3: Cardiac Pathology 1

Question 1

Leading cause of death in the US

Answer 1

Heart disease

Question 2

What determines dominance pattern of blood supply to the heart?

Answer 2

Supply of lower posterior heart thru posterior descending artery (PDA) - can be right, left, or co-dominant

Question 3

What vessel pattern is dominant in 65-70% of hearts?

Answer 3

Right dominant

Question 4

Most sensitive and specific biomarkers of myocardial damage (2)

Answer 4

Troponin T and I (cTnT, cTnI)

Question 5

Primary and secondary pacemaker of the heart

Answer 5

Primary: SA node
Secondary: AV node

Question 6

What happens if SA node is damaged?

Answer 6

AV node takes over primary pacemaker function

Question 7

Average bpm of SA vs AV node

Answer 7

SA: 60-100 bpm
AV: 40-60 bpm

Question 8

Most common cause of sudden cardiac death

Answer 8

CAD -> arrhythmia -> ischemia

Question 9

5 Common causes of sudden cardiac death in younger patients

Answer 9

1. Drug abuse
2. Hereditary conduction abnormalities
3. Hypertrophic or dilated cardiomyopathy
4. Myocarditis
5. Mitral valve prolapse

Question 10

What happens in diastolic vs systolic dysfunction

Answer 10

Diastolic: loss of ability to fill ventricles
Systolic: loss of myocardial contractile function

Question 11

Three most common causes of left sided heart failure (CHF)

Answer 11

1. Ischemic heart disease
2. HTN
3. L-sided valve disease

Question 12

Normal amount and color of pericardial fluid

Answer 12

<50mL of clear/straw colored fluid

Question 13

What type of tumors are myxomas, lipomas, papillary fibroelastomas, and rhabdomyomas?

Answer 13

Benign

Question 14

Most common malignant tumor of the heart

Answer 14

Angiosarcoma

Question 15

Most common cardiac tumor in adults**

Answer 15

Myxoma

Question 16

Most common cardiac tumor in children**

Answer 16

Rhabdomyoma

Question 17

Four things in McCune-Albright syndrome

Answer 17

1. Polyostotic fibrous dysplasia
2. Cafe au last spots
3. Endocrine abnormalities
4. Myxomas

Question 18

Mutation in McCune-Albright syndrome vs Carney complex

Answer 18

McCune Albright: GNAS1

Carney: PRKAR1A null mutation

Question 19

Carney complex: three things

Answer 19

1. Skin lentigines
2. Endocrine dysfunction
3. Myxomas

Question 20

What is more common than a primary tumor of the heart?

Answer 20

Metastases from lung, breast, melanoma, or lymphoma

Question 21

Five effects of tumors in the heart

Answer 21

1. Mass effect -> limits filling
2. Decreased contractility
3. Pericardial effusion
4. SVC syndrome
5. Circulating mediators/hormones

Question 22

Heart transplant survival at 1 year vs 5 yrs

Answer 22

1yr: 90%
5yrs: >70%

Question 23

List of changes in the aging heart**

Answer 23

1. Reduction in elasticity/compliance
2. Valves: calcification, stenosis, prolapse
3. Chambers: LV size reduction, atrial dilation
4. Atherosclerosis
5. Increase in epicardial fat
6. Lipofuscin + amyloid accumulates
7. Basophilic degeneration + myocytes loss

Question 24

Most common cause of arrhythmia**

Answer 24

Ischemic heart disease

Question 25

Five common causes of arrhythmias

Answer 25

1. Ischemic heart disease**
2. Cardiomyopathies
3. Myocarditis
4. Valvular disease
5. Congenital disorders

Question 26

Sick sinus syndrome

Answer 26

SA node is damaged -> bradycardia

Question 27

Hereditary channelopathies of the heart

Answer 27

Voltage-gated ion channels are abnormal -> arrhythmias

Question 28

Most common hereditary channelopathy

Answer 28

Long QT syndrome