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Organ Pathology Exam 2 > Cardiac 2 > Flashcards

Cardiac 2 Flashcards

1
Q

Cardiomyopathies can often lead to

A

Cardiovascular death or progressive heart failure

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2
Q

Dilated cardiomyopathy is aka

A

Congestive

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3
Q

Dilated cardiomyopathy causes ____ dysfunction.

A

Systolic

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4
Q

Hypertrophic cardiomyopathies cause

A

Diastolic & systolic dysfunction

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5
Q

Restrictive cardiomyopathy causes

A

Diastolic dysfunction

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6
Q

Septum is highly enlarged in which cardiomyopathy

A

Hypertrophic

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7
Q

Left HF

A

Cant get blood out to systemic circulation and backs up to your lungs

Pulmonary congestion: dyspnea, orthopnea

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8
Q

Right HF

A

Systemic circulation is drawing to R atrium and backs up

Edema, nausea, abdominal pain, nocturia

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9
Q

Left and right HF will both lead to

A

Low cardiac output

Fatigue and weight loss

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10
Q

How to manage DCM

A

Limit activity of the heart, restrict salt and fluid. Diuretics, beta blockers

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11
Q

Digoxin

A

Used to treat DCM

Stimulates heart contraction

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12
Q

Hypertrophic cardiomyopathy

A

Massively hypertrophied L ventricle can’t fill.
ASH: asymmetrical septal hypertrophy
SAM: systolic anterior motion of the mitral valve leaflet

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13
Q

What causes hypertrophic cardiomyopathy

A

Mutation in a sarcomere protein gene (50% AD)

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14
Q

Clinical manifestation of HCM

A 
Asymptomatic 
Dyspnea 
Angina pectoris 
CHF 
Sudden death
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15
Q

Management of HCM

A

Drugs to promote ventricular relaxation: beta blockers, antiarrhythmic, pace maker

Surgery:
Myectomy: ASH
Plication of the anterior mitral leaflet: SAM

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16
Q

Other causes of hypertrophy

A

Metabolic disorders
Genetic
Exaggerate physiologic response: old age hypertrophy from high blood pressure, athletes heart

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17
Q

How do you know HCM vs Athletes Heart ?

A

In athletes heart, thickness can be decreased with deconditioning, does not restrict LV cavity, no family history.
Nothing abnormal with EKG or filling

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18
Q

Hypertensive HCM of the elderly

A
  • Not as severe so it doesn’t compromise space of the LV

- associated with hypertension

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19
Q

Typical hallmark of restrictive cardiomyopathy

A

Abnormal diastolic function

Rigid ventricular walls

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20
Q

Restrictive cardiomyopathy can have functional resemblance to

A

Constrictive pericarditis

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21
Q

Symptoms of restrictive cardiomyopathy

A

Symptoms of Right and left heart failure , shortness of breath, peripheral edema

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22
Q

What treatment should never be used in restrictive cardiomyopathy

A

Digitalis and other inotropic agents are not indicated because if you increase contraction of heart full of scars, heart will just break and tear.

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23
Q

Treatment of RCM

A

Diuretics, vasodilator said, calcium channel blockers

70% of patients dead within 5 years

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24
Q

Most common disorder found in the pericardium

A

Pericarditis

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25
Q

Pericardial effusion is

A

Serous fluid accumulation in the pericardium

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26
Q

Seroanguinous

A

Fluid in pericardial effusion containing blood (typically aortic dissection)

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27
Q

Chylous

A

Lymph in pericardial effusion (form lymphatic obstruction)

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28
Q

Pericardial effusion outcome depends on stretchiness of pericardial sac

A 
Slow = asymptomatic 
Sudden = death
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29
Q

Pericarditis can be primary or secondary

A

Primary from infection

Secondary from other pathology which include the massive inflammation ( MI, radiation, pneumonia)

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30
Q

Most typical symptom of pericarditis

A

Atypical chest pain triggered by position with the highest contact in between heart and pericardial sac

31
Q

As a complication of pericarditis you can have

A

Tamponade and chronic fibrosis

32
Q

Serous pericarditis

A

Low protein, low cell number

33
Q

Fibrinous pericarditis

A

Contains fibrin coming from inflammatory disorder

Dry, shaggy, rough surface

34
Q

Purulent pericarditis

A

Contains pus

35
Q

Hemorrhagic pericarditis

A

Contains some type of bleeding

36
Q

What causes infectious pericarditis?
Viral:
bacterial:

A
  • Viral: coxsackie B or Echovirus (most common)
  • Bacterial: staphylococcus, streptococcus pneumoniae
  • TB
37
Q

