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23 General Pathology > 10/26 - Pathology of the Heart > Flashcards

10/26 - Pathology of the Heart Flashcards

1
Q

infective endocarditis can be subacute or acute depending on what

A

virulence of organism
1. low virulence
2. high virulence

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2
Q

what virulence has low-grade fever, malaise, and weight loss?

A

low virulence

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3
Q

what virulence has high fever, shaking chills, and overt septicemia?

A

high virulence

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4
Q

what are organisms of high virulence in acute endocarditis? what valves involved

A

staph aureus; normal valves

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5
Q

how do people get acute infective endocarditis

A

IV drug use

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6
Q

what valves are involved in acute infective endocarditis

A

tricuspid and pulmonary valves (rather than left heart valves)

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7
Q

what is caused by low virulence organisms on previously damaged valves and streptococcus viridans?

A

subacute infective endocarditis

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8
Q

who gets subacute infective endocarditis

A

Pre-existing cardiac abnormalities, especially valvular disease:

Small Ventriculoseptal defects
Calcific aortic stenosis
Mitral valve prolapse (most common predisposing factor)
Chronic rheumatic valvular disease

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9
Q

what is involved in noninfective endocarditis

A
  1. lupus erythematous
  2. usually mitral valve (“Libman-Sacks Disease”)
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10
Q

which condition in which libman sacks endocarditis is seen

A

systemic lupus erythematosus

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11
Q

what layer involved in cardiomyopathy

A

muscular layer

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12
Q

what are the different functional patterns of cardiomyopathy

A
  1. dilated
  2. hypertrophic
  3. restrictive
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13
Q

functional pattern: DILATED

left ventricular ejection fraction
mechanism of failure
CAUSES
secondary myocardial dysfunction

A

especially know: genetics, alcoholism, and sarcoidosis

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14
Q

functional pattern: HYPERTROPHIC

left ventricular ejection fraction
mechanism of failure
CAUSES
secondary myocardial dysfunction

A

especially know genetics and diabetic mothers

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15
Q

functional pattern: RESTRICTIVE

left ventricular ejection fraction
mechanism of failure
CAUSES
secondary myocardial dysfunction

A

especially know amyloid (protein) and radiation

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16
Q

what is the inflammatory process causing myocardial injury (middle heart)

A

myocarditis

17
Q

causes of myocarditis

A
  1. infection mediated (viral, bacterial, parasistic, fungal)
  2. immune mediated myocardial injury (not well understood)
18
Q

how does myocarditis present

A
  1. arrythmias, congestive heart failure
  2. dilated cardiomyopathy
19
Q

what infiltrate and damage myocardial fibers

A

lymphocytes

20
Q

what are abnormalities of the pericardium

A
  1. pericarditis
  2. pericardial effusion
  3. hemopericardium
21
Q

causes of pericarditis

A
  1. infectious agents
  2. presumably immunilogically mediated
  3. misc
22
Q

infectious agents that cause pericarditis

A
  1. Viruses
  2. Pyogenic bacteria
  3. TB
  4. Fungi
  5. Other parasites
23
Q

immunologically mediated causes of pericarditis

A
  1. Rheumatic fever
  2. SLE
  3. Scleroderma
  4. Drug hypersensitivity reaction
24
Q

what are misc. causes of pericarditis

A
  1. MI
  2. Uremia
  3. After cardiac surgery
  4. Neoplasia
  5. Trauma
  6. Radiation
25
Q

what is the most frequent type of pericarditis

A

fibrinous and serofibrinous pericarditis

26
Q

what is fibrinous and serofibrinous pericarditis associated with

A
  1. Acute myocardial infarction
  2. Systemic lupus erythematosus (SLE)
  3. Chest irradiation
  4. Trauma
27
Q

what can develop a loud pericardial friction rub

A

fibrinous and serofibrinous pericarditis

28
Q

what can comprimise cardiac output due to fluid accumulation in percardcial sac

A

fibrinous and serofibrinous pericarditis

29
Q

what can purulent (bacterial) pericarditis complicate?

A
  1. Empyema (pleural space infection)
  2. Lobar pneumonia
  3. Mediastinal infections
  4. Infective endocarditis

ALSO: bacterial septicemia

30
Q

is chronic, fibrosing pericarditis a constrictive pericarditis?

A

YES

31
Q

what is fibrosis with obliteration of pericardial cavity

A

constrictive pericarditis

32
Q

is chronic, fibrosing pericarditis idiopathic

A

yes

33
Q

causes of chronic, fibrosing pericarditis

A

radiation therapy, infection post surgery

34
Q

what may represent the result of any pericarditis which resolved with scarring

A

chronic, fibrosing pericarditis

35
Q

what occurs when fluid accumulation in the pericardial space occurs

A

pericardial effusions

36
Q

the nature of pericardial effusion is determined by what causes?

A
  1. Serous: congestive heart failure, hypoalbuminemia
  2. Serosanguineous (watery, blood tinged): blunt chest trauma, malignancy
  3. Chylous (milky): mediastinal lymphatic obstruction, usually by mediastinal neoplasm
37
Q

clinical features of pericardial effusions

A
  1. Often asymptomatic
  2. Cardiac tamponade; heart unable to expand during diastole due to fluid in sac
  3. Relatively common in SLE
38
Q

what occurs when heart is unable to expand during diastole due to fluid in sac

A

cardiac tamponade

39
Q

what happens in hemopericardium

A
  1. Ruptured infarction
  2. Penetrating cardiac trauma
  3. Cardiac tamponade results

23 General Pathology (24 decks)

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