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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…….?

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
Causative organism of rheumatic fever?
Group A strep (pyogenes)
26
Histology for rheumatic fever?
Vegetations (verrucae) Aschoff bodies (small giant cell granulomas) Antischow myocytes (regenerating myocytes)
27
Jones major criteria for rheumatic fever?
CASES ``` Cariditis Arthritis Subcutaneous nodules Erythema marginatum Sydenham's chorea ```
28
Treatment for rheumatic fever?
BenPen *erythromycin in pen allergic
29
Maranitic vegetations caused by?
Hypercoagulable state eg DIC
30
How many weeks of antibiotics for infective endocarditis?
4-6 weeks
31
Pansystolic Radiates to axilla Loudest at apex Associated with AF
Mitral regurgitation
32
Rumbling mid diastolic murmur with opening snap and tapping apex. Associated with malar flush
Mitral stenosis
33
Diastolic murmur with a collapsing pulse and wide pulse pressure. Heard best at LL sternal edge
Aortic regurgitation
34
Austin flint murmur?
Mid diastolic murmur caused by regurgitant jet in AR
35
Ejection systolic murmur radiating to carotids associated with narrow pulse pressure and a slow rising pulse
Aortic stenosis
36
Most common cause of mitral regurgitation?
Infective endocarditis
37
Most common cause of mitral stenosis?
Rheumatic fever
38
Most common cause of aortic regurgitation?
Infective endocarditis
39
Most common cause of aortic stenosis?
Senile calcification
40
Aortic stenosis secondary to a congenital bicuspid aortic valve seen in?
Williams syndrome
41
Mid systolic click with a late diastolic murmur?
Barlow syndrome *in young women due to myxomatous degeneration
42
CXR findings for pericardial effusion?
Large globular heart Echo free border (Low voltage QRS)
43
Kussmaul's sign?
Raised JVP on inspiration Sign of constrictive pericarditis
44
Becks triad of tamponade?
Raised JVP Low BP Quiet heart sounds
45
Treatment for tamponade
Emergency Urgent pericardiocentesis
46
Which flow is atherogenic?
Turbulent flow with low shed/oscillatory stress *mostly at Ostia (branches of major vessels)

Histopath (5 decks)

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