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Vascular dz take two
Step one and question for vascular dz
| Question | Answer |
|---|---|
| What are described as "ball-valve" obstruction in the left atrium | Myxoma cardiac tumor |
| Myxomas are associated /w multiple | syncopal episodes |
| What is the number one most common cardiac tumor in adults | Myxomas |
| 90% of myxomas occure? | atria (mostly left atrium) |
| What is the most frequent cardiac tumor in children | rhabdomyomas |
| Rhabdomyomas are associated /w | tuberous sclerosis |
| Metastases to the heart most commonly from? | Melanoma and lymphoma |
| Cardiac tumors are associated /w Kussmaul's sign. What is Kussmaul's sign? | Increase in jugular venous pressure on inspiration |
| What are dilated, tortuous superficial veins due to chronically increased venous pressure called | Varicose veins |
| Varicose veins are predisposes a person to what? | Poor wound healing and varicose ulcers |
| Raynaud's disease is due to what? | arteriolar vasospasm |
| What type of vessels does Raynaud's dz affect | small vessels |
| Raynaud's disease is in response to? | Cold temp. or emotional stress |
| Decreased blood flow to the skin due to arteriolar vasospasm when secondary to a mixed connective tissue disease, SLE or CREST syndrome is called? | Raynaud's phenomenon |
| Wegener's granulomatosis is characterized by a triad of what? | Focal necrotizing vasculitis necrotizing granulomas in the lung and upper airway Necrotizing glomerulonephritis |
| Wegener's granulomatosis affects what size vessels? | small vessels |
| Symptoms of Wegener's granulomatosis | Hemoptysis hematuria perforation of nasal septum chronic sinusitis otitis media mastoidistis cough dyspnea |
| What are the clinical findings for Wegener's granulomatosis | c-ANCA is a strong marker of the disease Chest x-ray may reveal large nodular densities hematuria and red cell casts |
| What is the treatment for wegener's granulomatosis | Cyclophosphamide and corticosteroids |
| What are the ANCA-positive vasculitides? | c-ANCA = wegener's granulomatosis p-ANCA = Microscopic polyangiitis, 1 pauci-immune crescentic glomerulonephritis and churg-strauss syndrome |
| ANCA-positive vasculitides affect what size vessels | small vessels |
| What dz is similar to Wegener's but lacks granulomas? | Microscopic polyangiitis |
| What vasculitis is limited to kidney? | 1 pauci-immune crescentic glomerulonephritis |
| What vasculitides is characterized by granulomatous vasculitis /w eosinophilia | Chrug-Strauss syndrome |
| Churg-Strauss syndrome most often presents /w | asthma sinusitis skin lesions peripheral neuropathy (e.g = wrist/foot drop) Can also involve heart, GI and kidneys |
| What dz is a congenital vascular disorder that affects capillary sized blood vessels | Sturge-weber disease |
| What disorder presents with Port-wine stain (nevus flammeus) on face, ipsilateral leptomeningeal angiomatosis (intracerebral AVM), seizures and early-onset glaucoma. | Sturge-Weber disease |
| What is the most common form of childhood systemic vasculitis | Henoch-Schonlein purpura |
| Henoch-Schonlein is associated /w what type of immune complexes? | IgA Can follow an URI |
| What is the common triad in Henoch-Schonlein purpura | skin, joints, and GI /w multiple lesions of the same age |
| Henoch-Schonlein is what kind of hypersensitivity? | Type III |
| What are the symptoms of Henoch-Schonlein dz? | skin rash on buttocks and legs (palpable purpura) arthralgia intestinal hemorrhage abdominal pain melena |
| Buerger's disease is also known as? | Thromboangiitis obliterans |
| What disease is seen in heavy smookers | Buerger's disease (thromboangiitis obliterans) |
| What size vessels does Buerger's disease (thromboangiitis obliterans) affect? | Small and medium sized vessels |
| What dz. is associated /w idiopathic, segmental, thrombosing vasculitis of small and medium peripheral arteries and veins. | Buerger's disease (thromboangiitis obliterans) |
| What are the symptoms for Beurger's disease? | Intermittent claudication superficial nodular phlebitis cold sensitivity (raynaud's pehomenon) sever pain in affected par May lead to gangrene and autoamputation of digits |
| What is the treatment for Buerger's disease | Smoking cessation |
