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gen path 2 > cardio 2 > Flashcards

cardio 2 Flashcards

1
Q

what is CHF

A

failure of the heart to pump enough blood for the metabolic requirements of the organs.

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2
Q

CHF may be due to conditions inside or outside the heart

T/F?

A

TRUE

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3
Q

how does the body/heart compensate for CHF

A
  1. myocardial hypertrophy- cells get bigger but require more oxygen
  2. ventricular dilation
  3. physiological mechanisms- increased heart rate, increased catecholoamines, increase intravascular volume
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4
Q

causes of CHF

A
  1. ischemic heart disease.
  2. hypertension
  3. myocarditis
  4. cardiomyopathy
  5. valvular disease
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5
Q

manifestations of CHF

A
  1. right ventricular failure
  2. left ventricular failure
  3. left and/or right ventricular failure
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6
Q

right ventricular failure leads to what

A
  • Congestion of liver (zonal or “nutmeg” pattern) and spleen

- Edema of subcutaneous tissue (feet and ankles)

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7
Q

left ventricular failure leads to what

A

pulmonary edema

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8
Q

left and/or right ventricular failure leads to what

A
  • Cerebral hypoxia
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9
Q

T/F CHF due to left ventricular failure eventually leads to right ventricular failure

A

TRUE

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10
Q

what is congenital heart disease (defect)

A

Congenital heart defect (CHD) or congenital heart anomaly[2] is a defect in the structure of the heart and great vessels that is present at birth. Many types of heart defects exist, most of which either obstruct blood flow in the heart or vessels near it, or cause blood to flow through the heart in an abnormal pattern.

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11
Q

CHD may be caused what what two factors

A

environmental or genetics (chromosome abnormality)

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12
Q

two forms of CHD

A

cyanotic and noncyanotic

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13
Q

noncyanotic examples

A

A. Atrial septal defect – allows shunting between the atria
B. Ventricular septal defect – allows shunting between the ventricles
C. Patent ductus arteriosus – this should close within a few days after birth and connects the aorta and pulmonary artery

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14
Q

cyanotic exmaples

A
  1. tetralogy of fallout four anomalies 1) ventricular septal
    defect, 2) narrowing of right ventricular outflow, 3) overriding of the aorta over VSD and 4) right ventricular hypertrophy
  2. Transposition of the great arteries
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15
Q

Ishemic heart disease pathogenesis

A
  1. Narrowing of coronary arteries (usually at least 75%) by atherosclerosis (more than 90% of IHD)
  2. Coronary artery thrombosis initiated by fissure in the fibrous cap of an atherosclerotic plaque.
  3. other- hypotension, increased myocardial oxygen demand, decrease blood volume, reduced oxygen carrying capacity (anemia), reduced oxygenation (pneumonia, CHF),
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16
Q

3 types of IHD

A
  1. angina pectoralis
  2. acute myocardial infarction
  3. chronic IHD with CHF
  4. sudden cardiac death
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17
Q

angina pectoralis

A

“chest pain” of several minutes duration usually associated with exercise or emotional stress and relieved by rest. No myocardial necrosis occurs. In unstable angina, the episodes of chest pain become more frequent and the pain becomes more severe.

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18
Q

Acute Myocardial Infarction clinical presentation

A

chest pain, shortness of breath, nausea/vomiting, diaphoresis, low grade fever.

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19
Q

diagnosis of acute myocardial infarction

A

1) ECG changes

2) Elevation of serum enzymes (creatine kinase; CK-MB) and troponin derived from necrotic myocytes.

20
Q

Pathology of acute myocardial infarction

A 
coagulation necrosis (few hours), neutrophil infiltration 
(few days), granulation tissue (1 week), scar formation (wks-mos).
21
Q

treatment of acute myocardial infarction

A
  1. placement of stents to open the coronary arteries clogged by atherosclerotic plaques
  2. coronary artery by-pass grafts (CABG),
  3. clot destroying drugs like tPA
22
Q

risk of all of these treatements is?

A

reperfusion injury

23
Q

primary cardiomyopathy

A

disease is soley confined to the heart muscles

24
Q

secondary cardiomyopathy

A

the heart is involved as part of a multi-system disorder

25
Q

The three morphologic patterns of cardiomyopathy:

A
  1. dilated,
  2. hypertrophic
  3. restrictive
26
Q

dilated cardiomyopathy is a _______ group of cardiac diseases

A

heterogenous

27
Q

dilated cardiomyopathy can be genetic or acquired and primary or secondary T/F??

A

TRUE

28
Q

dilated cardiomyopathy characteristics

A

b. dilation of all 4 heart chambers
c. histology shows variable fibrosis and myocyte hypertrophy
d. poor ventricular contractility (systolic dysfunction)

29
Q

Hypertrophic cardiomyopathy is a ___ and ____ cardiomyopathy

A

(a primary, genetic cardiomyopathy)

30
Q

T/F hypertrophic cardiomyopathy can be primary or secodary and genetic or acquired?

A

FALSE

31
Q

hypertrophic cardiomyopathy is a disorder of

A

disorder of sarcomeric proteins (myosin, myosin binding protein C, troponin T)

32
Q

what happens in hypertrophic cardiomyopathy?

A

inappropriate (spontaneous) myocardial hypertrophy, asymmetric hypertrophy which is greater in the interventricular septum than the left ventricular free wall and often obstructs the left ventricular outflow tract.

33
Q

hypertrophic cardiomyopathy inheritance…

A

inherited as autosomal dominant with variable expression

34
Q

disarray of cardiac myocytes and fibrosis is associated with which cardiomyopathy?

A

hypertrophic

35
Q

T/F Restrictive cardiomyopathy can be idiopathic or associated with other conditions that happen to affect the myocardium, such as radiation fibrosis, amyloidosis, hemochromatosis, and sarcoidosis

A

TRUE

36
Q

what area of heart is most affected in restrictive cardiomyopathy?

A

decrease in ventricular compliance (wall is stiffer), resulting in impaired ventricular filling during diastole

37
Q

MYOCARDITIS is what

A

inflammation involving the myocardium

38
Q

most common cause of myocarditis is what

A

viral infections

39
Q

what viruses cause myocarditis

A

Coxsackie A and B, other Enteroviruses

40
Q

T/F Myocarditis cant be caused by bacterial, fungal and parasitic organisms.

A

false, they can.

41
Q

T/F non- infectious agents can also cause myocarditis

A

toxins, hypersensitivity reactions and auto immune disorders.

42
Q

produces a lymphocytic infiltrate with foci of necrosis

A

viral pathology

43
Q

causes abscesses

A

pyogenic bacteria pathology

44
Q

infect individual myocytes or are in interstitial areas with surrounding inflammatory cells

A

parasites pathology

45
Q

causes a perivascular inflammatory infiltrate with many eosinophils.

A

hypersensitivity pathology

gen path 2 (8 decks)

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