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Histopath > Cardiac Pathology > Flashcards

Cardiac Pathology Flashcards

1
Q

Which part of aorta more prone to atherosclerosis?

A

Abdominal more than thoracic

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2
Q

Process of atherosclerosis?

A

Endothelial injury
Trapping of LDL in intima
LDL oxidised causing inflam
Oxidised LDL taken up by macrophages (foam cells)
Foam cell apoptosis leaves plaque core with high cholesterol
Vascular SM produces fibrous cap

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3
Q

Modifiable risk factors for atherosclerosis?

A

T2DM

Hypertension

Hyperlipidaemia

Smoking

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4
Q

Non modifiable RF for atherosclerosis?

A

Male gender

Age

Family history

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5
Q

Complications of MI?

A

“Death passing praaed street”

Death
Pump failure
Pericarditis
Rupture
Arrhythmias
Aneurysm
Emboli (LV mural thrombus)
Dresslers syndrome
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6
Q

Evolution of MI?

0-6hrs?

A

No histological changes, normal Ck-MB

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7
Q

Evolution of MI?

6-24 hrs?

A

Loss of nuclei, homogenous cytoplasm, necrosis

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8
Q

Evolution of MI?

1-4 days?

A

Polymorph and macrophage infiltration

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9
Q

Evolution of MI?

5-10 days?

A

Removal of debris

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10
Q

Evolution of MI?

1-2 weeks?

A

Granulation tissue, new vessels form, myofibroblasts produce collagen

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11
Q

Evolution of MI?

Was-months?

A

Strengthening, decellularisation of scar tissue

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12
Q

High output heart failure occurs when?

A

Increased demand

*A anemia
T thyroroxicosis
P pregnancy

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13
Q

Low output cardiac failure?

A

Decreased cardiac output due to increased preload (eg AR, MR), increased afterload (AS, HTM, HOCM) or pump failure (cardiomyopathy)

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14
Q

LV heart failure results in?

A

Pooling blood in pulmonary circulation

  • SOB
  • pink frothy sputum
  • wheeze
  • orthopnoea
  • PND
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15
Q

RV failure results in?

A

Pooling of blood systemically

  • peripheral oedema
  • ascites
  • facial oedema
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16
Q

Heart failure associated with cirrhosis?

A

Nutmeg liver

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17
Q

NYHA stages?

A

1 no limit

2 comfortable at rest, SOB with exertion

3 marked limitation in normal activity

4 SOB at rest

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18
Q

Dilated cardiac myopathy involves impaired …..?

A

Contraction

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19
Q

Restrictive cardiomyopathy involves impaired…….?

A

Filling

20
Q

Causes of dilated cardiomyopathy?

A 
D muscular dystrophy
I infection (mycocarditis)
L late pregnancy (peripartum)
AI (SLE)
T oxins - alcohol
E ndo- thyroroxicosis
21
Q

Restrictive cardiomyopathy?

A

miSSHAPEN

Sarcoidosis
Systemic sclerosis
Haemochromatosis
Amyloidosis
Primary endomyocardial fibrosis
Eosinophilia
Neoplasia
22
Q

Inheritance of HOCM?

A

Autosomal dominant?

23
Q

Mutation?

A

Beta MHC gene

(403 Arg-Gln)

Associated with mutations in troponin T and MYBP-C

24
Q

Myocyte loss with fibrofatty replacement?

A

Arrhythmogenic RV cardiomyopathy

25
Q

Causative organism of rheumatic fever?

A

Group A strep (pyogenes)

26
Q

Histology for rheumatic fever?

A

Vegetations (verrucae)

Aschoff bodies (small giant cell granulomas)

Antischow myocytes (regenerating myocytes)

27
Q

Jones major criteria for rheumatic fever?

A

CASES

Cariditis
Arthritis
Subcutaneous nodules
Erythema marginatum
Sydenham's chorea
28
Q

Treatment for rheumatic fever?

A

BenPen

*erythromycin in pen allergic

29
Q

Maranitic vegetations caused by?

A

Hypercoagulable state eg DIC

30
Q

How many weeks of antibiotics for infective endocarditis?

A

4-6 weeks

31
Q

Pansystolic

Radiates to axilla

Loudest at apex

Associated with AF

A

Mitral regurgitation

32
Q

Rumbling mid diastolic murmur with opening snap and tapping apex.

Associated with malar flush

A

Mitral stenosis

33
Q

Diastolic murmur with a collapsing pulse and wide pulse pressure. Heard best at LL sternal edge

A

Aortic regurgitation

34
Q

Austin flint murmur?

A

Mid diastolic murmur caused by regurgitant jet in AR

35
Q

Ejection systolic murmur radiating to carotids associated with narrow pulse pressure and a slow rising pulse

A

Aortic stenosis

36
Q

Most common cause of mitral regurgitation?

A

Infective endocarditis

37
Q

Most common cause of mitral stenosis?

A

Rheumatic fever

38
Q

Most common cause of aortic regurgitation?

A

Infective endocarditis

39
Q

Most common cause of aortic stenosis?

A

Senile calcification

40
Q

Aortic stenosis secondary to a congenital bicuspid aortic valve seen in?

A

Williams syndrome

41
Q

Mid systolic click with a late diastolic murmur?

A

Barlow syndrome

*in young women due to myxomatous degeneration

42
Q

CXR findings for pericardial effusion?

A

Large globular heart

Echo free border

(Low voltage QRS)

43
Q

Kussmaul’s sign?

A

Raised JVP on inspiration

Sign of constrictive pericarditis

44
Q

Becks triad of tamponade?

A

Raised JVP

Low BP

Quiet heart sounds

45
Q

Treatment for tamponade

A

Emergency

Urgent pericardiocentesis

46
Q

Which flow is atherogenic?

A

Turbulent flow with low shed/oscillatory stress

*mostly at Ostia (branches of major vessels)

Histopath (5 decks)

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