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Pathology Unit 4 > Cardiac-valvular disorders > Flashcards

Cardiac-valvular disorders Flashcards

1
Q

what pathogen causes acute rheumatic fever?

A

pharyngitis due to group A B-hemolytic steptococci

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2
Q

when does someone get acute rheumatic fever?

A

2-3 weeks after an episode of strep throat

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3
Q

why does strep go onto cause acute rheumatic fever?

A

molecular mimicry

bacterial M protein resembles proteins in human tissue

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4
Q

what are the minor criteria for acute rheumatic fever?

A

fever and elevated ESR

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5
Q

what are the 5 major criteria of acute rheumatic fever?

A
  1. migratory polyarthritis (J=joint)
  2. pancarditis (O looks like a heart)
  3. subcutaneous nodules (N=nodules)
  4. erythema marginatum (E=erythema)
  5. syndenham chorea (S=syndenham)
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6
Q

what characterizes the endocarditis (part of pancarditis) seen in acute rheumatic fever?

A

small vegetations along the lines of closure that lead to regurg

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7
Q

in what disease do you see anitschkow cells

A

in myocarditis due to acute rheumatic fever

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8
Q

what is the most common cause of death during the acute phase of rheumatic fever?

A

myocarditis

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9
Q

what does pericarditis cause (symptoms) in a person with acute rheumatic fever?

A

friction rub and chest pain

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10
Q

what is the following describing? when is this seen?

“annular, non-puritic rash with erythematous borders commonly seen on trunk and limbs”

A

erythema marginatum seen in acute rheumatic fever

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11
Q

what is syndenham chorea that is seen in acute rheumatic fever

A

rapid, involuntary muscle movements

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12
Q

what is chronic rheumatic HD

A

valve scarring that arises due to rheumatic fever

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13
Q

what characterizes the valvular scarring in chronic rheumatic HD

A

stenosis with classic “fish mouth” apperance

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14
Q

what is the most common valve that is affected in chronic rheumatic HD

A

mitral (2nd valve would be aortic where you see fusion of commissures)

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15
Q

what classically causes aortic stenosis

A

wear and tear

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16
Q

what congenital issue puts a person at higher risk for aortic stenosis

A

a bicuspid aortic valve

17
Q

how can you separate chronic rheumatic HD vs “wear and tear” as the cause of aortic stenosis?

A

chronic rheumatic HD- coexisting mitral stenosis and fusion of aortic valve comissures

18
Q

wha sounds are heard in aortic stenosis

A

systolic ejection click followed by crescendo-decrescendo murmur

19
Q

what are 2 causes of aortic regurg? what is most common?

A

aortic root dilation (most common) or valve damage

20
Q

what are 2 causes of aortic root dilation

A

syphilitic aneurysm and aortic dissection

21
Q

what is 1 example of what could cause valve damage

A

infectious endocarditis

22
Q

what is heard with aortic regurg

A

early, blowing diastolic mumur

23
Q

what is “hyperdynamic circulation” that is seen in aortic regurg?

A

increased pulse pressure

diastolic pressure decreased and systolic pressure increased (due to increased SV)

24
Q

what is mitral valve prolapse

A

ballooning of mitral valve into L. atrium during systole

25
Q

what causes a mitral valve prolapse?

A 
myxoid degeneration (accumulation of ground substance) of the valve making it floppy
could be due to marfans or Ehlers-Danlos but usually unknown
26
Q

what is heard in mitral valve prolapse

A

incidental mid-systolic click followed by regurg murmur

27
Q

what action makes the mitral valve prolapse click and murmer softer? why?

A

squatting bc it increases systemic resistance will decrease L. ventricular emptying

28
Q

what are the rare complications seen with mitral valve prolapse? (3)

A
  1. infectious endocarditis
  2. arrhythmia
  3. severe mitral regurg
29
Q

when do you hear this type of murmur:

“holosystolic blowing murmur”

A

mitral regurg

30
Q

what 2 things make a mitral regurg murmur louder? give reasons for both

A
  1. squatting-increased systemic resistance will decrease L ventricular emptying
  2. expiration-increases return to L. atrium
31
Q

what is most common cause of mitral stenosis

A

chronic rheumatic valve disease

32
Q

what is heard with mitral stenosis

A

opening snap followed by diastolic murmur

33
Q

what 3 things occur due to L. atrium dilation secondary to mitral stenosis

A
  1. pulmonary congestion and edema
  2. pulmonary HTN and R. sided HF
  3. atrial fibrillation & mural thrombus risk
34
Q

what are some causes of mitral regurg?

A
  1. mitral valve prolapse (usually)
  2. LV dilation
  3. infective endocarditis
  4. acute rheumatic HD
  5. papillary muscle rupture after MI
35
Q

what are 3 complications of aortic stenosis

A
  1. concentric LV hypertrophy
  2. angina and syncope with exercise
  3. microangiopathic hemolytic anemia
36
Q

in what valvular defect do you see the following
water hammer pulse
pulsating nail bed- quincke pulse
head bobbing

A

aortic regurg

Pathology Unit 4 (17 decks)

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