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CPR II Exam 1 > Cardiac Pathology (Part 2) > Flashcards

Cardiac Pathology (Part 2) Flashcards

1
Q

what is the most common type of atrial septal defect?

A

ostium secundum ASD

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2
Q

what is the most common VSD?

A

membranous

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3
Q

what does left-to-right shunt lead to?

A

eisenmenger syndrome

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4
Q

what are the four principal features of tetralogy of fallot?

A

VSD, right ventricular hypertrophy, subpulmonic stenosis, overriding aorta

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5
Q

what drives the degree of symptoms in tetralogy of fallot?

A

the degree of stenosis

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6
Q

what are some classic symptoms of kids with tetralogy of fallot?

A

tet spells, compensatory squatting; two murmurs: holosystolic from the VSD and systolic ejection murmur from the subpulmonic stenosis

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7
Q

what is the xray finding consistent with tetralogy of fallot?

A

boot shaped heart

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8
Q

how can one stay alive with a tricuspid atresia?

A

ASD and VSD must be present

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9
Q

what is coarctation of the aorta associated with?

A

1) turner syndrome 2) additional cardiovascular abnormalities (bicuspid aortic valve, berry aneurysm)

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10
Q

how does the infantile form of coarctation of the aorta present?

A

cyanosis at birth of lower half of the body

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11
Q

how does the adult form of coarctation of the aorta present?

A

upper body: hypertension; lower body: hypotension, weak pulses; rib notching

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12
Q

how can congenital aortic stenosis present?

A

hypoplastic (small) valves; dysplastic (nodular) valves; abnormal cusp number; results in LVH

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13
Q

where does a paradoxical embolism of a PDA involve?

A

the lower body

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14
Q

when is one at risk for a paradoxical embolism?

A

if there is a transient increase in right pressure, bright right –> left shunt

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15
Q

what is the most common genetic cause of congenital heart disease?

A

down syndrome

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16
Q

what are the most common heart defects seen in down syndrome patients?

A

septal defects: atrioventricular > ventricular> atrial

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17
Q

what are the cardiovascular effects of marfan syndrome?

A

aortic aneurysm and dissection

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18
Q

what is the mechanism of marfan syndrome?

A

fibrillin 1 mutation, excessive TGF-beta activity, which causes increased metalloprotease (degrades elastin)

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19
Q

what causes Digeorge syndrome?

A

a deletion in chromosome 22

20
Q

what are the characteristics of digeorge syndrome?

A

CATCH 22: cardiac abnormality, abnormal facies, thymic aplasia, cleft palate, hypocalcemia

21
Q

what heart abnormality is associated with digeroge?

A

conotruncal heart abnormalities (TOF, transposition of the great arteries), ASD, VSD

22
Q

what type of hypertrophy is seen in hypertensive heart disease?

A

concentric

23
Q

how does hypertensive heart disease also lead to systolic dysfunction?

A

there is a lack of vascularization with muscle–> ischemia–> failure

24
Q

how does cor pulmonale present?

A

initially cor pulmonale shows dilation of the right ventricle; later there is compensatory hypertrophy of the right ventricle

25
Q

what is the most common valve abnormality?

A

calcific aortic stenosis

26
Q

what causes the calcifications in calcific aortic stenosis?

A

chronic progressive injury driven by similar factors which cause atherosclerotic disease (chronic HTN and hyperlipidemia)

27
Q

when does calcific aortic stenosis typically manifest?

A

7-9th decade of life

28
Q

a bicuspid aortic valve is caused by what?

A

1) acquired (typically rheumatic heart disease)

2) congenital abnormality

29
Q

what is the effect of bicuspid aortic valve?

A

there is an accelerated course of calcific aortic stenosis; the bicuspid valves may become incompetent: aortic valve porlapse

30
Q

having valve abnormalities predisposes individuals to what?

A

infective endocarditis

31
Q

what effect does calcific aortic stenosis have on the heart?

A

it increases LV pressure–> concentric left ventricular hypertrophy

32
Q

what are the signs and symptoms of calcific aortic stenosis?

A

systolic murmur, syncope, angina, CHF

33
Q

what is mitral annular calcifications?

A

calcific deposits in the fibrous annulus; usually presents in females >60 especially those with mitral valve prolapse

34
Q

how does mitral annular calcification affect the heart?

A

arrhythmias (heart block, sudden death)

35
Q

what is mitral valve prolapse?

A

the valve leaflets prolapse back into the left atrium

36
Q

what does the histology show in cases of mitral valve prolapse?

A

thickened and rubbery valve with myxomatous degeneration caused by increased proteoglycan deposits; hooding of the mitral leaflets

37
Q

how does mitral valve prolapse present?

A

asymptomatic with a mid systolic click; dyspnea

38
Q

how do you confirm suspected case of rheumatic fever?

A

test for antibodies against streptolysin O and DNase B

39
Q

what are the signs and symptoms of rheumatic fever?

A

migratory polyarthritis, subcutaneous nodules, erythema marginatum, and chorea

40
Q

what is the histology of acute rheumatic heart disease?

A

aschoff bodies with anitschkow cells

41
Q

what are the characteristics of cute rheumatic heart disease?

A

pericarditis, myocarditis, endocarditis, valvulitis, MacCallum plaques

42
Q

what are the characteristics of chronic rheumatic heart disease?

A

valvular leaflet thickening, short chordae tendineae, fusion, regurgitation

43
Q

how does mitral stenosis sound on auscultation?

A

diastolic rumbling murmur

44
Q

what can mitral stenosis and mitral regurgitation lead to?

A

left atrial enlargement–> leads to a fib

45
Q

what are the signs of infective endocarditis?

A

splinter hemorrhages janeway lesions, osler nodes, and roth spots

CPR II Exam 1 (13 decks)

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