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step 1 - path > cardio > Flashcards

cardio Flashcards

1
Q

5 Ts of congenital heart disease?

A 
Truncus
Transposition
Tricuspid
Tetralogy
TAPVR
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2
Q

cause of truncus?

A

failure of aorticopulmonary septum formation

usually accompanying VSD

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3
Q

cause of TGA?

A

failure of aorticopulmonary septum spiralling

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4
Q

what do you need for viability in tricuspid atresia?

A

ASD and VSD

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5
Q

ASD vs PFO?

A

ASD: missing tissue in ostium secundum > ostium primum
PFO: failure of fusion

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6
Q

congenital heart defect in infants of diabetic mothers?

A

TGA

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7
Q

cardiac defect in Williams syndrome?

A

supravalvular aortic stenosis

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8
Q

types of arteriolosclerosis?

A

hyaline: thickening of vessel walls
hyperplastic: onion skinning and proliferation of smooth mm cells - severe HTN

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9
Q

calcification of arterial elastic lamina?

A

Monckeberg medial calcific sclerosis
vascular stiffening without obstruction
“pipestem” on XR

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10
Q

pathogenesis of atherosclerosis?

A

endothelial cell dysfn –> macrophage and LDL accumulation –> foam cell formation –> fatty streaks –> PDGF, FGF, smooth mm cell migration –> proliferation, ECM deposition –> fibrous plaque –> complex atheromas

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11
Q

MC locations of atherosclerotic plaque?

A

abdominal aorta > coronary a > popliteal a > carotid a

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12
Q

risk factors for thoracic aortic aneurysm?

A

cystic medial degeneration

HTN, bicuspid aortic valve, CT disease, tertiary syphilis

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13
Q

how to treat types of aortic dissection?

A

A: surgery
B: BBs then vasodilators

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14
Q

tx of prinzmetal angina?

A

CCBs, nitrates, smoking cessation

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15
Q

changes 4-24 hr post-MI?

A

early coag necrosis, edema, hemorrhage, wavy fibers, neutrophils
dark mottling; pale with tetrazolium stain

** reperfusion injury may cause contraction bands (free radical damage)

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16
Q

complications 2-24 hr post-MI?

A

arrhythmia, HF, cardiogenic shock

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17
Q

changes 1-3 days post-MI?

A

coagulative necrosis, acute inflammation with neutrophils

hyperemia

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18
Q

complications 1-3 days post-MI?

A

postinfarction fibrinous pericarditis

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19
Q

changes 3-14 days post-MI?

A

macrophages –> granulation tissue at margins

hyperemic border with central yellow-brown softening

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20
Q

complications 3-14 days post MI?

A

free wall rupture
papillary mm rupture
IV septum rupture (from macrophage-mediated structural degradation)
LV pseudoaneurysm

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21
Q

changes 2 wks - months post-MI?

A

completed contracted scar

gray-white tissue

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22
Q

complications 2 wks - months post-MI?

A

Dressler syndrome
HF
arrhythmias
true ventricular aneurysm

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23
Q

Dressler syndrome?

A

autoimmune rxn post-MI –> fibrinous pericarditis several weeks after

24
Q

causes of dilated cardiomyopathy?

A 
alcohol
beriberi
cocaine
chagas
doxorubicin
hemochromatosis
sarcoid
peripartum
25
Q

beta-myosin heavy chain mutation?

A

familial hypertrophic cardiomyopathy

26
Q

Friedrich ataxia cardiac issues?

A

hypertrophic cardiomyopathy

27
Q

tx of hypertrophic cardiomyopathy?

A

stop high-intensity athletics
BBs or CCBs
ICD if high risk

28
Q

causes of restrictive infiltrative cardiomyopathy?

A 
sarcoidosis
amyloidosis
postradiation fibrosis
endocardial fibroelastosis
Loffler
hemochromatosis
29
Q

endomyocardial fibrosis with eosinophilic infiltrate?

A

Loffler syndrome

30
Q

which mx affect mortality in heart failure?

A

ACEis, ARBs
BBs
spironolactone
select patients: hydralazine with nitrate

31
Q

MC pathogen in acute endocarditis?

