Question | Answer |
thrombus superimposed on plaque, leading to complete occlusion | transmural MI |
incomplete occlusion +/- vasospasm | subendocardial MI, angina, sudden death |
1st step in MI | sudden change/disruption of plaque |
2nd step in MI | release of collagen and plaque contents |
3rd step in MI | stimulation of platelet adhesion and activation |
4th step in MI | release of platelet aggregators (TXA2) |
5th step in MI | vasospasm and activation of extrinsic pathway |
6th step in MI | occlusion |
partial LV failure w/hypotension +/- pulmonary edema | contractile dysfunction |
disturbances in conduction system and myocardial irritability | arrhythmias |
myocardial rupture of ventricular free wall | cardiac tamponade |
caused by severe pump failure | cardiogenic shock |
most common time frame for cadiac tamponade | 3-7 days post MI |
myocardial rupture of ventricular septum | L to R shunt |
clinical signs of L to R shunt caused by septum rupture | murmur, CHF |
papillary muscle rupture | acute, severe mitral regurgitation |
most common time frame for pericarditis | 2-3 days post transmural MI |
new necrosis adjacent to an existing infarct | extension |
stretching, thinning, and dilation of infarcted area of myocardium | expansion |
focal abnormality in contractility causes stasis of blood, and endocardial damage creates thrombogenic surface | mural thrombus |
usually results from large anteroseptal MI that has undergone expansion | ventricular aneurysm |
not likely to rupture | ventricular aneurysm |
account for nearly half of all transplant pts | CIHD |
enlarged, heavy heart with LV hypertrophy and dilation | CIHD |
80-90% is due to IHD | sudden cardiac death |
typical mechanism of sudden cardiac death | lethal arrhythmia |
increased cardiac mass is independent risk factor | sudden cardiac death |
account for >90% of thrombophlebitis cases | DVTs |
first manefestation of thrombophlebitis | PE |
trousseau sign of malignancy | migratory thrombophlebitis |
most common cause of lymphangitis | group A beta-hemolytic strep |
painful subQ red streaks and painful enlargement of regional lymph nodes | lymphangitis |
cause of primary lymphedema | congenital defect |
congenital defect causing missing lymph channels in legs/groin | familial milroy disease |
common cause(s) of secondary edema | malignant tumors, surgical procedures, post-irradiation fibrosis, filariasis, post inflammatory scarring |
may be caused by persistance of edema | peau d'orange, skin ulcers |
increased numbers of normal or abnormal BVs filled with blood | hemangioma |
location of most superficial hemangiomas | head/neck |
location of most internal hemangiomas | liver |
most common variant of hemangiomas | capillary hemangiomas |
bright red to blue, flat or elevated | capillary hemangiomas |
unencapsulated aggregates of closely packed, blood filled, thin-walled caps with partial or complete thrombi capillary hemangiomas | |
"strawberry type" hemangiomas | juvenile capillary hemangioma of skin |
grows rapidly w/in first few months of age, fades at 1-3 yrs, and completely regresses by age 7 | juvenile capillary hemangioma of skin |
less well circumscribed, large, dilated vascular channels that involve deep structures | cavernous hemangiomas |
most problematic cavernous hemangiomas | brain hemangiomas |
von hippel-lindau disease | cavernous hemangiomas of cerebellum, brainstem, retina |
red-blue, soft spongy mass, 1-2 cm, sharply defined | cavernous hemangiomas |
associated w/dystrophic calcification | cavernous hemangiomas w/intravascular thrombosis |
rapidly growing pedunculated red nodule of skin, giniva, or oral mucosa that bleeds easily | pyogenic granuloma |
proliferating cap's with extensive edema andd inflammatory infiltrate | pyogenic granuloma |
involves small lymphatic channels of head, neck, axilla | simple lymphangioma |
distinguishes hemangioma from simple lymphangiomas | presence/absence of RBCs |
occurs in the neck or axilla of children, and may cause deformities | cavernous lymphangioma |
associated w/turner syndrome | cavernous lymphangioma |
massively dilated lymphatic spaces | cavernous lymphangioma |
benign exquistely painful tumors, usually found under fingernails | glomus tumor |
round, slightly elevated, red-blue, <1cm | glomus tumor |
group of abnormally prominent cap's, venules, and arterioles | vscular ectasias |
most common form of ectasia | nevus flammeus |
light pink to dark purple, in dermis of head/neck | nevus flammeus |
special kind of nevus flammeus that grows w/child and thickens skin surface | port wine stain |
often follows distribution of CNV | port wine stain |
sometimes associated w/Sturge-Weber syndrome | port wine stain |
aka encephalotrigeminal angiomatosis | port wine stain |
venous angiomatous mass in cortical meninges, port wine stain, MR, seizures, and hemiplegia | Sturge-Weber syndrome |
focal network of subQ small arteries/arterioles arranged in radial fashion around a central core | spider telangiectasia |
blanches w/pressure | spider telangiectasia |
associated w/pregnant women and cirrhosis | spider telangiectasia |
autosomal dominant disorder causing multiple aneurysmal telangiectasias | Osler-Weber-Rendu disease |
aka hereditary hemorrhagic telangiectasias | Osler-Weber-Rendu disease |
affects skin and oral mucosa, resp, GI, and urinary tracts | Osler-Weber-Rendu disease |
can cause serious epistaxis, GI bleed, hematuria | Osler-Weber-Rendu disease |
opportunistic infection in immunocompromised individuals | bacilliary angiomatosis |
microorganism associated with bacilliary angiomatosis | bartonella family |
red papules and nodules, containing neutrophils, nuclear dust, and bacteria | bacilliary angiomatosis |
diagnosed with PCR | bacilliary angiomatosis |
4 forms of kaposi sarcoma | chronic, lympadenopathic, transplant-associated, AIDS associated |
older men of easter european or mediterranean descent, red to purple skin plaques/nodules on distal lower extremities that spread proximally | chronic KS |
location of chronic KS | remain localized to skin and subQ |
south african bantu children, sparse skin lesions, aggressive lymphadenopathy | lymphadenopathic KS |
associated w/solid organ transplantation that involves nodes, mucosa, and viscera | transplant-associated KS |
virus associated with KS | HHV-8 |
1st stage of KS | patch |
2nd stage of KS | plaque |
3rd stage of KS | nodule |
red to purple macules, confined to distal lower extremities | patch |
larger, raised red to purple macules, spread more proximally | plaque |
sheets of plump, distinctly neoplastic nodules that invade subQ/dermis | nodule |
malignant endothelial neoplasms | angiosarcoma |
population more commonly affected w/angiosarcomas | older adults |
common locations for angiosarcoma | skin, soft tisue, breast, liver |
large, fleshy masses of red-tan to gray-white tissue with unclear margins | angiosarcoma |
will have central areas of necrosis and hemorrhage | angiosarcoma |
may be express CD31 or von Willebrand factor | undifferentiated angiosarcomas |
slowly enlarging, painless mass | hemangiopericytoma |
gaping sinusoidal spaces enclosed within nests of cells | hemangiopericytoma |
common locations for hemangiopericytoma metastasis | lungs, bone, liver |