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Barry Path II

6-20-10 Patho II Heart Tumors +

S/S of Heart tumors are related to Anatomical location (not their histological types)
Most myocardial tumors are clinically revealed by Disturbances of conduction of rhythm
The most common type of primary cardiac tumor Myxomas (a benign mucus type tumor)
Sporadic Myxomas usually happen at what age in what gender Mean age of 56 yrs and 70% female
The majority of Myxomas occur where Left Atrium (if found elsewhere should suspect malignancy - like left ventricle)
T/F: The majority of Myxomas are found as single, alone tumors True
Clinical S/S of Myxomas are Nonspecific including embolization and mechanical interference with cardiac function
What is the most common cardiac tumor in Infants and Children Rhabdomyomas
T/F: Rhabdomyomas are benign striatified muscle tumors True
T/F: Rhabdomyomas are solitary tumors like myxomas False -Rhabdomyomas are multiple
Rhabdomyomas are found with equal frequency in the Left and Right Ventricles and septal myocardium
Clinical manifestations of Rhabdomyomas include Cardiomegaly, RHF, LHF, Murmurs, and may mimic other Dx (mitral stenosis, aortic stenosis, subaortic stenosis, infundibular pulmonic stenosis, and mitral atresia
What is the second most common benign cardiac tumor in children Fibromas
T/F: Fibromas are more prominant in Females False - Equal between genders
T/F: Fibromas are derived from Fiboblasts and are considered connective tissue tumors True - they resemble soft tissue fibromatoses found in other areas of the body
Angiomas are composed of what kind of benign proliferating cells Endothelial cells
T/F: Angiomas are rare and are found most often in the intraventricular septum or AV node True
T/F: Angiomas, being benign, are not very harmful False - depending on their location (AV node or Septum) may cause complete heart block and sudden death
A type of tumor that contains three germ layers and occur mostly in the anterior mediastinum Teratomas
When a Teratoma occurs (usually occurs in a child)in the heart, what part of the heart does it not usually form at/in The Left side (atria or ventricle). It usually forms in the RA, RV, or Intraventricular Septum
T/F: Sarcomas are in the same class as Myxomas, Angiomas, Fibromas, and Teratomas False - Sarcomas are Malignant (all the other were benign)
What percentage of cardiac tumors exhibit malignant chacteristics and metastic behaviors 25%
They are the second most frequent cardiac tumors overall and are also malignant Sarcomas
Sarcomas are derived from what kind of cells Mesenchyme - which are the precursers of connective tissue (muscle and bone); therefore Sarcomas display a wide variety of morphological types (angio, rhabodo, fibro..)
Death from Sarcomas most often occurs from a few ? to a couple of ? Weeks, years
Cardiac finding (r/t Sarcomas) include unexplained (8 things) CHF, Precordial pain, Pericardial effusion, Tamponade, Arrhythmias, Conductive disturbances, Obstructive Vena Cava, and Death
Name 5 benign tumors (talked about in the slides) Myxomas, Rhabdomyomas, Fibromas, Angiomas, and Teratomas
These malignant tumors are most often found in the Right atrium and may be infiltrative or polypoid in nature Angiosarcomas
Angiosarcomas show a 2:1 ratio of which genders Male:Female (2:1)
Which tumor is characterized by ill-defined,varible anastomotic vascular channels lined with atypical endothelial cells Angiosarcomas
Which tumors are of striated muscle infiltrate the myocardium and sometimes form a polypoid into the cardiac chambers (sometimes mistaken for myxoma) Rhabdosarcomas
Rhabdomyoblasts are the histological hallmark of what tumor Rhabdosarcomas
What is the management of Benign cardiac tumors Surgical excision - usually results in complete cure
Why the prompt surgical date for a benign tumor Even though not malignant they may be lethal due growing and obstructing valves, cavities, causing emboli, or causing arrhythmias
The major role of surgery regarding malignant tumors is to Diagnose. A diagnosis of malignancy excludes the possibility of a curable benign tumor
