Cerebrovascular disease – 3rd most common cause of death – most common of all CNS diseases Stroke = sudden and dramatic development of a focal neurological dificit due to a vascular impairment 10% of all deaths in the U.S. 500,000 new victims each year mainly results from HTN, cerebral atherosclerosis, or both SYMPTOMS OF STROKE [...]
Definitions shock- pathological state induced by a decreased cardiac output usually associated with an inadequate venous filling pressure disproportion exists between the vol of circulating blood and the volume of the circulatory system that needs to be filled Classical syndrome presentations 1. hypotension 2. weak, thready pulse 3. tachycardia 4. hyperventilation 5. coll, clammy skin [...]
Primary Cardiomyopathies: Disease of the cardiac muscle which are of unknown etiology. Secondary cardiomyopathies: Specific cardiac muscle diseases secondary to pericardial, hypertensive, congenital, valvular or ischemic diseases. Anatomical and functional classification of CMP 1. Dilated (DCM) 2. Hypertrophic (HCM) 3. Restrictive (RCM) Similarities between 3 groups of CMP-ies Etiology: most of the time unidentifiable Main [...]
<!– /* Font Definitions */ @font-face {font-family:”Cambria Math”; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:1; mso-generic-font-family:roman; mso-font-format:other; mso-font-pitch:variable; mso-font-signature:0 0 0 0 0 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:””; margin:0pt; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:”Times New Roman”,”serif”; mso-fareast-font-family:”Times New Roman”;} h1 {mso-style-unhide:no; mso-style-qformat:yes; mso-style-link:”Heading 1 Char”; mso-style-next:Normal; [...]
Know three types of cardiomyopathies know whether systolic or diastolic disorder Use cardiomegaly instead of hypertrophy KNOW- MOST COMMON PRIMARY CARDIAC TUMOR- BENIGN MYXOMA Cardiomyopathy Definition heart muscle disease of unknown cause In all forms… heart is enlarged (dilatation and hypertrophy) and often has focal endocardial thickenings or mural thrombi Classification of the Cardiomyopathies 1. [...]
Definitions IHD- results from all forms of myocardial disorders resulting in insufficient coronary blood flow 95% are due to atherosclerotic narrowing of coronary arteries Four distinct Clinicopathologic Patterns 1. Chronic Ischemic Heart Disease 2. Angina Pectoris 3. Myocardial Infarction 4. sudden cardiac death The electrical event triggered by the Ischemia is usually the cause of [...]
Mediator Source Effects Histamine & Serotonin Mast Cells, Platelets Bradykinin Plasma Pain C3a Plasma Opsonic fragment (C3b) C5a Macrophages Leukocyte adhesion, Activation Prostaglandins Mast Cells, Membrane Phospholipids Vasodilation, Pain, Fever Leukotriene B4 Leukocytes Leukocyte adhesion, Activation Leukotriene C4, D4, E4 Leukocytes, Mast Cells Bronchoconstriction, Vasoconstriction Oxygen Metabolites Leukocytes Endothelial & Tissue Damage PAF Leukocytes, Mast [...]
Inflammation- local response of tissue to injury Methods of Defense 1. Destruction- ex. phagocytosis 2. Dilution- ex. edema 3. Walling off- ex. fibrous rxn around a tubercle Classic signs of Inflammation Result of: 1. Rubor- redness hyperemia 2. Calor- warmth hyperemia 3. Tumor- swelling edema 4. Dolor- pain tissue turgor + action of amines, enzymes, [...]
Immune Function Screening Laboratory Exam 1. CBC- differential very important 2. DTH Skin test- tests cellular imunity 3. Quantitative Immunoglobulins (IgM, IgG, IgA, IgE)- tests humoral immunity 4. CD50 or CD100- tests complement checks for lysis (if 50% or 100%, complement normal) Specific workups 1. Cellular flow cytometry (tests CD3, CD4, CD8 #s) functional 2. [...]
a positive immune response that results in a disease process (Ag or immune mechanism initiated) Classification - Type 1: IgE mediated (ALLERGIES) - Type 2: Anticellular Ab - Type 3: Immune Complex disease - Type 4: Delayed Hypersensitivity Type I Hypersensitivity- Immediate IgE Mast Cells contain pre-formed mediators (histamine) 2nd Allergen exposure cause crosslinking of [...]
