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Term 4 CRS > Cardiac Path > Flashcards

Cardiac Path Flashcards

1
Q

p-Anti Neutrophil Cytoplasmic Antibodies target?

A

Myeloperoxidase

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2
Q

c-Anti Neutrophil Cytoplasmic Antibodies target?

A

Proteinase-3 (PR3)

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3
Q

Pathogenesis of Kawasaki disease

A

Autoantibodies against endothelial cell and smooth muscle cell
react against vessel wall and cause inflammation and vessel wall damage
(type II hypersensitivity)

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4
Q

Pathogenesis of Polyarteritis nodosa (associated with Hepatitis B)

A

Deposition of immune complexes
(type II hypersensitivity)

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5
Q

Pathogenesis of Giant cell arteritis and Takayasu
arteritis

A

T cell mediated

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6
Q

Giant cell Arteritis commonly involves which arteries?

A

Temporal artery

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7
Q

Takayasu Arteritis commonly involves which artery?

A

Aortic arch and great vessels

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8
Q

Polyarteritis Nodosa commonly involves which arteries?

A

Medium sized arteries of kidney > heart > liver > gastrointestinal tract

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9
Q

Kawasaki disease primarily involves which arteries?

A

Coronary arteries (medium)

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10
Q

Buerger’s Disease most commonly involves which arteries?

A

Tibial and radial arteries (extending into veins and nerves)

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11
Q

WEGENER’S GRANULOMATOSIS pathogenesis

A

c-ANCA/PR3-ANCA

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12
Q

pathogenesis

A
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13
Q

MICROSCOPIC POLYANGITIS pathogenesis

A

p-ANCA/MPO-ANCA

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14
Q

What condition(s) cause concentric hypertrophy?

A

HTN, Aortic Stenosis

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15
Q

What condition(s) cause Eccentric Hypertrophy?

A

Aortic Regurgitation

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16
Q

What is Cor Pulmonale?

A

R. sided heart failure due secondary to COPD, pulmonary HTN, or asthma

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17
Q

Which type of backward heart failure:
• Systemic venous congestion
• Distended neck vein
• Enlarged tender liver
• Pedal edema

A

Right Ventricular Failure

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18
Q

Which type of forward heart failure:
• Dyspnea due to pulmonary edema

A

Right Ventricular Failure

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19
Q

Which type of forward heart failure:
• Fatigue
• Shock
• Syncope

A

Left Ventricular Failure

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20
Q

Which type of backward heart failure:
• Dyspnea
• Orthopnea
• Paroxysmal nocturnal dyspnea (PND)

A

Left Ventricular Failure

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21
Q

Pathogenesis of Ischemic Heart Disease (IHD)

A

Chronic progressive atherosclerotic narrowing of the epicardial coronary arteries

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22
Q

Pathogenesis of Stable (typical) angina

A

Due to reduction of coronary perfusion because of fixed stenosis – No myocardial necrosis

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23
Q

Pathogenesis of unstable (crescendo) angina

A

Induced by disruption of plaque with superimposed thrombosis and possibly vasospasm

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24
Q

Pathogenesis of Prinzmental angina

A

Mechanism not clear but it occurs due to coronary artery spasm producing transient squeezing chest pain

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25
Q

Which type of infarction can also occur with Cocaine abuse?

A

Transmural Infarction

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26
Q

Diagnosis of MI
A. Most sensitive and specific marker
B. Normally not detectable in circulation
C. Rises in 3-12 hrs, peaks at 12-48 hrs. and persists for 5-14 days

A

Troponins (I and T)

27
Q

Diagnosis of MI
Rises in 3-12 hrs., Peaks at 18-24 hrs. and disappears by 48-72 hrs.
Useful for detection of reinfarction

A

Creatine Kinase isoenzymes (CK-MB)

28
Q

Diagnosis of MI
Rises in 24 hrs., peaks at 3-6 days and returns to baseline within 8-12 day

A

Lactate dehydrogenase (LDH)

29
Q

In adults what is the most common cause of Sudden Cardiac Death?

A

CAD

30
Q

In younger victims what is the most common cause of sudden cardia death?

A

Cardiomyopathy and myocarditis

31
Q

What is the ultimate mechanism of SCD?

A

lethal arrhythmia - left ventricular fibrillation

31
Q

What is the ultimate mechanism of SCD?

A

lethal arrhythmia - left ventricular fibrillation

32
Q

Does hyaline or hyperplastic arteriosclerosis cause retinal damage?

A

Hyperplastic Arteriolosclerosis > cotton wool spools

32
Q

Does hyaline or hyperplastic arteriosclerosis cause retinal damage?

A

Hyperplastic Arteriolosclerosis > cotton wool spools

33
Q

Acute Cor Pulmonale is due to ?

A

Due to massive pulmonary emboli
Right ventricle is dilated but no hypertrophy

34
Q

Chronic Cor Pulmonale is due to ?

A

• COPD – Most common cause
• Others – Idiopathic pulmonary fibrosis, cystic
fibrosis or marked obesity

35
Q

Cor Bovinum (cow’s heart) is seen in which pathology?

A

Syphilitic Aneurysm
-Fibrosis of the vascular wall
“tree bark appearance”
-Wrinkling of aortic intima due to secondary atherosclerosis may narrow or occlude coronary ostia
-Aortic valve ring dilation → valvular insufficiency
-Aortic valvular insufficiency→ massive hypertrophy of left
ventricle referred as
(cow’s heart)

36
Q

Which aneurysm is associated w/ autosomal dominant polycystic kidney disease
(ADPKD)

A

Berry Aneurysms

37
Q

Osler’s nodes, Janeway lesions, Roth spots are uncommon but pathognomonic for _____?