| What type of vasculitis is Kawasaki disease | Acute, self-limiting necortizing vasculitis in infants/children |
| Kawasaki disease is associated /w what ethnicity? | Asian |
| What sized vessels does Kawasaki affect? | Small + medium vessels |
| What are the symptoms for Kawasaki disease | Fever, conjunctivitis changes in lips/oral mucosa (strawberry tongue) lymphadenitis desquamative skin rash May develop coronary aneurysms |
| What is the treatment for Kawasaki disease | IV immunoglobulin Aspirin |
| Polyarteritis is what type of vasculitis? | Immune complex-mediated transmural vasculitis /w fibrinoid necrosis |
| What size vessels does polyarteritis nodosa affect | small and medium arteries |
| What are the symptoms for polyarteritis nodsa | Fever, weight loss malaise abdominal pain melena headache myaligia hypertension neurologic dysfunction cutaneous eruptions |
| What vasculitis is associated with Hepatitis B in 30% of pt. | Polyarteritis nodsa |
| What vasculitis typically involves renal and visceral vessels, NOT pulmonary arteries | Polyarteritis nodosa |
| What vasculitis has lesion at different stages | polyarteritis nodosa |
| What are the finding for polyarteritis nodosa | Hepatitis B seropositivity in 30% of pt. Multiple aneurysms and constrictions on arteriogram |
| What is the treatment for polyarteritis nodosa | corticosteroids cyclophosphamide |
| What arteritis is known as "pulseless disease" | Takayasu's arteritis |
| What size vessels does Takayasu's arteritis affect | medium and large arteries |
| What type of arteritis is Takayasu's arteritis? | Granulomatous |
| What arteritis is associated /w increased ERS | Takayasu's arteritis Temporal Arteritis (giant cell arteritis) |
| Takayasus' arteritis is thickening of what arteries | aortic arch and/or proximal great vessels |
| Takayasu's arteritis primarly affects who? | Asian femalses <40 years of age |
| What are the symptoms for Takayasu's arteritis | FAN MY SKIN On Wednesday Fever Artheritis Night sweats MYalgia SKIN nodules Ocular disturbances Weak pulses in upper extremities |
| What arteritis usually affects branches of the carotid artery? | Temporal arteritis (giant cell arteritis) |
| What size vessels does temporal arteritis affect | Medium and large arteries |
| Temporal arteritis is what type of arteritis | granulomatous inflammation |
| What population does temporal arteritis usually affect? | elderly females |
| What are the symptoms for temporal arteritis | Unilateral headache jaw claudication impaired vision (occlusion of ophthalmic artery that may lead to irreversible blindness) |
| What are the clinical findings for temporal arteritis? | Associated /w an increase ESR. half of pt have systemic involvement polymyalgia rheumatica |
| How is temporal arteritis treated? | High-dose steroids |
| What vascular tumors is a benign. Initially grows /w child; then spontaneously regresses | Strawberry hemangioma |
| What vascular tumor is found in elderly, does not regress and the frequency increases with age | cherry hemangioma |
| Pyogenic granuloma is associated /w | trauma an dpregnancy |
| Which vascular tumor is a polypoid capillary hemangioma that can ulcerate and bleed | pyogenic granuloma |
| Cystic hygroma is associated with what genetic disorder | Turner syndrome |
| A cavernous lymphangioma of the neck is called? | Cystic hyroma |
| A benign, painful, red-blue tumor under fingernails? | Glomus tumor |
| Which vascular tumor arises form modified smooth muscle cells of glomus body | Glomus tumor |
| Bartonella henselae is associated /w what vascular tumors | Bacillary angiomatosis |
| Which vascular tumor is considered a benign capillary skin papules found in AIDS pt. and mistaken for Kaposi's sarcoma | Bacillary angiomatosis |
| What is the vacular tumor called that is a highly lethal malignancy of the liver | Angiosarcoma |
| What is associated /w causing liver angiosarcoma | Vinyl chloride arsenic ThO2(Thorotrast) |
| What vascular tumore is associated /w post radical mastectomy | Lymphangiosarcoma |
| What vascular tumor is associated with peristent lymphedema | Lymphangiosarcoma |
| Kaposi's sarcoma is associated /w what virus | HHV-8 and HIV |
| Kaposi's sarcoma is frequently mistaken for? | Bacillary angiomatosis |
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schrla
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