Cardiac Valvular Disease and Vasculitis

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thezidane
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47202
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Cardiac Valvular Disease and Vasculitis
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2010-11-03 21:49:17
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pathology
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Cardiac Valvular Disease and Vasculitis
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  1. list 5 complications of infectious endocarditis
    • 1. rupture of chordae tendineae
    • 2. spread of infection into myocardium or aorta
    • 3. thromboembolism with infarction
    • 4. septic thrombi with metastatic abscesses
    • 5. valvular dysfunction and CHF
  2. list 5 characteristics of Acute Endocarditis
    • 1. short duration
    • 2. virulent organism
    • 3. large strep. aureus vegetations
    • 4. previously normal valve
    • 5. prominent tissue destruction
  3. list 5 characteristics of Subacute Endocarditis
    • 1. longer duration
    • 2. low virulence organisms
    • 3. small s. viridans vegetations
    • 4. previously abnormal valve
    • 5. less tissue damage
  4. list two types of vasculitis for large vessels
    • 1. giant cell (temporal) arteritis
    • 2. takayasu arteritis
  5. list two types of medium vessel vasculitis
    • 1. polyarteritis nodosa (classic)
    • 2. kawasaki syndrome
  6. list two types of vasculitis for small vessels
    • 1. microscopic polyarteritis
    • 2. wegener's granulomatosis
  7. list clinical presentations of giant cell arteritis
    • visual problems, claudication of jaw, pain and tenderness over temporal artery, polymyalgia rheumatica.
    • rare under 50 yo
  8. what is the pathology of giant cell arteritis
    granulomatous inflammation with giant cells, fibrosis
  9. list the clinical presentations of takayasu arteritis
    thickening wall reduces blood flow in major branches off the aortic arch. causes weak pulses in the arms and usually affects young women.
  10. what is the pathology of takayasu arteritis
    granulomatous inflammation with fibrosis involving the aortic arch and the arch branches
  11. explain the etiology behind polyarteritis nodosa
    most cases unknown. 30% have HepB surface Ag in serum
  12. list clinical presentations of polyarteritis nodosa
    hematuria, renal failure, abdominal pain, melena. usually involvement of multiple organ systems.
  13. explain the pathology of polyarteritis nodosa
    • - segmental involvement of small to medium sized muscular arteries
    • - fibrinoid necrosis, thrombosis, neutrophils and aneurysms
    • - progressive fibrous scarring
    • - sites of involvement: kidneys, heart, liver, GI
  14. explain the etiology behind kawasaki's disease
    viral infection triggers a hypersensitivity reaction
  15. explain the clinical presentations of kawasaki's disease
    • affects infants and young children. Show skin rash, mucous membrane lesions, lymphadenopathy (swollen lymph nodes).
    • usually self limiting, but 1-2% die with coronary artery vasculitis
  16. explain the etiology behind microscopic polyarteritis
    often due to AgAb complexes
  17. what are the clinical presentations of microscopic polyarteritis?
    rash, joint swelling, pleural effusion, pulmonary infiltrates, myocarditis, GI bleeding, renal failure, pANCA
  18. describe the pathology behind microscopic polyarteritis
    • - involves arterioles, capillaries, venules.
    • - fibroid necrosis and neutrophils (leukocytoplastic vasculitis)
  19. what is the etiology of wegener's granulomatosis
    T-cell mediated hypersensitivity
  20. what are the clinical presentations of wegener's granulomatosis
    • - involves sinuses, lungs and kidneys (glomerulonephritis)
    • - cANCA
  21. Describe the pathology behind wegener's granulomatosis
    necrotizing granulomas with vasculitis
  22. what is the etiology behind buerger's disease?
    endothelial injury from cigarette smoke
  23. what are the clinical aspects of buerger's disease
    usually begins before age 35. pain and ischemia in extremities
  24. describe the pathology for buerger's disease
    segmental acute and chronic vasculitis in extremities with thrombosis

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