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Pathoma > Cardiac Pathology > Flashcards

Cardiac Pathology Flashcards

1
Q

Stable angina

A

.Chest pain with exertion or emotional stress
.due to atherosclerosis (>70% stenosis )
. Represent reversible injury

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2
Q

Stable angina EKG shows

A

ST-segment depression (subendocardial ischemia)

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3
Q

Unstable angina

A

.Chest pain occur at rest
.Due to rapture of atherosclerotic plaque with thrombosis and **incomplete occlusion of coronaries
.Represent reversible injury

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4
Q

Unstable angina EKG shows

A

ST-segment depression

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5
Q

Prinzmetal angina

A

Episodic Chest pain unrelated to exertion

Represent reversible injury

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6
Q

Prinzmetal angina EKG shows

A

ST-segment elevation (due to transmural ischemia)

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7
Q

Myocardial infarction

A

.Necrosis of cardiac myocytes

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8
Q

MI occur due to

A

Rupture of atherosclerotic plaque with thrombosis and **complete occlusion of coronary artery

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9
Q

Other causes of MI include

A

Vasospasm , emboli and vasculitis

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10
Q

MI clinical features

A

Severe crushing chest pain (>20min)
Diaphoresis
Dyspnea

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11
Q

MI usually involve

A

The left ventricle

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12
Q

Cardiac enzymes include

A 
Troponin I (the most sensitive and specific marker )
CK-MB (useful for detecting reinfarction)
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13
Q

MI treatment

A 
Aspirin/heparin
Supplemental O2
Nitrate 
B blocker 
ACE inhibitor
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14
Q

Fibrinlysis / angioplasty complication

A

Result in 1.contraction band necrosis

2.Reperfusion injury

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15
Q

Microscopic changes during MI

………1Day……………..1week…………….1month

A

Coagulative necrosis /1day/inflammation /1week/granulation tissue/1month/Scar formation

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16
Q

Complication of MI during coagulative necrosis phase

A

Arrhythmia

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17
Q

Complication of MI during neutrophilic infiltration

A

Fibrinous pericarditis

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18
Q

Complication of MI during macrophages infiltration

A 
Rupture of ventricular free wall (lead to cardiac tamponade) 
Interventricular septum (shunt)
papillary muscle (insufficiency)
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19
Q

Complication of MI during Scar phase

A

Aneurysm , mural thrombus , **Dressler syndrome(autoimmune pericarditis)

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20
Q

Fibrinous pericarditis only seen with

A

Transmural infarction

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21
Q

Sudden cardiac death usually due to

A

Fatal ventricular arrhythmia

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22
Q

Most common etiology of SCD is

A

Acute ischemia

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23
Q

Causes of left sided heart failure

A 
Ischemia 
MI
Dilated cardiomyopathy 
Restrictive cardiomyopathy 
HTN
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24
Q

Consequences of HF

A

Pulmonary congestion

Decreased forward perfusion

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25
Q

Right sided HF most commonly due to

A

Left failure

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26
Q

Other important causes of Right sided HF

A

Left to right shunt , chronic lung disease

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27
Q

Right sided HF clinical features

A

Jagular venous distension
Painful hepatosplenomegally may lead to cardiac cirrhosis
Dependent pitting edema

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28
Q

Most common congenital heart defect is

A

VSD , associated with **fetal alcohol syndrome

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29
Q

VSD small defects are ………………

VSD large defects can lead to ……………….

A

Asymptomatic , Eisenmenger syndrome

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30
Q

Most common type of ASD is

A

Ostium secundum

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31
Q

Ostium primum type of ASD is associated with

A

**Down syndrome

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32
Q

ASD splits

A

S2 on auscultation

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33
Q

PDA associated with

A

Congenital rubella

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34
Q

Left to right shunts include

A

VSD , ASD and patent ductus arteriosus

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35
Q

PDA symptoms include

A
  1. Holosystolic machine-like murmur

2. **Eisenmenger syndrome(reversal of shunt ) result in lower extremity cyanosis

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36
Q

Treatment of PDA

A

Indomethacin (decrease PGE, result in PDA closure)

