Term
| Effect of some oral contraceptives on BP? |
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Definition
| some may stimulatin production of angiotensinogen from liver |
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Term
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Definition
| overexpression of the aldosterone synthase gene producing excessive aldosterone |
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Term
| 11B and 17a hydroxylase defiency effect on bp? |
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Definition
| shunts steroid synthesis to mineralcorticoid synthesis |
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Term
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Definition
apparent mineralcorticoid excess
deficiency in 11B-HSD that converts cortisol to cortisone. Buildup of cortisone has mineralcorticoid effect |
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Term
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Definition
| Autosomal dominant disorder gain of function in ENaC. |
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Term
| polymorphisms in what system predispose to essential HTN? |
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Definition
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Term
| What are the two most common mechanisms of vasculitis? |
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Definition
Immune mediated
Infectious
Infections may lead to secondary immune mediated vasculitis |
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Term
| What are ANCAs? what are their significance and name two ANCAs? |
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Definition
antineutrophil cytoplasmic antibodies
Antibodies in pts with vasculitis that react to neutrophil antigens such as MPO (p-ANCA) and PR3 (c-ANCA). |
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Term
| What typically induces p-ANCA? |
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Definition
| MPO-ANCA is typically induced by various drugs |
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Term
| What typically induces the formation of c-ANCAs? |
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Definition
| PR3-ANCA are typically induced by various infections |
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Term
| How are ANCAs related to vasculitis? |
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Definition
| repeated drug interactions or infections increase the titers of ANCA's which cause degranulation of neutrophils and injure the endothelium |
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Term
| Name 3 types of vasculitis mediated by ANCAs |
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Definition
Wegeners granulomatosis
Churg-Strauss Syndrome
Microscopic polyangitis |
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Term
| Name 3 immunological kinds of vasculitis |
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Definition
SLE
RA
serum sickness
Drug Induced
Infection induced |
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Term
| Name 2 vasculitis syndromes via direct antibody attack |
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Definition
| Goodpasteurs and Kawasaki disease |
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Term
Giant Cell Ateritis
how common? ateries involved? pt population? Sx's? Dx? Morphology? Pathogenesis? |
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Definition
| most common vasculitis, involving arteries of the head: temporal, vertebral, opthalmic. pt > 50. Fever, fatigue, facial pain and headache. Ocular symptoms tender superficial temporal. Dx w/ biopsy. mononuclear infiltrate w/ giant cells and destruction of IEL. Most likely caused by cell mediated immune response against Ag in IEL. |
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Term
Takayasu Arteritis (aka ??)
involved arteries? pt population? Sx's? Morphology? Pathogenesis? |
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Definition
aka pulseless disease.
involves aorta and its branches + pulmonary arteries. Women <40. decreases BP in UE and increased BP in LE. Visual disturbances, blindness, dizziness, weakness, hemiparesis, pulmonary HTN. Mononuclear infiltrate, giant cells, fibrosis. Most likely a cell mediated immune response to Ag in vessel wall. |
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Term
polyarteritis nodosa (aka ??)
arteries involved? pt population? sxs? Morphology? pathogenesis? |
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Definition
aka systemic necrotizing vasculitis
Involves medium and small arteries (especially renal) and SPARES PULMONARY ARTERIES (different from takayasu). young adults. Fever, malaise, HTN, chronic renal failure. shows inflammation w/ fibrinoid necrosis -> aneurysms, thrombi, fibrosis -> nodules. pathogenesis unknown |
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Term
Kawasaki's disease
pt population? arteries involved? related manifestations? morphology? pathogenesis? |
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Definition
Leading cause of acquired heart disease in young children
Frequently involves the coronarys: aneurysms, thrombi, stenosis, fibrosis.
Hypersensitivity to Ag, activate b cells, autoantibodies attack endothelial and vsm cells. Morphology similar to polyarteritis nodosa |
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Term
Microscopic Polyangitis (aka ??)
vessels affected? lab findings? Sx's? Morphology? Cause? |
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Definition
| aka leukocytoclastic Vasculitis affecting arterioles, capillaries, and venules. labs show positive p-ANCA. Sx's include palpable purpura, hemoptysis, hematuria, proteinuria, abd. pain, myalgias, necrotizing glomerulonnephritis. Morphology similar to polyarteritis nodosa w/ neutrophil infiltrations. pauci-immune injury |
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Term
Churg-Strauss Syndrome
pt population? vessels involved? lab tests? organs involved? morphology? |
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Definition
| rare disease involving medium to small vessels. seen in atopic pts. labs show positive p-ANCA, effects, heart, skin, GI, and kidneys. morphology shows fibrinoid necrosis, eosinophilic infiltrates and granulomas |
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Term
Wegeners Granulomatosis
Triad of disease?
clinical findings? Morphology? lab findings? pathogenesis? |
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Definition
triad: necrotizing granuloma in resp tract, focal/granulomatous vasculitis of small arteries, and necrotizing glomerulonephritis.
Shows bilateral nodular cavitary lung infiltrates, sinusitis, ulcers of nasopharynx, renal disease, skin rashes, myalgias. Morph resembles TB. Labs show positive c-ANCA. caused by cell mediated hypersensitivity to inhaled Ag. |
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