Path cardio condensed

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dtminhthu
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Path cardio condensed
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2010-09-11 10:53:32
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Path cardio
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  1. Alpha granules of platelets contain
    P-selectin, fibrinogen, fibronectin, factors V and VIII, PDGF, and TGF alpha, thrombospondin
  2. Dense granules of platelets contain





























    ADP
    & ATP, ionized calcium, histamine, thromboxane A2, serotonin, and
    epinephrine
    ADP & ATP, ionized calcium, histamine, thromboxane A2, serotonin, and epinephrine
  3. 4 basic syndromes of IHD
    Angina pectoralis, acute MI, chronic IHD, sudden cardiac death
  4. Irreversibly damaged myocytes subjected to reperfusion show
    contraction band necrosis
  5. what is contraction band necrosis
    intensely eosinophilic transverse bands composed of hypercontracted sarcomeres
  6. Transmural MIs show
    Q waves. more negative deflections. stage II & III
  7. Pericarditis most often at _____ days post MI
    2-3
  8. posterior transmural infarcts associated with
    better prognosis, serious conduction block
  9. free wall rupture, expansion, mural thrombi, and aneurysm (worse clinical course) associated with...
    anterior transmural infarcts
  10. Dilated cardiomyopathy
    most common cardiomyopathy, CoxA & B, dystrophin, delta sarcoglycan, nuclear lamins A &C, assoc w/ pregnancy, systolic dysfxn
  11. Restrictive cardiomyopathy
    Biatrial dilation, interstitial fibrosis, hypereosinophilia
  12. lymphocytic myocarditis. Most common myocarditis. Most common causes: Cox A & B and enterovirus.
  13. most common helminthic dz w/ cardiac involvemt. Uncooked deer, bear or pork. S shaped helminth
    Trichinosis
  14. Other causes of myocarditis
    Toxoplasma infection, Borrelia (Lyme dz) infection, lupus, polymyositis, sarcoidosis
  15. Primary pulmonary hypertension
    Cor pulmonale. Almost always encountered in young persons, more common in women. Medial thickening. Duplication of internal/external elastic lamina.
  16. fibrinous exudate, bread and butter appearance (irregular shaggy appearance to pericardial surface)
    Acute viral pericarditis
  17. exuberantly shaggy fibrinous exudate & bloody effusion
    malignant pericarditis
  18. can be delicate adhesions or dense fibrotic scars
    chronic pericarditis
  19. most common tumor of the heart
    metastatic tumor. from lung, breast, lymphoma, leukemia, melanoma, carcinomas of colon & liver
  20. rhabdomyoma. most common primary cardiac tumor in infants/children. Tan, round tumor in L ventricle, of myocardial cell origin
  21. microscopic polyangiitis
    pANCAs, MPO protein, Necrotizing glomerulonephritis and pulmonary capillaritis are common, Segmental fibrinoid necrosis of media, Little or no Ig seen in most lesions (pauci-immune injury)
  22. Anti-endothelial Abs
    assoc w/ or predispose to Kawasaki dz. Delayed type hypersensitivity T cell response. PAN-like, not much of fibrinoid necrosis as in PAN. Mucocutaneous lymph node syndrome. Conjunctival and oral erythema, edema of hands and feet, erythema of palms and soles
  23. Giant cell (Temporal) Arteritis
    T cell mediated, granulomatous formation, noninfectious, fragmentation of internal elastic lamina, nodular intimal thickening
  24. Takayasu arteritis
    granulomatous of medium & larger arteries, ocular disturbances, weakened pulses in upper extremities (pulseless dz). Transmural fibrous thickening of aorta. Most frequent in women under 40, more assoc w/ Japanese. Intimal hyperplasia, only difference from giant cell arteritis is AGE of onset

  25. most common hemangioma. Occur in
    skin, subcutaneous tissues, mucous membranes of oral cavities and lips, liver,
    spleen, kidneys.






























