12-13. Valvular Heart Disease

Question 1

condition causing mid systolic click?

Answer 1

Mitral valve prolapse

Question 2

major criteria for acute rheumatic fever?

Answer 2

Joints (migratory arthritis)
Carditis
Nodules on skin (subcutaneous)
Erythema marginatum
Sydenham chorea

Question 3

2 laboratory diagnosis of acute RF?

Answer 3

Steptolysin O antibody

DNAse B

Question 4

most common complication of aRF? associated heart murmur?

Answer 4

Chronic Rheumatic Heart Disease

Mitral stenosis

Question 5

organism causing acute endocarditis?
subacute?
virulence?
type of valves affected?

Answer 5

acute - S aureus (high virulence)
- normal valves
subacute - viridans streptococci (low virulence)
- abnormal valves

Question 6

condition with vegetations most commonly on valves?

hw to diagnose?

Answer 6

infective endocarditis

Blood culture

Question 7

symptoms of infective endocarditis?

Answer 7

Fever
Roth Spots
Osler nodes
Murmur
Janway lesions
Anemia
Nail-bed Hemorrhages
Emboli

Question 8

Complication of biopresthesis artificial valve?

mechanical valve?

Answer 8

bio - structural deterioration

mech - thromboembolic

Question 9

2 cause of aortic stenosis?

wt happens to the heart in each

Answer 9

dystrophic calcificaiton due to age and CRF

ca- LV concentric hypertrophy

CRF - dilation

Question 10

pts w what condition are at a really high risk of aortic stenosis?
characteristic of congenital cause?
acquired? wt causes acquired?

Answer 10

bicuspid valve

con - mitral valve is normal

acq - abnormal mitral valve, caused by rheumatic heart disease

Question 11

2 morphologic characteristics of mitral valve prolase?

Answer 11

ballooning of leaflets

annular dilation

Question 12

3 histo characteristics of mitral valve prolapse?

Answer 12

attenuation of collagenous fibrosa layer
thickening spongiosa
myomatous deposition in leaflets

Question 13

symptoms of most mitral valvue prolapse?

4 complicaitons?

Answer 13

asymptomatice

infective endocarditis
arrhythmias
stroke from embolie
mitral insufficiency w chordae tendineae rupture

Question 14

wt procederes rheumatic fever? location?

Answer 14

Strep A infection of pharyngitis

Question 15

wt is seen microscopically in the heart during acute rhematic fever? 2 components?

Answer 15

Aschoff bodies

• T lymphocytes
• Anitschkow cells (plump macrophages)

Question 16

wt is seen w endocarditis associated w Acute rheumatic fever?

Answer 16

fibrinoid necrosis

Question 17

most frequent cause of mitral stenosis?

Answer 17

chronic rheumatic fever

Question 18

most important consequence of acute RF?

Answer 18

chronic RHD

Question 19

hw doe smitral valve look in chronic rheumatic fever?

Answer 19

fish mouth

Question 20

agent causing infective endocarditis on prosthetic valves?

Answer 20

staph epidermidis

Question 21

2 signs =/ symptoms of infective endocarditis?

Answer 21

fever

murmur