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CPR II Exam 1 > Cardaic Pathology Pt 2 > Flashcards

Cardaic Pathology Pt 2 Flashcards

1
Q

What is the MC structural birth defect?

A

Congenital heart disease

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2
Q

What is congenital heart disease?

A

Abnormality or defect that affects the heart or great vessel which is present before birth

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3
Q

What are some causes of congenital heart disease?

A

Most commonly due to sporadic genetic mutations

Also environmental factors (ex fetal alcohol syndrome)

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4
Q

What are the most common congenital heart disease?

A 
Septal defects 
(VSD #1)
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5
Q

How do ASD and VSD affect RV and pulmonary outflow pressure and volume?

A

They both increase RV and pulmonary outflow volumes and pressure
Whereas PDA increases pulmonary outflow volume and pressure only

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6
Q

What is the result of increased pulmonary pressure?

A

Increases pulmonary vascular resistance which will result in Eisenmenger syndrome

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7
Q

Does staph aureus cause acute or subacute endocarditis?

A

Acute

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8
Q

Is early (<2 months) prosthetic valve infection typical with staph aureus infection?

A

Yes

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9
Q

What are risk factors for infective endocarditis caused by staph aureus?

A

IV drug abuse, very common with prosthetic valves

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10
Q

What is the #1 cause of endocarditis?

A

Staph aureus

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11
Q

What are unique features of staph aureus?

A

Right sided (tricuspid valve) endocarditis associated with IV drug abuse

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12
Q

What are causes of subacute infective endocarditis?

A

Strep viridans, enterococci, staph epidermidis, HACEK group

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13
Q

Is early (<2 months) prosthetic valve infection typical with strep viridans, enterococci, staph epidermidis, or the HACEK group?

A

Only for staph epidermidis

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14
Q

What are risk factors for strep viridans?

A

Dental procedures/poor dentition

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15
Q

What are unique features of strep viridans?

A

1 for native, structurally abnormal

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16
Q

What are risk factors and unique features for staph epidermidis?

A

Very common with prosthetic valves

Unique feature is that its present in normal skin flora

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17
Q

What are risk factors for the HACEK group?

A

Dental procedures/poor dentition

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18
Q

What are unique features of the HACEK group?

A

Rare

<2% of endocarditis cases

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19
Q

Which organisms are apart of the HACEK group?

A 
Haemophilus
Aggregatibacter (previously actinobacillus)
Cardiobacterium
Eikenella
Kingella
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20
Q

What are the two types of prosthetic valves?

A

Mechanical and tissue valves

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21
Q

What are mechanical valves?

A

Caged ball, tilting disk, hinged flap (bi-leaflet)

Risk of thromboembolism

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22
Q

What are tissue valves (bioprostheses)?

A

Bovine (cow) or porcine (pig)

Risk of mechanical failure (tearing, incompetence)

23
Q

Both types of prosthetic valves have a risk of what?

A

Infective endocarditis

24
Q

What are other risks associated with prosthetic valves?

A

Anti-coagulant related hemorrhage (lifelong anticoagulation with mechanical valves)
Dysfunction (regurgitation or exuberant healing)
Hemolytic anemia

25
Q

Which prosthetic valve lasts longer?

A

Mechanical valves last a long time (greater than 25 years) whereas tissue valves last 10-15 years

26
Q

What type of dysfunction is seen with dilated cardiomyopathy?

A

Systolic dysfunction

27
Q

What is the principal cardiac abnormality in dilated cardiomyopathy?

A

Enlargement of all chambers

28
Q

What are some additional features of dilated cardiomyopathy?

A

Most common type

Multiple causes

29
Q

What type of dysfunction is seen with hypertrophic cardiomyopathy?

A

Diastolic dysfunction

30
Q

What is the principal cardiac abnormality seen with hypertrophic cardiomyopathy?

A

Thickened left ventricular wall (septal)

31
Q

What are additional features associated with hypertrophic cardiomyopathy?

A

Risk of sudden death in young athletes

Beta myosin heavy chain mutation (common mutation)

32
Q

What type of dysfunction is seen with restrictive cardiomyopathy?

A

Diastolic dysfunction

33
Q

What is the principal cardiac abnormality seen with restrictive cardiomyopathy?

A

Rigid ventricular walls

34
Q

What are additional features associated with restrictive cardiomyopathy?

A 
Least common type 
Multiple causes (especially amyloidosis)
35
Q

What is iron overload cardiomyopathy?

A

Hereditary hemochromatosis caused by mutation in HFE gene

36
Q

How does hereditary hemochromatosis affect different systems of the body?

A

Skin (pigmentation), pancreas (diabetes) = bronze diabetes
Heart (dilated cardiomyopathy and arrhythmia)
Liver (hepatosplenomegaly), bone (arthritis), testicles (hypogonadism)

37
Q

What are other types of restrictive cardiomyopathy?

A

Endomyocardial fibrosis
Loeffler endocarditis
Endocardial fibroelastosis

38
Q

What is endomyocardial fibrosis?

A

Children and young adults in tropical and subtropical regions (Africa)
Fibrosis of endocardium and subendocardium
Sx: Dyspnea with exertion, fatigue, paroxysmal nocturnal dyspnea, orthpnea

39
Q

What is Loeffler endocarditis?

A

Part of spectrum of endomyocardial fibrosis
Shows eosinophilic infiltration
Associated with myeloproliferative disorders (leukemia/lymphoma)
Seen in subtropical areas
Sx: Fever, cough, rash

40
Q

What is endocardial fibroelastosis?

A

Fibroelastic thickening of left ventricular endocardium
Presents in the first 2 years of life
Associated with congenital heart defects (aortic stenosis, atresia, etc)
S/S: Infant with feeding difficulty, breathlessness, failure to thrive and wheezing

41
Q

What is the most common functional pattern?

A

Dilated

42
Q

What is the least common functional pattern?

A

Restrictive

43
Q

What is the mechanism of heart feature in dilated functional pattern?

A

Impairment of contractility (systolic dysfunction)

44
Q

What are the causes of the phenotype associated with dilated functional pattern?

A 
Genetic 
Alcohol 
Peripartum
Hemochromatosis 
Doxorubicin toxicity
45
Q

What is the mechanism of heart failure associated with hypertrophic functional pattern?

A

Impairment of compliance (diastolic dysfunction)

46
Q

What are the causes of the phenotype associated with hypertrophic functional pattern?

A

Genetic (hypertrophic cardiomyopathy)

47
Q

What is the mechanism of heart failure for restrictive functional pattern?

A

Impairment of compliance (diastolic dysfunction)

48
Q

What are the causes of the phenotype associated with restrictive functional pattern?

A

Amyloidosis

Radiation induced fibrosis

49
Q

What is the MC form of myocarditis?

A

Lymphocytic myocarditis

Seen both in viral/post viral infection, autoimmune or idiopathic

50
Q

What is eosinophilic myocarditis?

A

Characterized by marked increased eosinophils
Hypersensitivity myocarditis due to underlying allergy (hypersensitivity) reaction (typically drug reaction)
Can be idiopathic
Must exclude parasitic infection

51
Q

What are the types of myocarditis with giant cells?

A

Idiopathic giant cell myocarditis

Myocardial sarcoidosis

52
Q

What is idiopathic giant cell myocarditis?

A

Aggressive, poor prognosis, survival less than 3 months from onset
Giant cells admired with variable mixed inflammation (typically increased eosinophils)

53
Q

What is myocardial sarcoidosis?

A

Idiopathic process, rare cause of myocarditis, variable presentation
Giant cells with non-necrotizing granulomas

CPR II Exam 1 (11 decks)

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