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37
Q

Tetralogy of Fallot is

A

Stenosis of RV outflow
Right ventricular hypertrophy
VSD
Aorta overrides the VSD

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38
Q

TOF patients learn to squat in response to cyanotic spell

Result in

A

Increased arteriolar vascular resistance decrease shunting

Allow more blood to reach the lung

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39
Q

Boot shaped heart on x-ray associated with

A

TOF

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40
Q

Transposition of great vessels definition

A

Pulmonary artery arises from LV and aorta arises from RV

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41
Q

Transposition of great vessels associated with

A

****Maternal diabetes

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42
Q

Creation of shunt after birth is required for survival of

A

Transposition of great vessels patients by PGE until surgery

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43
Q

Single large vessel arise from both ventricles is

A

Truncus arteriosus

44
Q

Coarctation of aorta has two forms

A

Infantile and adult form

45
Q

Infantile form fo coarctation of aorta

A

Associated with PDA
Distal to the aortic arch but proximal to the PDA
Present as lower extremity cyanosis
Associated with ***Turner syndrome

46
Q

Adult form of coarctation of aorta

A

Not associated with PDA
Coarctation distal to the aortic arch
Present as HTN in UE and hypotension in LE
Associated with ****bicuspid aortic valve

47
Q

Engorged arteries cause *****notching of ribs on X-ray occur with

A

Adult form of coarctation of aorta

48
Q

Acute rheumatic fever definition

A

Systemic complication of pharyngitis due to group A beta haemolytic streptococci

49
Q

RF caused by

A

***Molecular mimicry ; bacterial M protein resemble human tissues

50
Q

Acute RF affect

A

Children 2-3weeks after strep throat

51
Q

RF JONES major criteria

A

Polyartheritis , pancarditis , subcutaneous nodules ,Erythema marginatum , Sydenham chorea

52
Q

Fusion of the aortic valve commissures (fish mouth appearance) result in stenosis Occur with

A

Rheumatic Fever

53
Q

Aortic stenosis usually from

A

Wear and tear (bicuspid aortic valve increase risk)

54
Q

………………………………………………………. distinguish rheumatic disease from wear and tear

A

Coexisting mitral stenosis and fusion of aortic valve commissure

55
Q

………………………………………………………. distinguish rheumatic disease from wear and tear

A

Coexisting mitral stenosis and fusion of aortic valve commissure

56
Q

Hallmark of aortic stenosis

A

Systolic ejection click followed by crescendo-decrescendo murmur

57
Q

Hallmark of aortic stenosis

A

Systolic ejection click followed by crescendo-decrescendo murmur

58
Q

Complications of aortic stenosis

A

Concentric left ventricular hypertrophy
Angina and syncope with exercise
Microangiopathic haemolytic anemia

59
Q

Aortic regurgitation definition

A

Back flow of blood from aorta into LV during diastole

60
Q

Aortic regurgitation arises due to

A

Aortic root dilation (syphilitic aneurysm ) or valve damage (IE)

61
Q

Aortic regurgitation clinical features

A

Early blowing diastolic murmur
Bounding pulses ; pulsating nail beds and head bobbing(**hyperdynamic circulation)
LV delation and eccentric hypertrophy

62
Q

Complications of aortic stenosis

A

Concentric left ventricular hypertrophy
Angina and syncope with exercise
Microangiopathic haemolytic anemia

63
Q

Aortic regurgitation definition

A

Back flow of blood from aorta into LV during diastole

64
Q

Aortic regurgitation arises due to

A

Aortic root dilation (syphilitic aneurysm ) or valve damage (IE)

65
Q

Mitral valve prolapse definition

A

Ballooning of mitral valve into left atrium during systole

66
Q

Complications of aortic stenosis

A

Concentric left ventricular hypertrophy
Angina and syncope with exercise
Microangiopathic haemolytic anemia

67
Q

Aortic regurgitation definition

A

Back flow of blood from aorta into LV during diastole

68
Q

Aortic regurgitation arises due to

A

Aortic root dilation (syphilitic aneurysm ) or valve damage (IE)

69
Q

Aortic regurgitation clinical features

A

Early blowing diastolic murmur

Bounding pulses

70
Q

Aortic regurgitation definition

A

Back flow of blood from aorta into LV during diastole

71
Q

Aortic regurgitation arises due to

A

Aortic root dilation (syphilitic aneurysm ) or valve damage (IE)

