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Part 1 Pathophysiology > Cardiac > Flashcards

Cardiac Flashcards

1
Q

Lipid changes inc risk atherosclerosis

A

increased LDL levels,
increased levels of lipoprotein-a
decreased HDL levels.

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2
Q

Most common cause rv failure

A

Lv failure, mitral stenosis specifically

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3
Q

Heart changes aging

A

inc LA size, dec LV size
calcific deposits
brown atrophy and amyloid deposition myocardium
aorta tortuous

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4
Q

diastolic failure

A

heart failure with preserved EF and normal valves
LVH, amyloid, myocardial fibrosis, constrictive pericarditis
>65 female HTN, risk flash pulm oedema

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5
Q

hypertrophic myocytes

A

enlarged nuclei

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6
Q

Pulmonary changes LHF

A
  1. perivasc and interstitial oedema
  2. oedematous widening alveolar septa
  3. oedema in alveolar spaces
    hemosiderin laden macrophages (heart failure cells)
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7
Q

Cyanotic congenital heart disease

A

R->L shunts: TOF, TGA, eisenmenger
cyanotic
pulmonary stenosis
tricuspid atresia
anomalous pulmonary venous return

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8
Q

Coarctation

A

pre ductal infantile, assoc PDA (asymptomatic if no PDA) hypoplastic aortic arch
adult post ductal
50% + bicuspid aortic valve
male > female, turners

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9
Q

TOF

A

pulmonary stenosis
RVH
VSD
Overriding aorta

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10
Q

VSD

A

most common defect
20-30% isolated
thrill on examination

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11
Q

PFO

A

80% closed by 2y
loud S1 with fixed splitting S2

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12
Q

PDA examination

A

machinery murmur

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13
Q

Aortic stenosis and atresia

A

isolated in 80%

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14
Q

Typical LCA and RCA lesions

A

LCA - proximal and isolated
RCA diffuse

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15
Q

patterns cardiac infarction

A

transmural - stemi, plaque
subendocardial - inner 1/3 wall, hypotension, plaque
multi focal microinfarction - smaller intramural vessels, micro embolism, takutsubo

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16
Q

reversible damage MI

A

30m

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17
Q

<4h post MI

A

tissue looks normal, sarcolemma disruption

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18
Q

4-12h post MI

A

tissue dark mottling, coagulative necrosis

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19
Q

12-24h post MI

A

tissue dark mottling, pyknosis nuclei, neutrophil infiltration, oedema, haemorrhage

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20
Q

1-3d post MI

A

tissue yellow with mottling, loss of nucelei, neutrohils present, risk fibrinous pericarditis

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21
Q

3-7d post MI

A

hyperemic tissue with yellow core, disintegration dead myofibres, ding neutrophils, macrophages peripherally (weaken vent wall)

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22
Q

7-10d post MI

A

yellow/ tan soft tissue, phagocytes with granulation tissue at margins

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23
Q

10-14d post MI

A

red grey borders tissue, granulation tissue with new blood vessels, collagen deposition,

24
Q

2-8w post MI

A

grey white scar, increased collagen and celularity, 2m scarring complete

25
Q

Coagulative necrosis post MI

A

4-12h

26
Q

Neutrophil infiltration post MI

A

12-24h

27
Q

Macrophage infiltration post MI

A

3-7d

28
Q

Collagen deposition post MI

A

10-14d

29
Q

Dark mottling of heart post MI

A

4-24h

30
Q

Mortality from MI

A

30% in first year
50% of deaths in <1h due to arrhythmia

31
Q

Myocardial rupture

A

2-4d post MI
wall weakned by macrophages
Assoc transmural
vent free wall rupture most common
vent septa rupture
papillary muscle rupture (least common)

32
Q

dressler syndrome

A

2-3d post, fibrinous/ fibrinohaemorrhagic pericarditis

33
Q

Most common valve diseases in order

A

Aortic stenosis
Aortic insufficiency (dilated ascending aorta)
mitral stenosis
mitral insufficiency (prolapse)

34
Q

Calcific AS

A

age 70+ younger if bicuspid
calcified masses in cusps, free edges not involved
50% due to bicuspid valve

35
Q

Myxomatous degeneration mitral valve

A

assoc marfans
thinning fibrosa layer with expansion spongiosa layer

36
Q

Rheumatic heart disease lesions

A

Mitral stenosis
Askoff bodies (t lymph)
Anishkow cells - activated macrophages
stretoplysin O, DNAase

37
Q

Jones criteria rheumatic heart disease

A

major: migratory polyarthritis large joints, pancarditis, subcutaneous nodules, erythema marginatum, sydenham correa
minor: fever, arthralgia, acute phase proteins
2 major/ 1 major 2 minor

38
Q

Normal valve endocarditis organisms

A

staph aureus, enterococci, HACEK, oral cavity commensals

39
Q

Damaged valve endocarditis organism

A

strep viridans 60%

40
Q

Prosthetic valve endocarditis organism

A

staph epidermidis

41
Q

Fungal endocarditis organism

A

candida

42
Q

Duke criteria

A

endocarditis
2 maj, 1 maj 3 min, 5 min
maj (BE): Blood culture >2, Echo/ new valve regurge
Min (timer): Temp, Immunological phenomena, 1x Micro, , Embolic lesions, Echo consistent but not diagnostic, Risk factors - predisposing lesion/ IVDU

43
Q

Liebmann sachs

A

mitral and tricuspid endocarditis, sterile vegetations, assoc SLE

44
Q

Dilated cardiomyopathy

A

,pst common (90%), reduced EF systolic dysfunction
genetic AD, viral, alcoholic, doxyrubicin cobalt, takutsubo
2y survival 50%
mitral regurge

45
Q

Hypertrophic cardiomyopathy

A

preserved EF, diastolic
genetic, friedrich ataxia, maternal DM,
2 yr mort 50% , 5y 75%

46
Q

Restrictive cardiomyopathy

A

rare, diastolic, preserved EF
amyloid, radiation, idiopathic

47
Q

Myocarditis

A

viral - coxsacki + enteroviruses, HIV, flu, CMV
chagas (protozoan)
Lyme
drug, SLE, can become dilated cardiomyopathy

48
Q

Pericardial effusion

A

normal 30-50ml
300 can cause rupture
can accomodate p to 500

49
Q

Pressure vs volume overload effect on heart

A

pressure - hypertrophy
volume - dilation

50
Q

Contractile bands evidence of

A

recent reperfusion injury

51
Q

genetic risk factor atherosclerosis

A

apolipoprotein beta gene mutation

52
Q

age changes of heart

A

bigger LA, smaller LV, sigmoid shaped septum

53
Q

uraemic pericarditis type

A

serous

54
Q

Bicuspid aortic valve associations

A

Early calcification and symptomatic stenosis by 50y
50% of AS due to bicuspid valve

55
Q

Location of valve calcification rheumatic / not

A

Within cusps normal
Rheumatic free edges
Mitral annular at annulus

Part 1 Pathophysiology (15 decks)

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