A

S aureus

32
Q

MC pathogen in subacute endocarditis?

A

viridans strep

33
Q

pathogens in tricuspid valve endocarditis?

A

S aureus
Pseudomonas
Candida

34
Q

pathogens in culture negative endocarditis?

A

Coxiella
Bartonella
HACEK

35
Q

Aschoff bodies?

A

granuloma with giant cells - assoc with rheumatic fever

36
Q

Anitschkow cells?

A

enlarged macrophages with ovoid wavy rod-like nucleus

assoc with rheumatic fever

37
Q

syphilitic heart disease?

A

disruption of vasa vasorum of aorta –> atrophy of vessel wall and dilatation of aorta/valve ring
calcification of aortic root and ascending aortic arch
“tree bark” appearance of aorta

38
Q

myxoma?

A

MC primary cardiac tumor
90% in atria (usually L)
multiple syncopal episodes
diastolic “tumor plop” sound

39
Q

rhabdomyoma?

A

most frequent primary cardiac tumor in children

assoc with tuberous sclerosis

40
Q

blood vessel malignancy, elerly, sun-exposed areas?

A

angiosarcoma
assoc with radiation therapy and chronic postmastectomy lymphedema
very aggressive and difficult to resect

41
Q

benign capillary skin papules in AIDS patients?

A

bacillary angiomatosis
caused by Bartonella henselae infx

** neutrophilic infiltrate (vs Kaposi)

42
Q

benign capillary hemangioma of elderly?

A

cherry hemangioma

does not regress

43
Q

cavernous lymphangioma of neck?

A

cystic hygroma

assoc with Turner

44
Q

red-blue painful tumor under fingernails?

A

glomus tumor
benign
from modified smooth mm cells of thermoregulatory glomus body

45
Q

endothelial malignancy of skin, mouth, GI tract, resp tract?

A

Kaposi - assoc with HHV8 and HIV

** lymphocytic infiltrate (vs bacillary angiomatosis)

46
Q

polypoid capillary hemangioma, can ulcerate/bleed?

A

pyogenic granuloma

assoc with trauma and pregnancy

47
Q

benign capillary hemangioma of infancy?

A

strawberry hemangioma

rapid growth, regresses spontaneously by 5-8 yo

48
Q

tx of Raynaud?

A

CCBs

49
Q

old lady with unilateral headache and jaw claudication?

A

temporal arteritis

steroids and temporal artery biopsy

50
Q

younger Asian lady with fever, night sweats, arthritis, myalgias, weak upper extremity pulses?

A

Takayasu arteritis
granulomatous thickening and narrowing of aortic arch and prox great vessels
tx: steroids

51
Q

young adults with fever, weight loss, malaise, HTN,neurologic dysfunction, cutaneous eruptions, renal damage?

A

PAN
30% HBV seropositive
renal and visceral vessels - NOT pulmonary aa
immune complex mediated

tx: steroids, cyclophosphamide

52
Q

tx of Kawasaki?

A

IVIG and aspirin

53
Q

smoker, young male, intermittent claudication, digit autoamputation, Raynaud?

A

Buerger disease
segmental thrombosing vasculitis

tx: smoking cessation

54
Q

upper resp tract and lower respiratory tract sx, hematuria, urine RBC casts?

A

Wegener’s: focal necrotizing vasculitis, necrotizing granulomas in lung/airway, necrotizing glomerulonephritis

    • PR3-ANCA/c-ANCA
    • tx: cyclophosphamide, steroids
55
Q

lung, kidneys, skin involvement; glomerulonephritis and palpable purpura?

A

Microscopic polyangiitis
presentation like GPA but w/o nasopharyngeal involvement
no granulomas
MPO-ANCA/p-ANCA

tx: cyclophosphamide, steroids

56
Q

asthma, sinusitis, skin nodules, peripheral neuropathy?

A

Churg Strauss
can also involve heart, GI, kidneys
MPO-ANCA/p-ANCA
increased IgE

57
Q

palpable purpura, arthralgia, abdominal pain?

A

Henoch Schonlein purpura
follows URI
IgA immune complex deposition
associated with Berger disease (IgA nephropathy)

step 1 - path (12 decks)

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