4. Pathology of CVD

Question 1

Definition of arteriosclerosis (2)

Answer 1

Hardening of artery/BV wall

Vessel wall loses flexibility and elasticity, caused by calcification or atheroma

Question 2

Definition of atherosclerosis (3)

Answer 2

Change in BV wall due to cholesterol deposition
Multifactorial disease
Chromic inflammation followed by healing

Question 3

Most important risk factor in atherosclerosis

Answer 3

Cholesterol/hyperlipidaemia

Question 4

Non-modifiable risk factors (3)

Answer 4

Age
Sex
Genetics

Question 5

Phases of atherosclerosis (2)

Answer 5

Chronic inflammation phase

Healing response phase

Question 6

Chronic inflammation phase of atherosclerosis mechanism (3)

Answer 6

Modifiable risk factors damage endothelial cells
Endothelial cells change surface receptors and become more permeable to lipids
Change in cell adhesion molecules, allowing monocytes to attach to endothelium and move into BV walls

Question 7

Healing response phase of atherosclerosis mechanism (2)

Answer 7

Growth factors are produced (TGFa, FGF)
Fibrous fatty plaque (with central mass of lipid and necrotic tissue is produced from collagen laid down due to damage and healing)

Question 8

Effects of atherosclerosis (5)

Answer 8

Ischaemia
Infarction
Thrombosis
Embolism
Chronic periodontitis

Question 9

Types of PVD (4)

Answer 9

Ischaemia
Claudication
Gangrene
Coagulation necrosis and infection

Question 10

Definition of aneurysm

Answer 10

Abnormal dilations that occur in BV or cardiac wall, as well as other places in the body

Question 11

Aneurysm aetiology (3)

Answer 11

Developmental
Degenerative
Traumatic

Question 12

Pathological display of MI (4)

Answer 12

Infarction
Coagulation necrosis of myocardial muscle
Ineffective anaerobic respiration
Healing affects heart function

Question 13

CCS complications (3)

Answer 13

Ventricular hypertrophy
Oedema
Chronic venous congestion (CVC) of lungs and liver

Question 14

Pathophysiology of congestive HF (6)

Answer 14

Hypertrophy of myocyte
Capillaries do not increase in number
Heart may reach 2-3x normal weight
Increased metabolic demands, leading to ischaemia
Injury to mycocyte due to ischaemia
Apoptosis and HF

Question 15

Types of CV tumours (5)

Answer 15

Hamartoma
Kaposi sarcoma
Myxoma
Lipoma
Angiosarcoma

Question 16

Haemangioma growth (2)

Answer 16

Usually rapid during first weeks of life

Usually regress over first 10yrs of life

Question 17

Aetiology of Kaposi sarcoma

Answer 17

HHV-8 (human herpes simplex virus 8)

Question 18

Types of heart valve disease

Answer 18

Congenital

Acquired - due to result of other cardiac diseases such as ventricular hypertrophy

Question 19

Types of acquired valve diseases (2)

Answer 19

Stenosis (injury to valve)

Insufficiency (may causes)

Question 20

Most common valve condition and treatment

Answer 20

Calcific aortic disease

Replacement valve

Question 21

Aetiology of rheumatic heart disease (2)

Answer 21

Rheumatic fever

Damage caused by combo. of type 2 and 4 reactions

Question 22

Cause of endocardium inflammation (2)

Answer 22

Fibrinoid necrosis

Vegetations formed along valve linings, thickening, fusion and calcification

Question 23

Complications of endocardium inflammation (3)

Answer 23

Aortic dilation
AF
Thrombi in one/both atrial walls

Question 24

Infective endocarditis definition and causes (2)

Answer 24

Microbial infection of heart valves
S. aureus/S. viridens - vegetation formed on cusps contain fibrin, inflammatory cells and infective pathogens which can cause an infective embolus