    most common. Occur in
    skin, subcutaneous tissues, mucous membranes of oral cavities and lips, liver,
    spleen, kidneys
    Capillary hemangioma
  26. Common capillary hemangioma in newborns
    juvenile/strawberry hemangioma
  27. neck or axilla of children. Rarely in retroperitoneum. common in neck region of Turner syndrome (may fill axilla). Lesions not encapsulated
    Cavernous/cystic lymphangioma
  28. vascular ectasia that grows w/ child, no tendency to fade. (Sturge-Weber syndrome if distribution along trigeminal nerve)
    port wine stains
  29. what contributes to Spider telangiectasia?
    elevated estrogen
  30. Bacillary angiomatosis
    opportunistic infection. Gram negative bartonella (henselae in cat scratch and Quintana in trench fever). Vascular proliferations on skin, bone, brain
  31. No lines of Zahn in ..
    organized thrombus
  32. Infarct reaches its full size in
    3-6 hrs
  33. contraction bands, loss of nuclei, beginning of inflamm. May also see hemorrhage
    1-2 days post MI
  34. Heavy polymorphonuclear infiltrate in area of acute MI
    1-3
  35. myocardial rupture most common ____ days post MI
    6
  36. Nearly complete removal of necrotic myocytes by phagocytosis: ___ days post MI
    3-4
  37. Granulation tissue characterized by loose collagen and abundant capillaries: ____ _____ post MI
    1-2 weeks
  38. No onion skinning. Intimal proliferation. Onion skinning normally seen in kidneys, not in lungs. Fibrinoid necrosis is pink due to deposition of plasma proteins. Seen in vasculitis
    pulmonary hypertension. cor pulmonale
  39. pulmonary hypertension/cor pulmonale
  40. Acute pulmonary hypertension
    dilated R ventricle, no wall thickening
  41. Chronic pulmonary hypertension
    both ventricles may be dilated, R ventricle almost as thick as L
  42. Pulmonary hypertension grading
    Medial hypertrophy --> intimal hypertrophy --> intimal fibrosis --> dilated & thinned vessels --> vessels rupture --> fibrinoid necrosis
  43. aortic stenosis caused by
    calcification associated w/ old age
  44. mitral stenosis caused by
    rheumatic fever
  45. aortic insufficiency caused by
    hypertension, aging
  46. mitral insufficiency caused by
    Myxomatous degeneration (Mitral valve prolapse)
  47. JONES major criteria for acute rheumatic fever
    Joint arthritis (migratory), pancarditis, neurologic, erythema of skin (rash), subcutaneous nodules
  48. fish mouth deformity. chronic rheumatic myocarditis
  49. bacterial endocarditis can also be caused by
    HAECK (haemophillus, actinobacillus, cardiobacterium, eikenella, and kingella)
  50. bacterial endocarditis
  51. Nonbacterial thrombotic endocarditis (Marantic endocarditis)
    sterile vegetations. assoc w/ malignancy or wasting conditions
  52. Lupus/Libman-Sacks endocarditis. Fibrin deposition, no platelets
  53. Calcific aortic stenosis. due to chronic damage. Rheumatic diz, Degenerative (senile), Bicuspid aortic valve, Left ventricular hypertrophy
    • A = infarct w/ coagulative necrosis along w / wavy fibers (mostly start at 12hrs)
    • B= polymorphonuclear leukocytic (neutrophils looking like crushed ants) infiltrate in area of 1-3 day old MI
    • C = nearly complete removal of necrotic myocytes by macrophage. Also influx of fibroblasts. 3-4 days.
    • D = granulation tissue w/ loose collagen and abundant capillaries
    • E = well healed MI w/ dense collagenous scar. 1 month at least.
  54. coagulation necrosis. 18-24 hrs post MI?
  55. 7-8 weeks.
  56. Thrombus formation, papillary muscle rupture, pericarditis, endocarditis, ventricular aneurysm
  57. Churg-Strauss syndrome (aka Allergic granulomatosis and angiitis)
    rare, treated w/ corticosteroids, fibrinoid necrosis, eosinophilic infiltrates
  58. churg-strauss syndrome. p-ANCAs (MPO protein)
  59. 350 to 600 gm
    pulmonary hypertension & ischemic heart dz
  60. 400 to 800 gm
    Systemic hypertension, aortic stenosis, mitral regurgitation, or dilated cardiomyopathy
  61. 600 to 1000 gm
    aortic regurgitation or hypertrophic cardiomyopathy
  62. Lymphangiomas common in what regions?
    Neck and axilla
  63. Reynaud’s dz
    2ndary to autoimmune disease, Mainly affects young, and healthy women. Phase I ischemic. Phase II cyanosis. Phase III hyperemic
  64. Polyarteritis nodosa (PAN). more common in men. assoc w/ Hep B.
  65. Sarcoidosis. Non caseating granulomas. Elevated levels of Ca. Usually females, young, African American. Can be cause of restrictive cardiomyopathy
  66. Causes of dilated cardiomyopathy
    idiopathic, alcohol, doxorubicin, chronic anemia, genetic, peripartum, myocarditis
  67. causes of hypertrophic cardiomyopathy
    genetic, diabetic mothers, storage dz, friedrich ataxia,
  68. amyloidosis. causes can be diabetes, senile cardiac amyloidosis, lymphoma, chronic inflammatory disorder or familial mediterranean fever

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