Heart Failure
•Left-sided; Pulmonary edema
•Right-sided; Hepatomegaly, Nutmeg liver
Rubella
•Patent Ductus Arteriosus
•IgM antibody (anti-rubella) indicates recent primary infection
•Congenital associated with deafness, cataracts, glaucoma, and mental retardation
•Prenatal worse than postnatal
Cardiomyopathies
•Hypertrophic: autosomal dominance, obstructive. AKA. Idiopathic hypertrophic sub-aortic stenosis
•Dilated: Congestive. Associated with ethanol, doxorubicin (adriamycin), mercury and lead poisoning, thyrotoxicosis, hypophosphatemia, hypocalcemia, thiamine deficiency. Left and right congestive failure.
•Restrictive: Impaired diastolic filling. Sarcoidosis, amyloidosis, and carcinoid syndrome
2. VASCULAR PATHOLOGY
Atherosclerosis
•Mural thrombus
•Men more than women
•Hypercholesterolemia
•Abdominal aorta, coronary artery and carotid artery
•Inverse relation to HDL cholesterol
Pulmonary Embolism
•Wasted ventilation in the affected, and over-perfusion of the remaining lung tissue
•Wedge-shaped infarcts
•Immobilized post-op patients
•Deep venous thrombosis
•Lower extremity
Syphilitic Aortic Aneurysm
•Ascending aorta
•Tree bark appearance
•Tertiary syphilis
•Aortic valve insufficiency
Aortic Dissecting Aneurysm
•Cystic medial necrosis
•Longitudinal intraluminal tear
•Ascending aorta
•Marfan’s Syndrome
•Hypertension and Hemopericardium
Idiopathic Hypertrophic
Subaortic Stenosis
•Haphazard Myocardial Arrangement
•Ca++ channel blockers
Wegener’s Granulomatosis
•Paranasal sinuses
•Otitis media
•Necrotizing arteritis and glomerulonephritis
•Granuloma formation
•C-ANCA
•TRT: Methotrexate
Malignant Hypertension
•Young male Afro-Americans
•Accelerated, early death
•Flea-bitten Kidney
Berry Aneurysm
•Circle of Willis
•Bifurcation of cerebral arteries
•Subarachnoidal hemorrhage
Secondary Hypertension
•Renal ischemia, stenosis
•Coarctation of aorta
•Pheochromocytoma
•Hyperthyroidism
•Cushing’s syndrome
•Primary aldosteronism
Thromboangiitis Obliterans
•Buerger’s disease
•Young Jewish men
•Heavy smoking
•Ischemia of extremities
Polyarteritis Nodosa
•P-ANCA
•Small-medium sized arteries
•Increased ESR
Budd-Chiari Syndrome
•Occlusion of inferior vena cava
•Central lobular hepatic necrosis
•Congestive liver disease
•Polycythemia vera
3. HEMATOLOGY AND ANEMIA
Hereditary Spherocytosis
•Spectrin defect
•Increased RBC Brittleness
•Increased mean corpuscular hemoglobin concentration
Glucose 6-Phosphate
Dehydrogenase Deficiency
•Antimalarial induced hemolysis
•X-linked
•Episodic and acute
•Mediterranean heritage + Blacks
•Sulfa drugs induced hemolysis
•Fava beans
•Intravascular hemolysis
Pyruvate Kinase Deficiency
•Autosomal recessive
•Chronic anemia, non-episodic
•Non-spherocytic hemolytic anemia
Sickle Cell Anemia
•Substitution of VAL for glutamic acid
•Afro-Americans
•Resistance to malaria
•Small spleen in adults
•Pigment gallstones
•Chronic leg ulcers
•Painful occlusion of vessels
β-Thalassemia
•Fetal hemoglobin (HbF) increases
•Hemosiderosis
•Mediterranean anemia
•Microcytosis, hypochromia
•Splenomegaly
α-Thalassemia
•HbA2
•Hb Bart in fetal life
•Southeast Asia
Megaloblastic Anemia
•B12 or Folate deficiency
•Pancytopenia
•Oval Macrocytosis
•Increased MCV
•Increased MCH
Pernicious Anemia
•B12 deficiency (megaloblastic)
•Anti-intrinsic factor
•Gastric