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[h] Cardiovascular System Flashcards

[i] Master this session in just 5 minutes.

[q] What is the most likely diagnosis?

60 years old male patient who is diabetic and heavy smoker presenting with severe hypertension + ultrasound shows left renal artery stenosis with diffuse cortical thinning and atrophy of the left kidney?

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[q] In cases of unilateral renal artery stenosis, morphologic changes in the affected kidney are related to hypoperfusion and include ………….? In contrast, the contralateral nonstenotic kidney is exposed to high blood pressure and therefore demonstrates typical signs of ………………….?

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[f]IGRpZmZ1c2UgY29ydGljYWwgdGhpbm5pbmcgYW5kIGF0cm9waHkuIGh5cGVydGVuc2l2ZSBuZXBocm9zY2xlcm9zaXMgYW5kIGh5YWxpbmUgYXJ0ZXJpb2xvc2NsZXJvc2lzLg==

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[q] Severe (≥ 180/≥ 120 mm Hg) hypertension without acute end-organ damage is called ……………..?

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[q] Severe hypertension with evidence of acute end-organ damage (encephalopathy, stroke, retinal hemorrhages and exudates, papilledema, MI, HF, aortic dissection, kidney injury, microangiopathic hemolytic anemia, eclampsia) is called ……………….?

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[q] ……….. is diagnosed when the systolic blood pressure is elevated (>130) with a normal (<80) diastolic blood pressure (DBP) and is caused by age-related decreases in the compliance of the aorta and its proximal major branches (aortic stiffening).

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[q] ……………. is characterized by hypotension, pallor, sweating, nausea, and dizziness that occur when a pregnant woman lies supine (on her back) and resolve with sitting, standing up, or when assuming a left lateral decubitus position.

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[q] The pathogenesis of atherosclerotic plaques (atheromas) is thought to begin with ……………, which results in increased endothelial permeability and enhanced leukocyte adhesion.

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[q] Platelet-derived growth factor (PDGF) released by locally adherent platelets, dysfunctional endothelial cells, and infiltrating macrophages within the atherosclerotic plaque which promotes migration of …………………… from the media into the intima.

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[q] Fatty streaks are composed of …………….. whic is derived from macrophages and smooth muscle cells (SMC) that have engulfed lipoprotein (predominantly LDL).

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[q] High intraplaque activity of …………….. enzymes predisposes the patient to plaque rupture and a consequent acute coronary syndrome, including myocardial infarction.

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[q] ……………. is caused by proteins leaking into the vessel wall which is typically produced by long-standing nonmalignant hypertension and/or diabetes, producing vascular thickening; proteins are seen as pink hyaline on microscopy. This results in reduced vessel caliber with end-organ ischemia.

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[q] ……………….. presents as onion-like concentric thickening of the walls of arterioles as a result of laminated smooth muscle cells (SMC) and reduplicated basement membranes due to malignant hypertension. It results in reduced vessel caliber with end-organ ischemia.

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[q] ……………is a calcification of the media of muscular (medium-sized) arteries. Not clinically significant because its nonobstructive. It seen as an incidental finding on x-ray or mammography “Pipestem appearance on x-ray”.

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[q] ……….. are plaques or nodules composed of lipid-laden histiocytes in skin, especially the eyelids.

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[q] ………………… is lipid deposit in tendon, especially Achilles.

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[q] …………. is lipid deposit in cornea. Common in elderly (arcus senilis) but appears earlier in life in hypercholesterolemia.

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[q] What is the most likely diagnosis?

56 years old patient with history of hypertension, DM, and heavy smoker presenting with tearing chest pain of sudden onset, radiating to the back, and markedly unequal BP in arms + CXR shows mediastinal widening + Chest CT is shown below?

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[q] ………………… is initiated by a tear in the aortic intima forming a false lumen.

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[q]…………… is the single most important risk factor for the development of intimal tears leading to aortic dissection.

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[q] Stanford type (A or B) involves ascending aorta and may extend to aortic arch or descending aorta. The intimal tear usually originates in the sinotubular junction. May result in acute aortic regurgitation or cardiac tamponade?

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[q] Stanford type (A or B) involves only descending aorta (Below left subclavian artery). No ascending aorta involvement. The intimal tear usually originates below the origin of the left subclavian artery?

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[q] The most common cause of death in aortic dissection is ……………?

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[q] What is the most likely diagnosis?

56 years old patient with history of hypertension, DM, and heavy smoker presenting with pain, which is typically localized to the chest and back, dysphagia, hoarseness of the voice. Chest x-ray shows a widened mediastinum, enlarged aortic knob, and tracheal deviation?

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[q] The pathogenesis of thoracic aortic aneurysm due to tertiary syphilis begins with ………………….. resulting in inflammation, ischemia, and weakening of the aortic adventitia.

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[q] …………….. is characterized by the fragmentation of elastic tissue (“basket weave” pattern, compared to normal) and separation of the elastic and fibromuscular components of the tunica media by small, cleft-like spaces that become filled with amorphous extracellular matrix?

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[q] What is the most likely diagnosis?

66 years old patient with history of hypertension, DM, and heavy smoker presenting with pulsatile abdominal mass that grows with time + Abdominal CT is shown below?

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[q] ……………. is characterized by chronic transmural inflammation of the aortic wall.

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[q] ………….. should be suspected in patients with abdominal distension, a pulsatile abdominal mass, hypotension, tachcardia, syncope and umbilical/ flank hematoma.

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