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PATH: CH Defects
Getting organized
| Question | Answer |
|---|---|
| Concordance main categories | Shunting, Stenosis, Atresia, and Abnormal Valve (S and A) |
| Discordance | Ventriculo-arterial issues and Veins |
| When does PBF increase | increases in all but decreases in 1) tetrology of Fallot 2) Ebsteins anomaly 3) pulmonary atresia or SEVERE stenosis and stays the same in any other mild to moderate stenosis |
| what are the shunting defects of the heart | 1) atrial septal defect 2) ventricular septal defect 3) atrioventricular septal defect 4) patent ductus arteriosus |
| what are the stenotic defects | pulmonary, aortic, and aortic coarctation |
| what are the atresias | Pulmonary, aortic and hypoplastic Left heart |
| who is cyanotic and who is not | all discordance defects and atresias and Ebstein's anomaly (who are in concordance) |
| who is the abnormal valve defect | ebstein's anomaly |
| who is the ventriculo-arterial discordance defect | tetralogy of Fallow, transposition of the great vessels and truncus arteriosus |
| what is the vein defect | total anomalous pulmonary venous return |
| GRA = Glucocorticoid remediable aldosteronism (HTN) | auto dominant chromosome 8q results in ectopic aldosterone production via ACTH |
| AME - apparent mineralcorticoid excess (HTN) | Autosomal recessive chromosome 16q inactivating mutation of B hydroxysteroid dehydrogenase to there is more cortisol stimulating the mineralcorticoid receptor |
| Liddle Syndrome (HTN) | Autosomal Dominant on 16p gain of function mutation that causes sustain sodium channel activity independent of mineralcorticoids |
| fibromuscular dysplasia of the kidney | arterial dysplasia resulting in renal ischemia in young to middle aged women |
| Pheochromocytoma | a tumor of the adrenal medulla that results in secreted catecholamines that stimulate the alpha adrenergic receptors increasing resistance and contractility |
| Primary Hyperaldosteronism | Conn's syndrome (adrenal cortical adenoma that is idiopathic and causes bilateral adrenal hyperplasia (Conn's) |
| glomerular hyperfiltration | ang II causes preferential vasoconstriction of efferent arterioles resulting in hyperfiltration with sustained increase in glomerular pressure and damage to the glomerular basement membrane (ang II also makes tubules secreted tubal fibrosising factors) |
| cerebrovascular complications of hypertension | hemorrhage, atheroembolic stroke, lacunar type infarct, dementia, |
| chronic hypertension can make? | chrcot bouchard aneurysms with can rupture commonly in the putamen caudate, thalamus, pons, cerebellum |
| Malignant Nephrosclerosis | fibrinoid necrosis of the arterioles, onin skin ateriosclerosis, hypercellular glomeruli (from malignant hypertension |
| hypertensive encephalopathy | cerebral edema as a result of malignant hypertension increased intracranial pressure headaches and vomiting with confusion and coma |
| Papilledema and retinal hemorrhage | edema of the optic nerve and ruptured retinal arterioles you may see cotton wool spots and flame hemorrhage |
Created by:
jmuame03
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