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38 Cards in this Set

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Lab findings in PAN
p-anca. HBsAg+ in 30%, anemia, leukocytosis
Microscopic features of PAN
Segmental necrotizing vasculitis in three stages: fibrinoid necrosis with neutrophils, fibroblast proliferation, nodular fibrosis with loss of internal elastic lamina
Lab findings in PAN
p-anca. HBsAg+ in 30%, anemia, leukocytosis
Microscopic features of PAN
Segmental necrotizing vasculitis in three stages: fibrinoid necrosis with neutrophils, fibroblast proliferation, nodular fibrosis with loss of internal elastic lamina
Clinical features of PAN
Affects all organs except lungs. Fever, hematuria/renal failure/hypertension, abdominal pain/GI bleeding, myalgia/arthralgia
Clinical features of Wegner granulomatosis
Bilateral pneumonitis with nodular and cavitary infiltrates, chronic sinusitis, nasopharyngeal ulcerations, renal disease
Microscopic features of Wegner granulomatosis
Necrotizing vasculitis of small vessels (granulomas), necrotizing granulomas of respiratory tract, focal necrotizing glomerulonephritis
Lab findings in Wegner granulomatosis
c-anca
Treatment of Wegner granulomatosis
cyclophosphimide
Clinical features of temporal arteritis
Throbbing unilateral headache, visual disturbances, jaw claudication
Microscopic features of temporal arteritis
Segmental granulomatous vasculitis with multinucleated giant cells and fragmentation of the internal elastic lamina with intimal fibrosis and luminal thickening
Diagnosis, lab findings and treatment of temporal arteritis
Dx.: biopsy of temporal artery. Lab: increased ESR. Rx.: steroids
Clinical features of Takayasu asteritis
Loss of pulse in upper extremities, visual disturbances, neurologic abnormalities
Microscopic features of Takayasu arteritis
Granulomatous vasculitis with massive intimal fibrosis, thickening of the aortic arch and narrowing of the major arterial branches
Clinical features of Buerger's disease
Severe pain in affected extremity, thrombophlebitis, Raynaud phenomenon, ulceration and gangrene. Associated with heavy cigarette smoking
Microscopic features of Buerger's disease
Recurrent neutrophilic vasculitis with microabseses, segmental thrombosis and vascular insuficiency
Clinical features of Kawasaki disease
Affects children < 4. Acute febrile illness, conjuctivitis, maculopapular rash, lymphadenopathy, coronary aneurysms in 70% of cases
Microscopic features of Kawasaki disease
Segmental necrotizing vasculitis with coronary aneurysms
Diseases that feature Raynaud phenomenon
SLE, CREST, Buerger, atherosclerosis
Raynaud diseasse
Small artery vasospasm resulting in blanching cyanosis of fingers and toes precipitated by cold temperature and emotions
Henoch-Schonlein purpura
IgA-C3 immunocomplexes, IgA nephropathy (Berger disease), palpable purpura on buttocks
Major risk factors for atherosclerosis
Hyperlipidemia, hypertension, smoking, diabetes
Most common sites for atherosclerosis
Abdominal aorta followed by coronary arteries
Complications of atherosclerosis
Ischemic heart disease, abdominal aortic aneurysm, peripheral vascular disease (pain, pulselessness, paresthesia, claudication), TIA (vertebral basilar oclussion), renovascular hypertension (high renin).
Pathophysiology of essential hypertension
Retention of sodium and water with increase in stroke volume (systolic pressure). Sodium in smooth muscle opens up calcium channels with vasoconstriction of arterioles (increased diastolic pressure). Low renin hypertension.
Complications of hypertension
Concentric ventricular hypertrophy, AMI, hyaline arteriosclerosis, nephrosclerosis and CRF, intracranial bleeds, athersoclerosis
Renovascular hypertension
Atherosclerosis of renal artery orifice in males or fibromuscular hyperplasia in women. Severe hypertension, epigastric bruit. High renin hypertension. Screen with captopril.
Captopril screening test for renovascular hypertension
In renovascular hypertension there's decreased RPF and high levels of renin and angiotensin II. With captopril (ACE inhibitor), there's loss of negative feedback on renin and exagerated high levels of renin post-stimulation. The test has the potential for renal failure if bilateral renal artery stenosis is present as AII is responsible for maintaining renal blood flow.
Ahterosclerotic aneurysms
MC site is abdominal aorta below renal arteries (no vasa vasorum). Pulsitile mass with pain and abdominal bruit
Syphilitic aneurysm
Obliterative endarteritis of vasa vasorum with ischemia and atrophy of ascending aorta, aortic insuficiency, airway encroachment and laryngeal nerve involvment (brassy cough)
Associated diseases of dissecting aortic aneurysm
Marfan, Ehlers-Danlos, copper deficiency (no lysyl oxidase)
Signs and symptoms of dissecting aortic aneurysm
Acute retrosternal severe chest pain, aortic insuficiency and cardiac tamponade
Phlebothrombosis Vs. Thrombophlebitis
Phlebothrombosis is venous thrombosis of deep veins without inflamation or infection. Thrombophlebitis is venous thrombosis of superficial veins due to inflamation and infection
Signs, symptoms, diagnosis and complications of DVT
Leg swelling, warmth, erythema. Increased venous pressure from deep to superficial veins (which drain in deep veins) produces varicosities in superficial system. Complications are thromboembolism, thrombophlebitis. Dx.: Doppler
Signs, symptoms and causes of thrombophlebitis
Palpable cord, pain, induration, warmth, erythema. MCC is superficial varicose veins, phlebothrombosis, catherthers, drug abuse
Clinical features of varicose veins
Edema, thrombosis, stasis dermatitis, ulcerations
Clinical features of superior vena cava syndrome
Compression of SVN by primary lung cancer. Blue discoloration of the face, arms and shoulders, dizziness, convulsions, visual disturbances, distended jugular veins
Clinical features of Kaposi sarcoma
Malignant endothelial cell tumor caused by HHV-8. Multiple red-purple patches, plaques or nodules. Spindle shaped cells