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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
Pericardial effusion is
Serous fluid accumulation in the pericardium
26
Seroanguinous
Fluid in pericardial effusion containing blood (typically aortic dissection)
27
Chylous
Lymph in pericardial effusion (form lymphatic obstruction)
28
Pericardial effusion outcome depends on stretchiness of pericardial sac
``` Slow = asymptomatic Sudden = death ```
29
Pericarditis can be primary or secondary
Primary from infection | Secondary from other pathology which include the massive inflammation ( MI, radiation, pneumonia)
30
Most typical symptom of pericarditis
Atypical chest pain triggered by position with the highest contact in between heart and pericardial sac
31
As a complication of pericarditis you can have
Tamponade and chronic fibrosis
32
Serous pericarditis
Low protein, low cell number
33
Fibrinous pericarditis
Contains fibrin coming from inflammatory disorder | Dry, shaggy, rough surface
34
Purulent pericarditis
Contains pus
35
Hemorrhagic pericarditis
Contains some type of bleeding
36
What causes infectious pericarditis? Viral: bacterial:
- Viral: coxsackie B or Echovirus (most common) - Bacterial: staphylococcus, streptococcus pneumoniae - TB
37
What causes non infectious pericarditis
Drug induced Radiation induced Autoimmune disease
38
Symptoms of pericarditis
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
Most common tumor in the heart
Metastasis
40
Most common primary tumor in heart
Myxoma
41
Rheumatic valvular disease
Occurs from rheumatic fever
42
What is rheumatic fever
Systemic inflammatory disease occurring a few weeks after strep throat. After long term it affects the valves
43
Rheumatic valvular disease consequence
Valves are scarred, Stenosis (narrowing of valve) causing abnormal regurgitation
44
Rheumatic fever is a disease that occurs after
GABH streptococcal infection
45
Systemic complications occurring from rheumatic fever
Upper respiratory tract infection | Involved heart, joints, subcutaneous tissue and CNS
46
Rheumatic fever can affect CNS specifically
Basal ganglia of the brain | Causing alteration movements (chorea)
47
Why do we have an abnormal systemic response to rheumatic fever
Abnormal response of immune system: Body makes antibody to streptococcus that cross reacts with antigens in heart and joints
48
Most common long term symptom of rheumatic fever
Mitral stenosis
49
Symptoms of rheumatic fever
Pericardial friction rub, arrhythmias | Mitral stenosis if long term
50
Which group of the GAMH causes the rheumatic fever?
Only M types
51
____ produced by GABHS can lead to rheumatic heart disease and glomerulonephritis
Pharyngitis
52
_____ produced by GABHS leads to glomerulonephritis ONLY
Skin infection
53
Typical lesions for rheumatic fever
Aschoff nodules
54
In rheumatic fever. Pancarditis in the heart occurs in _______.
Endocarditis, myocarditis and pericarditis
55
Acute and chronic rheumatic valvular disease difference
Acute phase: valvulitis (endocarditis) | Chronic pahse: fibrosis, calcification & stenosis of heart (fishmouth valves)
56
Fishmouth valbveds
Small opening of valves occurs in Rheumatic valve disorder
57
Pathological lesions of rheumatic valve disorder
Migratory arthritis, erythema marginatum, aschoff nodules, chorea from basal ganglia lesions
58
Laboratory findings of rheumatic valve disorder
Anti streptolysin O (ASO) titer
59
Rheumatic fever can occur whenever
The person experiences new GABH strep infection, if not on prophylactic medicines
60
Infective endocarditis
Microbial invasion of heart valves, endocarditis
61
Acute endocarditis
Highly virulent microorganism attacks normal valve (valve doesnt have to have abnormality to be infected/colonized)
62
Subacute endocarditis
Valves have to be abnormal Low virulence Most recover
63
Common risk factor of infective endocarditis
Intravenous drug abuse
64
Risk factors of infective endocarditis
Any problems with valves/ heart either congenital or acquired Intravenous drugs Instrumentation foreign to body
65
Pathophysiology of infective endocarditis
Altered endothelium makes endocardium sticky. Bacteria sticks to it & proliferates. Invasion of valvular leaflets is the most severe part because it formed vegetations
66
Common bacteria causing infective endocarditis
S. Aureus (drug abuser) | Streptococci, enterococci
67
Onset of symptoms in infectious endocarditis are
Usually 2 weeks or less from the initiating bacteremia
68
Specific signs of infectious endocarditis
Oslers nodes Janeway lesions Roth spots
69
Osler nodes are____. Caused by ___. Seen in _____.
Painful and erythematous nodules usually on fingers and toes. Caused by immune complexes Seen in infective endocarditis
70
Janeway lesions are ___. Caused by ___. Seen in___.
Non painful Erthematous blanching modules located on palms and soles. Caused by septic emboli. Seen in infectious endocarditis
71
How does one treat infectious endocarditis
Parenteral antibiotics (IV) has to be high enough concentration to get to vegetations. Surgery if needed.
72
Four etiologies of infection endocarditis
``` Any type of spreading of the infection: Emboli Local spread Metastatic spread FORMATION OF IMMUNE COMPLEXES: Target vasculature, kidneys, and joints ```
73
Only cardiomyopathy that can be fixed with surgery
HCM Myotomy myectomy Plication of the anterior mitral leaflet

Organ Pathology Exam 2 (8 decks)

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