Infects a variety of cell types via CD4 cell surface molecule. Leading cause of death 25-44 yo in USA. Cyotpathic Retrovirus – kills cells it infects and contains RNA & Reverse Transcriptase CD4 – receptor for HIV-1 (USA) & HIV-2 (West Africa) Evelope has viral glycoproteins gp120 and gp41. Core has proteins p24 and p18 [...]
Edema accumulation of excess fluid in the interstitium can be localized or systemic definitions anasarca- edema in all tissue and organs ascites- edema in the peritoneal cavity hydrothorax- pleural effusion pericardial effusion transudate- non-inflammatory and protein-poor exudate- protein-rich (albumin) and maybe + for leukocytes Pathogenesis Starling’s forces osmotic- push hydrostatic- pull Primary causes increased hydrostatic [...]
Apical impulse (PMI) = systolic beat at 5th interspace, 7 cm from midsternal line Produced by left ventricle Systole = aortic valve open: blood ejected from left ventricle > aorta Mitral valve closed Diastole = aortic valve closed Mitral open: blood from left atrium into left ventricle Auscultation, first and second heart sounds define systole [...]
Connective tissue diseases Primarily Effects: 1. rheumatoid arthritis joint synovium 2. SLE wide spectrum (nephritis, vasculitis, nervous, rashes, etc.) 3. Sjogren’s syndrome exocrine glands 4. Polymyositis (Dermatomyositis) skeletal muscle 5. Scleroderma diffuse fibrosis ( skin, lungs, GI tract ) circulating ANAs are found in all of the connective tissue diseases In each, antibodies [...]
Necrosis- the sum of changes that accompany and follow irreversible cell injury or cell death in a living organism TYPES Coagulation Necrosis Most common form results from coagulation (denaturation) of protein soon after cells die occurs with: ischemia, toxicity, and thermal injury MICRO: cells convert to acidophilic, opaque, loss of nuclei, preservation of cell outlines [...]
Mitral Stenosis (pressure overload) is a diastolic murmur CAUSES Most common valvular dysfunction in 20% of popn 90% are 2ndary to RHD Presentation Females > males (2:1) Present 20-50 y.o. Typically a thin female Dyspnea on exertion, Paroxysmal nocturnal dyspnea, orthopnea Atrial fibrilation, palpitations Effects Left atrial HYPERTROPHY (first concentric then eccentric) elevated LVEDP, Left [...]
Four stages of malignant tumor growth 1. transformation 2. growth 3. local invasion 4. distant metastases Clonality of Tumors Most are Monoclonal (arise from malignant transformation of a single cell) To find out use: G6PD isoenzyme analysis a monoclonal cell should carry only one type of isoenzyme if monoclonal RFLP Rarely there are cases where [...]
Arteriosclerosis Definition arteriosclerosis- a group of diseases characterized by thickening and loss of elasticity of the arterial walls Three forms 1. atherosclerosis aorta and large branches 2. Monckeberg’s arteriosclerosis Ca2+ deposits in the medial part of the artery 3. arteriolosclerosis small vessels Atherosclerosis Definition disease of large and medium arteries characterized by focal intimal [...]
Terms HTN without orthostatic change = not due to volume depletion Acute Renal Failure = recent (1-2 mo.) decline in renal function measured by: 1) increased serum creatnine. If baseline was <3.0 mg/dl, the increase must be >0.5 mg/dl. If baseline was >3.0 mg/dl, the increase must be => 1.0 mg/dl 2) Fall in urine [...]
Rheumatic Fever a recurring, inflammatory, self-limited disease that involves multisystem tissues sequel of Group A, b-hemolytic streptococcal infection characterized by fever, sore throat, increased WBCs age of first attack: 5-14 years Comes about 10-20 days after a strep pharyngitis and at this time the organisms are no longer culturable to prevent occurrence-antibiotics Jones Criteria Rheumatic [...]
