Cardiac Pathology

Question 1

How much after myocardial infarction occurs can you see coagulative necrosis?

Answer 1

4-24 hours

Question 2

At 28 days after myocardial infarction what do you expect to see microscopically?

Answer 2

Granulation tissue

Question 3

What finding microscopically do you expect to see on a “early” myocardial infarction?

Answer 3

Neutrophilic infiltrate

Question 4

Possible effects of cardiac rupture after myocardial infarction

Answer 4

• free wall ▶️ cardiac taponade
• interventricular septum ▶️ left to right shunt
• papillary muscle ▶️ mitral insufficiency

Question 5

Why is the Dressler syndrome?

Answer 5

Necrotic heart muscle ▶️ autoantibodies ▶️ cardiac self-antigens
Autoimmune type II reaction

Question 6

What finding at microscopic do you expect in acute rheumatic heart disease affecting myocardium?

Answer 6

Aschoff body ▶️ fibrinoid necrosis surrounded by anitschkow cells (macro), lymphocytes, plasma cells

Question 7

What are the MacCallum plaques?

Answer 7

Left atrial endocardial thickening

*endocardial affection of acute rheumatic heart disease

Question 8

What suggest a S. bovis bacteremia with or without endocarditis? What study should be done to them?

Answer 8

• underlying malignancy or premalignant lesions of the colon

- colonoscopy

Question 9

What type of congenital heart disease do you suspect if on chest x-ray show notching of the ribs?

Answer 9

Postductal coarctation of the aorta

*bone remodeling as a consequence of increased blood flow through the intercostal artery (collateral circulation supplied via internal mammary and intercostal arteries)

Question 10

Which clinical sign allow differentiate between preductal and postductal coarctation of the aorta?

Answer 10

Cyanosis in lower extremities

• preductal: cyanosis
• postductal: no cyanosis

Question 11

Develop right ▶️ left shunt after primarily left ▶️ right, because secondary pulmonary HTN. Reversal of shunt.

Answer 11

Eisenmenger syndrome

Question 12

What do the infants with transposition of the great arteries need to survive?

Answer 12

VSD, ASD, PDA

Question 13

How can you maintain PDA open?

Answer 13

Prostaglandin E2

Question 14

How do you close the PDA? What situation is needed?

Answer 14

• indometacin

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Question 15

What type of atrial septal defect is most common? And what type do the Down syndrome patients have?

Answer 15

• osteum secundum type

- osteum primum type

Question 16

What is the most common congenital heart defect? And the second one?

Answer 16

• bicuspid aortic valve

- ventricular septal defect

Question 17

Primary cardiomyopathy common cause of sudden death in young athlete

Answer 17

Hypertrophic cardiomyopathy

Asymmetrical septal hypertrophy or idiopathic hypertrophic subaortic stenosis

Question 18

What is the carcinoid heart disease? What is the cause?

Answer 18

• Right side endocardial and valvular fibrosis

- ⬆️ serotonin by carcinoid tumors

Question 19

What metabolite can you use to diagnose carcinoid heart disease?

Answer 19

⬆️ urinary 5-hydroxyindoleacetic acid (5-HIAA

Question 20

Genes possibly mutated in tuberous sclerosis complex? What cardiac tumor is associated?

Answer 20

• TSC1 (hamartin), TSC2 (tuberin)

- cardiac rhabdomyoma