Cv: Test 2: Leech: Final Study Guide

Front 1

the localized abnormal dilation of a vessel is known as what?

Back 1

an aneurysm

Front 2

what is the difference between a true and false aneurysm?

Back 2

i. True aneurysm has complete arterial wall

ii. False aneurysm has a missing part of vessel wall

Front 3

what are the 2 most common causes of an aneurysm

Back 3

atherosclerosis, cystic medial degeneration are the most common

Front 4

Where is the most common place for an aneurysm to occur?

Back 4

Most common site for atherosclerotic plaques (and thus aneurysms) are abdominal aorta between renal arteries and iliac bifurcation or in common iliac

Front 5

what population is most likely to have an aneurysm in the abdominal aorta?

Back 5

i. Mostly in men older than 50

ii. Increased risk of rupture with increase in bulge over 5cm

iii. Operative risk increases with rupture

Front 6

What stage of syphilis do Syphilitic aneurysms occur? Where in the body do they occur?

Back 6

tertiary stage of syphilis

Usually involves only ascending and arch of aorta

Front 7

what population are you likely to see aortic dissection?

Back 7

i. Over 90% seen in hypertensive men 40-60

Front 8

what problem is associated with Marfan's syndrome?

Back 8

f. Aortic dissection

Front 9

Pathology of vessel is elastic tissue fragmentation and disruption, focal separation of elastic and fibromuscular tissue; this describes?

Back 9

Aortic Dissection

Front 10

there are 2 types of aortic dissection...what are they, where do they occur, and which is more dangerous

Back 10

Type A: proximal, more common and more dangerous, involves ascending aorta

Type B: distal to the subclavian

Front 11

excruciating pain in anterior chest radiating to the back and down is the clinical presentation of what?

Back 11

Aortic Dissection

Front 12

what is the most common of the vasculitides?

Back 12

Giant Cell Arteritis

Front 13

patient presents with a headache, and facial pain....later he complains of visual problems. What does this patient have? What do you treat them with?

Back 13

Giant Cell Arteritis

Treat with STEROIDS

Front 14

this vascular problem is most common in Asian women, unknown cause; involves medium to large arteries including aortic arch and major branches...what is it? Treatment?

Back 14

Takayasua Arteritis

Steroids

Front 15

affects young adults, may be associated with Hep B antigen, affects any organ but LUNG..what is this?

treatment?

Back 15

b. Polyarteritis nodosa (PAN)

immunosuppresive therapy provides 90% cure rate

Front 16

describe Microscopic polyangiitis

Back 16

like PAN but involves smaller vessels, can involve the lungs

Front 17

illness of infants and children, 20% have coronary arteritis; etiology unknown but patients have immunoregulatory problems --> t cell activation, auto antibodies to endothelial cells, circulating immune complexes; will see fever

Back 17

Kawasaki disease

**remember, with the fever, it must last at LEAST 5 DAYS in order to make the diagnosis***

Front 18

What is the triad seen in Wegener granulomatosis

Back 18

triad of focal necrotizing vasculitis of lung, necrotizing granulomas of upper respiratory tract, necrotizing glomerulitis;

lesions like PAN but with granulomas, greatest occurrence in 40s, 90% have C-ANCA antibodies, w/o treatment 80% die in a year

Front 19

seen in heavy smokers before age 35; nodular phlebitis develops into Raynauds, cause in unknown, cause 4+ pain and gangrene of extremities

Back 19

f. Thromboangiitis obliterans (buerger disease

Front 20

unknown etiology but is an exaggeration of normal central and local vasomotor responses; found in young, healthy women

Back 20

g. Raynauds disease

Front 21

what is the commonest cause of superior vena cava syndrome?

Back 21

most common is bronchogenic CA

or mediastinal lymphoma

Front 22

what causes superior vena caval syndromes?

Back 22

secondary to neoplasms that compress or invade the SVC, most common is bronchogenic CA or mediastinal lymphoma

Front 23

patient presents with cyanosis and marked dilation of the veins of the head, neck and arms....what do they have?

Back 23

SVC syndrome

Front 24

i. Clinically presents with marked edema of legs, distention of superficial collateral veins of lower abdomen; when renal veins involved, massive protein urea...what do they have

Back 24

IVC syndrome

Front 25

what is the commonest cause of inferior vena cava syndrome?

Back 25

secondary to neoplasm such as hepatocellular CA and renal cell CA

Front 26

What are the 3 types of cardiomyopathy? which is most common?

Back 26

Dilated--most common

hypertrophic

restrictive

Front 27

what is characterized by gradual four chamber hypertrophy?

Back 27

dilated cardiomyopathy

Front 28

May occur at any age as slow progressive CHF;

Unknown etiology, but genetic defects, etOH, viral myocarditis may contribute

Gross changes include cardiomegaly, thrombi, endocardial thickening

Back 28

dilated cardiomyopathy

Front 29

this is characterized by a heavy, muscular, hypercontractile heart with poor diastolic relaxation resulting from asymmetric interventricular septal hypertrophy (on the left side, resulting in left ventricular outflow obstruction)

Back 29

hypertrophic cardiomyopathy

Front 30

Clinically presents in young adults with dyspnea, angina, syncope, CHF, can see sudden death in young atheletes

Back 30

hypertrophic cardiomyopathy (HCM)

Front 31

what are the gross changes seen in HCM?