What causes non infectious pericarditis

A

Drug induced
Radiation induced
Autoimmune disease

38
Q

Symptoms of pericarditis

A

Pleuritic pain: Increase pain when lying down , relief when leaning forward. Increased with inspiration (NOTHING TO DO WITH EXERCISE)
Dyspnea, fever
malaise and myalgia (if viral)

39
Q

Most common tumor in the heart

A

Metastasis

40
Q

Most common primary tumor in heart

A

Myxoma

41
Q

Rheumatic valvular disease

A

Occurs from rheumatic fever

42
Q

What is rheumatic fever

A

Systemic inflammatory disease occurring a few weeks after strep throat.
After long term it affects the valves

43
Q

Rheumatic valvular disease consequence

A

Valves are scarred, Stenosis (narrowing of valve) causing abnormal regurgitation

44
Q

Rheumatic fever is a disease that occurs after

A

GABH streptococcal infection

45
Q

Systemic complications occurring from rheumatic fever

A

Upper respiratory tract infection

Involved heart, joints, subcutaneous tissue and CNS

46
Q

Rheumatic fever can affect CNS specifically

A

Basal ganglia of the brain

Causing alteration movements (chorea)

47
Q

Why do we have an abnormal systemic response to rheumatic fever

A

Abnormal response of immune system: Body makes antibody to streptococcus that cross reacts with antigens in heart and joints

48
Q

Most common long term symptom of rheumatic fever

A

Mitral stenosis

49
Q

Symptoms of rheumatic fever

A

Pericardial friction rub, arrhythmias

Mitral stenosis if long term

50
Q

Which group of the GAMH causes the rheumatic fever?

A

Only M types

51
Q

____ produced by GABHS can lead to rheumatic heart disease and glomerulonephritis

A

Pharyngitis

52
Q

_____ produced by GABHS leads to glomerulonephritis ONLY

A

Skin infection

53
Q

Typical lesions for rheumatic fever

A

Aschoff nodules

54
Q

In rheumatic fever. Pancarditis in the heart occurs in _______.

A

Endocarditis, myocarditis and pericarditis

55
Q

Acute and chronic rheumatic valvular disease difference

A

Acute phase: valvulitis (endocarditis)

Chronic pahse: fibrosis, calcification & stenosis of heart (fishmouth valves)

56
Q

Fishmouth valbveds

A

Small opening of valves occurs in Rheumatic valve disorder

57
Q

Pathological lesions of rheumatic valve disorder

A

Migratory arthritis, erythema marginatum, aschoff nodules, chorea from basal ganglia lesions

58
Q

Laboratory findings of rheumatic valve disorder

A

Anti streptolysin O (ASO) titer

59
Q

Rheumatic fever can occur whenever

A

The person experiences new GABH strep infection, if not on prophylactic medicines

60
Q

Infective endocarditis

A

Microbial invasion of heart valves, endocarditis

61
Q

Acute endocarditis

A

Highly virulent microorganism attacks normal valve (valve doesnt have to have abnormality to be infected/colonized)

62
Q

Subacute endocarditis

A

Valves have to be abnormal
Low virulence
Most recover

63
Q

Common risk factor of infective endocarditis

A

Intravenous drug abuse

64
Q

Risk factors of infective endocarditis

A

Any problems with valves/ heart either congenital or acquired
Intravenous drugs
Instrumentation foreign to body

65
Q

Pathophysiology of infective endocarditis

A

Altered endothelium makes endocardium sticky. Bacteria sticks to it & proliferates. Invasion of valvular leaflets is the most severe part because it formed vegetations

66
Q

Common bacteria causing infective endocarditis

A

S. Aureus (drug abuser)

Streptococci, enterococci

67
Q

Onset of symptoms in infectious endocarditis are

A

Usually 2 weeks or less from the initiating bacteremia

68
Q

Specific signs of infectious endocarditis

A

Oslers nodes
Janeway lesions
Roth spots

69
Q

Osler nodes are____. Caused by ___. Seen in _____.

A

Painful and erythematous nodules usually on fingers and toes.
Caused by immune complexes
Seen in infective endocarditis

70
Q

Janeway lesions are ___. Caused by ___. Seen in___.

A

Non painful Erthematous blanching modules located on palms and soles.
Caused by septic emboli.
Seen in infectious endocarditis

71
Q

How does one treat infectious endocarditis

A

Parenteral antibiotics (IV) has to be high enough concentration to get to vegetations.

Surgery if needed.

72
Q

Four etiologies of infection endocarditis

A 
Any type of spreading of the infection: 
Emboli 
Local spread 
Metastatic spread 
FORMATION OF IMMUNE COMPLEXES:  Target vasculature, kidneys, and joints
73
Q

Only cardiomyopathy that can be fixed with surgery

A

HCM
Myotomy myectomy
Plication of the anterior mitral leaflet

Organ Pathology Exam 2 (8 decks)

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