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Sam Clin Path > Cardio > Flashcards

Cardio Flashcards

1
Q

When does autoregulation of coronary blood flow breakdown?

A

> 75%

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2
Q

> 90% stenosis may be what?

A

Insufficient at rest

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3
Q

When does most perfusion of coronary artery occur?

A

Diastole

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4
Q

What is stable angina?

A

Not getting worse predictable effects!

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5
Q

Unstable angina/

A

Unpredictable coronary artery spasm-

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6
Q

Crescendo angina is bad because?

A

pain at rest, unpredictable getting worse

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7
Q

What is ACS not acronym actual conditions?

A

Acute MI +/- ST elevation crescendo angina

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8
Q

STEMI affects what parts of heart?

A

Full thickness myocardium necrosis “transmural”

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9
Q

NSTEMI is physiologically what?

A

Partial block to a coronary artery sub-endocardial

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10
Q

After X weeks you cannot tell how old an infarct is?

A

4 around

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11
Q

creatine kinase type thats mostly cardiac?

A

MB type

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12
Q

Complications of MI?

A

Arrhythmia, rupture, infarct extension, aneurysm

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13
Q

What is dresslers syndrome?

A

secondary pericarditis due to cardiac injury

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14
Q

Mural thrombus?

A

Thrombus or thrombi that adhere to vessel wall

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15
Q

LDL receptor gene frequency>

A

1/500

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16
Q

Apolipoprotein B frequency?

A

1/1000

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17
Q

When to start worrying about sustained BP?

A 
Sys = >140 
Dia = >90
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18
Q

Causes of secondary HTN?

A

Cushings, phaeochromocytoma,

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19
Q

What does HTN do to kidneys?

A

Slow decline in renal function :(

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20
Q

Cerebral problems with HTN?

A

Haemmhorage and berry aneurysms

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21
Q

Hypertensive crisis talk?

A

> 180/120 quick onset, organ damage and stroke risk!

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22
Q

Pulmonary hypertension?

A

++ blood pressure in pulmonary artery

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23
Q

Pulmonary hypertension causes?

A

Many loss of vasculature, idiopathi, or secondary to left failure

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24
Q

What can pulmonary HTN cause?

A

Right heart failure

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25
Q

Left or right failure causing oedema?

A

Right venous return

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26
Q

Where is renin released from?

A

Juxtaglomerular apparatus

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27
Q

What does renin do?

A

Angiotensinogen to angiotensin I

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28
Q

Angiotensin II cause what to be released?

A

Aldosterone = bp higher

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29
Q

Where is angiotensin I converted?

A

Lungs

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30
Q

What is conns syndrome

A

Excess aldosterone from “somewhere”

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31
Q

Conns syndrome most likely cause?

A

Adrenocortical adenoma

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32
Q

Conns syndrome biochem?

A

+aldosterone -renin -K+

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33
Q

Phaeochromocytoma symptoms?

A

HTN, nervousness, sweating, flushing, headaches, pallor

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34
Q

Phaeochromocytoma ?

A

Adrenal medulla tumour

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35
Q

24 hr urine collection for diagnosis of what?

A

Phaeochromocytoma adrenaline metabolites

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36
Q

Difference between cushings syndrome and disease?

A

Syndrome is by any steroid you have taken etc disease = pituatary lesion usually

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37
Q

Cause of cushings disease?

A

Adrenacortico neoplasm, or pituatary adenoma (80%) cases

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38
Q

Which cancer may produce adrenacorticotopic hormone?

A

Small cell lung producing ACTH

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39
Q

Left sided heart failure?

A

Congestion, PND, dyspnoea, orthopnoea,,cyanosis

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40
Q

Right sided heart failure?

A

Ascites, congestive splenomegaly, transudates and pleural effusion

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41
Q

BOXCAR nuclei consistent with what finding in autopsy?

A

Congestive heart failure

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42
Q

70% of all valvular heart disease involves which?

A

Aortic and mitral

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43
Q

Mitral stenosis is associated with what?

A

Rheumatic fever

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44
Q

Aortic stenosis can cause hypertrophy of what?

A

Left ventricle in abscence of HTN

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45
Q

What is mitral annular calcification?

A

Calcification of mitral skeleton- usually no dysfunction, may be regurg

46
Q

Causes of Aortic regurg?

