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CS1 Exam 1 > 9&10- Cardiac Pathology I > Flashcards

9&10- Cardiac Pathology I Flashcards

1
Q

leading discharge diagnosis in patients over 65 in US

A

CHF

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2
Q

variable degrees of decreased CO and tissue perfusion as well as pooling of blood in the venous system which may cause pulmonary edema, peripheral edema or both

A

CHF defined

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3
Q

two most common causes of HF

A
  • coronary a disease

- high blood pressure

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4
Q

ejection fraction of heart failure

A

below 45%

normal should be 50-70%

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5
Q

how is systolic dysfunction different than diastolic dysfunction

A
  • systolic dysfunction has a low EF

- diastolic dysfunction has a normal EF, but the total volume of blood being ejected is lower

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6
Q

previous or current symptoms of heart failure in the context of n underlying structural heart problem, but managed with medical treatment: what stage CHF?

A

stage C

A- high risk
B- no symptoms
D- advanced need hospital

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7
Q

what does b-type natriuretic peptide idnicate?

A

CHF

BNP > 100 pg/mL

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8
Q

how does the kidney sense CHF?

A

activates RAAS because it senses it as a low volume state (give diuretics to treat)

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9
Q

trouble breathing, lungs fill with fluid

A

left sided CHF

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10
Q

VJD, splenohepatomegaly

A

right sided CHF

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11
Q

what is biventricular CHF

A

left heart failure causes right sided failure

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12
Q

heart failure cells

A

left sided CHF

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13
Q

paroxysmal nocturnal dyspnea

A

left sided CHF

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14
Q

what is the major cause of ischemic heart disease?

A

chronic atherosclerosis

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15
Q

leading cause of death worldwide for men and women

A

ischemic heart disease

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16
Q

due to an imbalance between the supply and demand of the heart for oxygenated blood

A

ischemix heart disease

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17
Q

what is coronary artery disease?

A

reduced blood flow due to obstructive atherosclerotic lesions in the coronary arteries CAD

18
Q

major risk factor for atherosclerosis

A

cigarette smoking

19
Q

what level of obstruction is required for ischemia?

A

75% or greater for symptomatic ischemia

90% of the lumen can lead to inadequate coronary blood flow even at rest

20
Q

components of coronary plaque

A

necrotic grumous core

cholesterol clefts

foam cells

smooth muscle cells

21
Q

describe a vulnerable plaque

A
  • soft w/ lipid filled core
  • eccentric
  • only 40-60% stenotic
22
Q

vulnerable –> rupture –>

A

thrombus –> MI

bleeding into plaque can accompany rupture

23
Q

ischemia v. infarction

A

ischemia is reversible and infarction is irreversible

24
Q

physical activity, emotional excitement, or any other increased cardiac worload results in an imbalance in coronary perfusion relative to demand. Relieved by rest or nitro

A

stable angina

most common form

25
Q

pattern of increasingly frequent pain precipitated by progressively lower levels of physical activity or at rest. Caused by disruption of a plque with partial thrombosis or embolization or vasospasm

A

unstable or crescendo angina

warning that an acute MI may be imminent

26
Q

episodic myocardial ischemia caused by coronary artery spasm. Not retaled to activity, HR or BP. Responds promptly to vasodilators.

A

prinzmetal variant angina

uncommon

27
Q

what is the ankle brachial pressure index?

A

value of greater than 1.3 is considered abnormal and suggeste calcification

under 0.5 is sever arterial disease

28
Q

ST segment depression

A

ischemia

29
Q

ST segment elevation

A

MI

30
Q

if you do an angiogram 14 hrs after MI will you see stenosis

A

only 60% of time

some occlusion resolve

31
Q

most common site for MI

A

LAD

anterior wall of left ventricle near apex, anterior portion of ventricular septum and apex circumferentially

32
Q

when would you see a wavy fiber histo?

A

half hour to 4 hr post MI

33
Q

dark mottling is indicative of..

A

early coagulation necrosis, 12-24 hrs post MI

34
Q

yellow-tan infarct indicates …

A

1-3 days post MI

peak neutrophils

35
Q

when is risk of myocardial rupture greatest?

A

post MI 3-7 days

36
Q

overly ischemic tissue loses its ability to contract =

A

contractile dysfunction

37
Q

rupture of free wall of LV –>

A

cardiac tamponade

38
Q

rupture of papillary muscle –>

A

acute mitral valve incompetence

39
Q

rupture of ventricular septum –>

A

acutely acquired VSD

40
Q

what is dressler’s syndrome?

A

autoimmune inflammatory rxn to myocardial neo-antigens formed as a result of the MI

41
Q

acute MI mortality for 30 days after discharge

A

16%

5% for every year after

42
Q

which graft is better for CABAG?

A

internal mammary a. because 90% are patent at 10 yr compared to saphenous (50%)

CS1 Exam 1 (13 decks)

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