T/F: There is a high success rate with Chemo and Radiation of Cardiac Sarcomas False
Buerger Disease is also called Thromboangiitis Obliterans (that is the correct spelling ..giitis)(it is a PAD)
Name two Peripheral Arterial Diseases Thromboangiitis Obliterans (Buerger Disease) and Raynaud Disease
This PAD tends to occur in young males who are heavy cigarette smokers, consists of inflammation of periphery arteries and accompanied by thrombi and arterial vasospasm Thromboangiitis Obliterans
What eventually occurs with small and medium size arteries in the hands and feet with Thromboangiitis Obliterans Portions are Obliterate ("Obliterans")- rendering them physiologically useless
S/S of Thromboangiitis Obliterans (5 things) Pain, Tenderness (of affected parts), Rubor (redness of skin), Cyanosis, Ischemia and gangrene (advanced cases)
Treatment of Thromboangiitis Obliterans includes Cessation of smoking, increase ciculation (vasodilators and exercise), Sympathectomy (reduce vasospasm), Amputation (gangrene)
Name the Diagnosis of the following: Charcaterized by attacks of vasospasm in the small arteries and arterioles of the fingers and toes Both Raynaud Phenomenon and Raynaud Disease
What is the difference between Raynaud disease and Raynaud Phenomenon The causes are different
What is the diagnosis called in which attacks of vasospasm in the arteries is caused by secondary means like cold conditions, vibrating machinery, Pulmonary HTN, or Collagen vascular disease Raynaud phenomenon
What is the cause of Raynaud Disease The origin is unknown
Which PAD is more common in females and which one is more common in males Raynaud Disease = women, Thromboangiitis Obliterans = males (heavy smokers)
Clinical manifestations of both Raynaud Phenomenon and Disease include Bilateral changes in skin color (pallor or cyanosis), and sensation (numbness and cold) which progresses from distal to proximal
When the vasospasm resolves in Raynaud Phenomenon and Disease what presents Rubor accompanied by throbbing and parestesias
What is the treatment for Raynaud Phenomenon Removing the stimulus or treating the symptoms
What is the treatment of Raynaud Disease Prevent or alleviate the vasospasm (removing the stimulus is not an option since it is not known)
What is a distended, tortuous, and palpable vein called A Varicose Vein
What causes a Varicose Vein Trauma (causing more valves) or gradual venous distention due to a combination of standing for a long time (gravity pooling blood in legs)
Which vein is usually associated with varicose veins Saphenous
Varicose veins (valvular incompetence) can progress to CVI which stands for Chronic Venous Insufficiency
What other clinical manifestations do varicose vein present Edema, hyperpigmentation, ischemia of ther feet and ankles
Necrosis of cells and tissue related to trauma or pressure on an area of reduced circulation developes into Venous Stasis Ulcers - which are susceptibleto infection
Treatment of varicose veins Will start uninvasive - stockings, no long periods of standing, and no restrictive clothing. If ineffective then surgical vein stripping performed
Up to 65% of patients with lower extremity trauma develope this DVT (Deep Venous Thrombosis)
Why are DVT more common than DAT Decreased blood pressure and flow in veins (more stasis)
Causative agents for venous thrombus include (3 things) Hypercoagulability (pregnancy, oral contraceptives use, coag dz, some cancers), Vessel trauma (physical or IV med), and Venous Stasis
With a DVT, the Coagulation Cascade causes Inflammation, extreme tenderness, swelling, and redness in the area of the thrombi
What is the major risk of a DVT It (or part of it) will be transported to the pulmonary circulation causing pulmonary emboli
If a DVT swelling compresses local nerve what happens Neuralgia (severe sharp pain)
DVT management includes Anticoagulation with Heprin, Rest and possibly Thrombectomy
Created by: smorrissey1



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