72
Q

Mitral valve prolapse definition

A

Ballooning of mitral valve into left atrium during systole

73
Q

Mitral valve prolapse due to

A

Myxoid degeneration in valve making it floppy

74
Q

Mitral valve prolapse clinical feature

A

Mid-systolic click followed by regurgitation murmur

75
Q

Mitral valve prolapse clinical feature

A

Mid-systolic click followed by regurgitation murmur

76
Q

Mitral regurgitation definition

A

Reflux of blood from LV into LA during systole

77
Q

Mitral regurgitation Usually arises as a complication of

A

Mitral valve prolapse

78
Q

Mitral regurgitation clinical feature

A

Holosystolic blowing murmur “louder with squatting or expiration”

79
Q

Mitral regurgitation Usually arises as a complication of

A

Mitral valve prolapse

80
Q

Mitral valve prolapse clinical feature

A

Mid-systolic click followed by regurgitation murmur

81
Q

*****Chronic RHD create ……………. while acute RHD create ………………..

A

Mitral stenosis , mitral regurgitation

82
Q

Mitral stenosis clinical feature

A

Opening snap followed by diastolic rumble (طنين)

83
Q

Mitral stenosis clinical feature

A

Opening snap followed by diastolic rumble

84
Q

*****Chronic RHD create ……………. while acute RHD create ………………..

A

Mitral stenosis , mitral regurgitation

85
Q

Mitral stenosis leads to

A

Volume overload and dilatation of the LA
Pulmonary congestion
Pulmonary HTN
Atrial fibrillation

86
Q

Mitral stenosis leads to

A

Volume overload and dilatation of the LA
Pulmonary congestion
Pulmonary HTN
Atrial fibrillation

87
Q

Most common overall cause cause of infective endocarditis is

A

S.viridans (infect previously damaged valves)

88
Q

Most common cause of IE in drug abuse

A

Staph aureus ( infect tricuspid)

89
Q

Endocarditis of prosthetic valve is caused by

A

S.epidermidis

90
Q

Endocarditis in patients with underlying colorectal carcinoma caused by

A

****S.bovis

91
Q

Endocarditis with negative blood cultures include

A

HACEK organisms ( Hemophilus, Actinobacillus , cardiobacterium ,Eikenella , Kingella)

92
Q

Infective Endocarditis clinical features

A 
Fever 
Murmur 
Janeway lesions
Osler nodes (painful) 
Anemia of chronic disease
93
Q

Non bacterial Thrombotic endocarditis definition

A

Sterile vegetations that arise with hypercoagulable state or underlying adenocarcinoma

94
Q

Sterile vegetation associated with SLE

Vegetations present on both sides of mitral valve

A

****Libman-sacks endocarditis

95
Q

Most common form of cardiomyopathy

A

Dilated cardiomyopathy

96
Q

Dilated cardiomyopathy results in ……………dysfunction lead to biventricular CHF

A

Systolic

97
Q

Dilated cardiomyopathy complications include

A

Mitral and tricuspid valve regurgitation , and arrhythmia

98
Q

Causes of Dilated cardiomyopathy include

A 
Idiopathic (most commonly )
Genetic mutation 
Myocarditis (Coxsackie B virus )
*****Alcohol abuse 
Drugs 
*****pregnancy
99
Q

Cause of Hypertrophic cardiomyopathy

A

****Genetic mutation in sarcomere protein (most commonly AD)

100
Q

A common cause of sudden death in young athletes

A

Hypertrophic cardiomyopathy (by ventricular arrhythmia )

101
Q

Hypertrophic cardiomyopathy biopsy

A

Myofiber hypertrophy with *****disarray

102
Q

Causes of Resrtictive cardiomyopathy

A 
Amyloidosis 
Sarcoidosis 
Hemochromatosis 
Endocardial fibroelastosis (children)
Loeffler syndrome
103
Q

Classic finding of Restrictive cardiomyopathy

A

Low voltage EKG , diminished QRS amplitudes

104
Q

Most common primary cardiac tumour in adults

A

Myxoma (benign mesenchymal proliferation )

105
Q

Myxoma present as

A

Pedunculated mass in the left atrium

Causes syncope due to obstruction of mitral valve

106
Q

Rhabdomyoma associated with

A

***Tuberous sclerosis

107
Q

Most common primary cardiac tumour in children is

A

Rhabdomyoma

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