Back 31

disproportionate thickening of septum vs. left ventricular free wall

Front 32

the myocardium is infiltrated with a material that results in impaired ventricular filling and decreased cardiac output ...this describes

Back 32

restrictive cardiomyopathy

Front 33

what are the 2 most common causes of restrictive cardiomyopathy?

Back 33

amyloidosis- stains orange/red/pink but seen blue/green in polarized light

hemochromatosis stains blue

Front 34

what would be seen with endomyocardial fibrosis that occurs in children and young adults in Africa?

Back 34

Eosinophilia

Front 35

most common cause of myocarditis?

Back 35

Coxsackievirus B (type 3/4)

[remember that adenovirus is second, and that these are enteroviruses]

Front 36

myocardial inflammation, broad clinical spectrum from asymptomatic to abrupt onset of arrhythmia, CHF, or sudden death; most recover quickly without sequelae

Back 36

myocarditis

Front 37

what can occur after a group A infection?

what type of hemolysis does this step clear?

Back 37

Rheumatic fever

beta

Front 38

in addition to having a history of a strep infection, what else is necessary to diagnose rheumatic fever?

Back 38

2 major jones criteria

OR

1 major and 2 minor

Front 39

what is the most common symptom/jones criteria seen with RF? 2nd?

Back 39

1: Poly arthritis

2. Carditis

Front 40

what can recurrent attacks of rheumatic fever lead to?

Back 40

congestive heart failure

Front 41

what are the 5 acute types of pericarditis?

Back 41

SPF Hates Cancer-

Serous, Purulent, Fibrinous, Hemorrhagic, Caseous

Front 42

what type of pericarditis is associated with....

slowly accumulating fluid typically secondary to nonbacterial involvement; unknown etiology; only about 200cc of fluid

Back 42

a. Acute serous pericarditis

Front 43

what type of pericarditis is associated with....

MI and produces friction rub; usually resolves without sequelae

Back 43

b. Acute fibrinous and serofibrinous pericarditis

Front 44

what type of pericarditis is associated with....

usually secondary to bacterial, fungal or parasitic infection which has reached the pericardium by direct extension...produces 500cc of fluid that can cause constrictive pericarditis

Back 44

c. Acute purulent pericarditis

Front 45

what type of pericarditis is associated with....

most often follows cardiac surgery or associated with TB or malignancy

Back 45

d. Acute hemorrhagic pericarditis

Front 46

what type of pericarditis is associated with....

secondary to TB and usually direct extension from lymph nodes

Back 46

e. Acute caseous pericarditis

Front 47

what type of pericarditis is most common?

Back 47

b. Acute fibrinous and serofibrinous pericarditis

Front 48

what are the 3 most common causative organisms for acute purulent pericarditis?

Back 48

GRAM POSITIVE STAPH, STREP AND PNEUMOCOCCI

Front 49

what is chronic pericarditis usually secondary to?

Back 49

TB or purulent pericarditis

Front 50

what is usually the cause of chronic pericarditis?

Back 50

TB

Front 51

i. Healing of acute lesions could form a thick nonadherent epicardial plaque in this problem...

what is a name for this plaque?

Back 51

Chronic pericarditis

Soldier's plaque

Front 52

what are the 4 types of hemangioma?

Back 52

Capillary

Juvenile capillary

Cavernous

Pyogenic granuloma

Front 53

ulcerated polypoid variant of capillary hemangioma secondary to trauma; PREGNANCY TUMOR, will regress after delivery

Back 53

iv. Pyogenic granuloma

Front 54

1-2cm, in addition to skin and mucous membranes, these lesions are common in the liver, CNS and other viscear;

Back 54

Cavernous hemangioma


von hippel-Lindau disease is cavernous lesions of the cerebellum, brainstem or eyes

Front 55

strawberry present at birth, grow rapidly for a few months, regress by age 7

Back 55

juvenile capillary hemangioma

Front 56

1-2mm lesion seen primarily in skin or mucous membrane and visecera

Back 56

capillary hemangioma

Front 57

benign, extremely painful tumor arising from smooth muscle cells, seen often in distal phalanges or beneath the nail bed

Back 57

Glomus Tumor

Front 58

birth mark, port wine stain of face and neck, grows with child, but most regress with age

Back 58

Nevus flammus

Front 59

facial port wine stain with associated mental retardation

Back 59

sturge weber syndrome

Front 60

minute focal subcutaneous arterioles arranged in radial fashion with central core; most often associated with hyperestrogenic states (pregnancy and cirrhosis)

Back 60

ii. Spider telangiectasis

Front 61

occurs in head, neck, axillary tissue, looks like hemangioma but NO blood cells

Back 61

e. Simple lymphangioma

Front 62

occur in the neck of axilla in children as large as 15cm, difficult to resect; looks like cavernous hemangioma, but no blood cells

Back 62

Cystic hygroma

Front 63

what is the most common adult heart tumor? where does it occur

Back 63

Myxomas

fossa ovale in atria

Front 64

what is the most common childhood heart tumor?

Back 64

rhabdomyomas

Front 65

what is A benign (noncancerous) tumor-like growth consisting of a disorganized mixture of cells and tissues normally found in the area of the body where the growth occurs.

Back 65

Hamartoma

Front 66

a mass of histologically normal tissue in an abnormal location

Back 66

Choristomas