages)
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Clinical manifestations of endocarditis
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Complications of endocarditis
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1- rupture of chordae tendinae
2- spread of infection into myocardium or aorta 3- thromboembolism w/ infarction 4- Septic thrombi w/ metastatic abscesses 5- Valvular dysfunction and CHF |
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Etiology: Unknown (?T-cell mediated)
Clinical:Fever, weight loss, headache, visual problems, claudication of jaw, pain and tenderness over temporal artery, polymyalgia rheumatica. Rare under the age of 50 years. Pathology: Granulomatous inflammation with giant cells, fibrosis. |
Giant Cell (Temporalis) Arteritis
- large vessel |
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Etiology: Unknown
Clinical: Thickening of the wall reduces blood flow in the major branches off the arch (“pulseless disease” due to weak pulses in the arms). Usually affects young women. Pathology: Granulomatous inflammation with fibrosis involving the aortic arch and the arch branches. |
Takayasu's Arteritis
- large vessel |
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Etiology: Mostly unknown; 30% Hep B surface antigen
Pathological: Segmental involvement of med and small muscular arteries; lots of macs and plasma cells Clinical: Multiple organ involvement |
Polyarteritis nodosa
- medium vessel |
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Etiology: It is suspected that a viral infection triggers a hypersensitivity reaction.
Clinical: Affects infants and young children. Skin rash, mucous membrane lesions, lymphadenopathy. Usually self-limited but 1-2% die with coronary artery vasculitis. |
Kawasaki's Disease
- medium vessel |
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Etiology: Often due to antigen-antibody complexes.
Clinical: Fever, rash, joint swelling, pleural effusion, pulmonary infiltrates, myocarditis, GI bleeding, renal failure, presence of circulating anti-neutrophilic cytoplasmic antibodies (pANCA). May be manifestation of malignancy, autoimmune disease or other disorder. Pathology: Involves arterioles, capillaries, venules. Fibrinoid necrosis, neutrophils (leukocytoclastic vasculitis). |
Microscopic Polyarteritis
-small vessel |
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Etiology: Probably a form of T-cell mediated hypersensitivity.
Clinical: Involves sinuses, lungs and kidneys (glomerulonephritis). Associated with the presence of anti-neutrophilic cytoplasmic antibodies (cANCA). Pathology: Necrotizing granulomas with vasculitis. |
Wegener's granulomatosis
- small vessel |
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Etiology: Endothelial injury from a substance in cigarette smoke
Clinical: Usually begins before age 35. Pain and ischemia in extremities. Pathology: Segmental acute and chronic vasculitis mainly in extremities with thrombosis. |
Buerger's Disease (Thromboangiitis obliterans)
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Dissecting aortic hematoma
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Longitudinal tear of the aortic media which begins in the ascending aorta and extends variable distance proximal (toward the heart) and distal to the descending aorta.
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Complications of dissecting aortic hematoma
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severe hemorrhage from rupture, organ ischemia due to luminal compression by the expanding hematoma.
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Predisposing factors of dissecting aortic hematoma
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hypertension, inherited connective tissue disorders (i.e., Marfan’s syndrome) with medial degeneration
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Pathogenesis of immune-mediated vasculitis
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1) Immune complex formation
2) Antineutrophilic cytoplasmic antibodies (ANCA) 3) Anti-endothelial cell antibodies 4) Cell-mediated immunity |
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How does rheumatic fever correlate w/ mitral stenosis
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The disease is thought to be due to the production of antibodies against the streptococcal bacteria which cross react with various antigens in the heart, joints and other sites
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Mitral valve prolapse
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Mitral valve prolapse is a condition in which the leaflets balloon into the left atrium during left ventricular contraction (systole)
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In severe prolapse (also called floppy mitral valve) the valve cusps are large and microscopically show fragmentation, separation and
loss of collagen. This is what? |
myxomatous degeneration
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Floppy mitral valve is associated with what syndrome?
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Marfan syndrome
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