A

Infective endocarditis

37
Q

Osler’s nodes, Janeway lesions, Roth spots are uncommon but pathognomonic for _____?

A

Infective endocarditis

38
Q

What type of hypersensitivity is Rheumatic fever?

A

Type 2 Hypersensitivity

39
Q

Which valves are usually involved with Endocarditis?

A

Mitral and Aortic

40
Q

Which valve is usally involved wtih Acute Rheumatic Fever?

A

Mitral Valve

40
Q

Which valve is usally involved wtih Acute Rheumatic Fever?

A

Mitral Valve

41
Q

• Distinctive lesions in the heart – Aschoff bodies (pathognomonic feature)
• Composed of foci of T lymphocytes, occasional plasma cells, and plump activated
macrophages called Anitschkow cells
• Small (1-2 mm) vegetations overlying these foci plus along lines of closure: Verrucae

This is seen in which condition?

A

Acute Rheumatic Fever

42
Q

Triad associated w/ mitral valve prolapse

A

1.) scoliosis
2.) high arched palate
3.) Mital Valve prolapse

42
Q

Triad associated w/ mitral valve prolapse

A

1.) scoliosis
2.) high arched palate
3.) Mital Valve prolapse

43
Q

INFECTED VEGETATIONS is composed of?

A

FIBRIN DEPOSITION + PLATELET AGGREGATION + MICROBIAL PROLIFERATION

44
Q

What is the most common cause of arrhythmias?

A

Ischemic Heart Disease that either directly causes damage to the conduction tissue or causes a dilation of the heart walls and alters electrical conduction

45
Q

Certain maneuvers like Valsalva maneuver and carotid massage could be helpful in diagnosing with arrhythmia?

A

Supraventricular arrhythmia

46
Q

Sudden Cardiac Death
Definition
Cause
Management

A

Definition: sudden death due to fatal arrhythmia
Cause: Most important = acute coronary syndrome; younger patients = non-atherosclerotic conditions
Management: pacemaker or automatic cardioverter defibrillator

47
Q

Sinus bradycardia

A

Rate < 60/min

48
Q

Sinus tachycardia

A

Rate >100/min

49
Q

First-degree atrioventricular block
EKG findings
Cause

A

a. ECG:prolongedPRinterval>0.2sec(200ms).
b. Causes: excess vagal tone, aging, ischemia, cardiomyopathy

If R is far for P then you have first degree

50
Q

Second-degree block - TypeI(MobitzI/Wenckebach) - atrioventricular block
EKG findings
Cause

A

i. ECG: progressive prolongation of the PR interval until a beat is dropped
ii. Block is above the bundle of His
iii. Causes: myocardial infarction, digitalis toxicity, excess vagal
tone etc.

Longer, longer, longer drop! then you have wenkebach

51
Q

Second degree - (MobitzII) block atrioventricular block
EKG findings
Cause

A

i. ECG: sudden occurrence of blocked beat without progressive prolongation of PR interval.
ii. Block is below the bundle of His
iii. Causes: myocardial infarction, degeneration of His-Purkinjee system
iv. Can present with sudden asystole or ventricular tachycardia or
fibrillation that causes circulatory arrest (Adam-Stoke
syndrome)

52
Q

Third-degree block atrioventricular block
EKG findings
Cause

A

a. ECG: all p waves are blocked and ventricles driven by an ectopic focus. No correlation between P waves and QRS complex
b. Causes: degenerative changes, infarction, any infectious of inflammatory processes, digitalis toxicity
c. Common to seeAdam-Stokesyndrome

53
Q

ECG: regular rhythm with usually a 2:1 block i.e. atrial beats at around 250/min and ventricles beats at 125/min. so every 3rd P wave gets conducted. The classic description is for the flutter waves is ‘saw-tooth appearance’.
Causes: alcohol, COPD, thyrotoxicosis, pulmonary embolism etc.

A

Atrial Flutter

53
Q

ECG: regular rhythm with usually a 2:1 block i.e. atrial beats at around 250/min and ventricles beats at 125/min. so every 3rd P wave gets conducted. The classic description is for the flutter waves is ‘saw-tooth appearance’.
Causes: alcohol, COPD, thyrotoxicosis, pulmonary embolism etc.

A

Atrial Flutter

53
Q

ECG: regular rhythm with usually a 2:1 block i.e. atrial beats at around 250/min and ventricles beats at 125/min. so every 3rd P wave gets conducted. The classic description is for the flutter waves is ‘saw-tooth appearance’.
Causes: alcohol, COPD, thyrotoxicosis, pulmonary embolism etc.

A

Atrial Flutter

54
Q

ECG will show wide, bizarre QRS complexes and the rate is usually >120/min.

A

VENTRICULAR TACHYCARDIA - Monomorphic type

55
Q

EKG shows aternating and undulating rotations of the QRS complexes around the baseline

A

VENTRICULAR TACHYCARDIA - Polymorphic / Torsade de Pointes type

56
Q

ECG: Rapid ventricular rate > 200/min, irregularly irregular (QRS) fibrillation waves.
Clinical Presentation: Sudden Cardiac Death, Asystole
Causes: Ischemic Heart disease (Post-MI), Valvular Heart disease, Myocarditis and also other arrhythmias may transform/evolve into VF

A

VENTRICULAR FIBRILLATION (VF):

Term 4 CRS (2 decks)

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