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31 Cards in this Set
- Front
- Back
Define Embolus?
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Detached intravascular mass carried by the blood to a site distant from its point of origin
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What is a Pulmonary Thromboembolus?
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Arises from a thrombus in a deep leg vein, travels to the heart, through IVC, RA, RV and into pulmonary arteries...then kills you
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What is the most common preventable cause of death?
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PE's
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how many PE's arise in large deep leg veins?
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95%
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Risk factors for DVT--> PE?
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Prolonged bed rest
Surgery on legs CHF |
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Significance of thrombus being banded?
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It is indicative of the organization in layers or RBC's and Fibrin/Platelets
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Morphology of a Thromboembolus?
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Granular Layered Outer Surface
Twisted back on itself (indicates movement and tumbling) Reddish/Purple (freshness) |
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Where is a Saddle thromboembolus located?
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main PA bifurcation
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Type of emboli that cause pulmonary infarcts?
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Peripheral (small)
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What part of lungs is most often affected by Pulmonary Infarct?
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Lower Lobes
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Character of Infarct?
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Wedge-Shaped
Hemorrhagic (not pale) Coagulative Necrosis |
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Clincal Course (%'s) of Pulmonary thromboemboli?
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60-80% silent
5% sudden death, acute cor pulmonale, shock 10-15% infarction |
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To cause sudden death, cor pulmonale, or shock, how much occlusion must occur?
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at least 60%
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What role do the lungs play in shunting blood through the ductus arteriosus?
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The pulmonary arterial walls are extra thick--> high pressure--> shunts RV output through DA
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Increased Pulmonary Arterial Pressure = ???
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mean pressure > 25 mmHg
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Systemic HTN is often idiopathic (90%). How often is pulmonary HTN idiopathic?
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5%
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What is Pulm HTN usually secondary to?
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Cardiac stuff (left to right shunt)
Vasculitis Chronic Interstitial Lung Disease Recurrent PE |
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What are PHTN morphologies that are reversible?
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Medial Hypertrophy
Intimal Hyperplasia |
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What are PHTN morphologies that are irreversible?
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Occlusive changes
Dilatation Plexiform Lesions Acute Necrotizing Arteritis |
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Results of Pulmonary Edema?
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Decreased Gas Exchange
Hypoxia Hypercapnia |
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Most common general cause of Pulmonary Edema?
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Hemodynamic Alterations in Heart (CHF)
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What is seen w/ chronic elevated pulmonary venous pressure?
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Hemosiderin laden intraalveolar macrophages
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What is Good Pasture Syndrome characterized by?
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Diffuse Alveolar hemmorhage
Glomerulonephritis |
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Pathogenesis of Good Pasture Syndrome?
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Circulating Cytotoxic Autoantibody to basement membranes
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Characteristic Good Pasture presentation?
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Young
Male Hemoptysis Renal Involvement in 3 months |
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Good Pasture's Fluorescence Pattern?
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Linear
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SLE's fluorescence pattern?
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granular
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Wegener's Granulomatosis' pattern on fluorescence?
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Negative
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General Characteristics of Wegener's?
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Aseptic, Necrotizing, Granulomatous Inflammation and vasculitis
Affects lungs and kidneys |
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Lung morphology in wegener's?
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Bilateral Nodules and CAVITATION
Large area of necrosis with SERPIGINOUS borders |
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Wegener's kicker w/ vasculitis on histo?
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Destruction of inner and outer elastic laminae
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