A

Rheumatic, infectious, dilatation syphillis or rheumatoid arth)

47
Q

Mitral regurg (prolapse) causes?

A

Infection, fen Phen, Pappillary muscle problems, mitral ring calcification

48
Q

WHat does myxomatous mean?

A

Weakening of connective tissue

49
Q

MVP is more common in which sex?

A

Women

50
Q

Mid systolic click characteristic of what?

A

MVP

51
Q

Holosystolic murmur of MVP present only is what ?

A

There is regurg

52
Q

What is tetrology of fallot?

A

Right ventricular hypertrophy, overriding aorta, VSD, pulmonary stenosis

53
Q

Which chromosome important for heart development

A

22

54
Q

Characteristics of L-R shunts?

A

All D’s in names, no cyanosis, pulmonary hypertention- significant = irreversible.

55
Q

Characteristics of R-L shunts ?

A

All T’s in name, cyanosis (blue baby) Venous emboli become systemic (paradoxical)

56
Q

Most common congenital heart defect?

A

VSD often with fallot

57
Q

Continuous machine like murmur?

A

PDA

58
Q

> 1/3 AVSD seen in ?

A

Downs

59
Q

R-L from what?

A

Tetralogy,transposition, truncus, tricuspis atresia

60
Q

What is endocarditis?

A

colonisation and or invasion of heart valves or chamber by microbe

61
Q

Prognosis for acute endocarditis?

A

Poor, highly virulent organism, often fatal and requires surgery.

62
Q

Sub-acute infective endocarditis prognosis?

A

Lower virulent organisms, less destructive often cured with antibiotics, but can be a wax and wane course

63
Q

Common causes of infective endocarditis?

A

MVP, stenosis, artificaila valves, bicuspid AV

64
Q

Most common organism causing endocarditis?

A

Strep viridans (from mouth ) 50-60%

65
Q

Staph aureus endocarditis common in which group of people?.

A

IV drug users

66
Q

prosthetic valves often infect with what?

A

s. epidermis (coag negative)

67
Q

Strep bovis prompts what?

A

bowel cancer investigation

68
Q

Characteristics of vegetations in acute IE?

A

Single, multiple bulky and friable

69
Q

% of left heart IE with murmurs?

A

90%

70
Q

pneumonic for IE?

A

FRoth spots OM JANE

71
Q

Marantic endocarditis aka?

A

NBTE non bacterial

72
Q

Non bacterial endocarditis occurs in who?

A

Debilitated patients usually

73
Q

What are vegetation sin non infective endocarditis like?

A

Small, sit on valve leaflets, minimal local effect

74
Q

SLE is associated with what type of endocarditis?

A

Libman -sacks

75
Q

In libman sacks endocarditis which valves are affected?

A

Mitral and tricuspid

76
Q

Characteristic of vegetation in libman sacks?

A

Small warty and pink vegetations often on under surfaces

77
Q

What is diagnostic histologically for rheumatic fever?

A

Aschoff bodies in all layers

78
Q

Classical valve changes in rheumatic fever?

A

Mitral- called vurrucae vegetation (virtually only cause of mitral stenosis)

79
Q

Fishmouth abnormality associated with what?

A

Mitral stenosis of rheumatic fever

80
Q

What criteria are used to diagnose rheumatic fever?

A

Jones

81
Q

Pericarditis causative organims?

A

Coxsackie virus, bacteria etc

82
Q

Acute pericarditis is more …

A

inflamed (serous, purulent etc)

83
Q

Chronic pericarditis characteristic?

A

Adhesive

84
Q

Serous pericarditis causes?

A

Non infectious usually

85
Q

Serofibrinous pericarditis causes?

A

Acute MI, dresslers

86
Q

Cheesy pericarditis in what infections?

A

TB

87
Q

Pain associated with pericarditis?

A

Pleuritic, relieved by sitting forwards

88
Q

Complication of pericarditis?

A

Pericardial effusion

89
Q

Main causes of dilated cardiomyopathy?

A

Genetics, cytoskeletal protein mutation-

alcohol and chemo too

90
Q

Age of dilated cardiomyopathy?

A

young usually 20-50 bad survival

91
Q

5 year survival of dilated cardiomyopathy?

A

25%

92
Q

Hypertrophic myopathy is what?

A

Hypertrophy in absence of obvious cause, diastolic dysfunction with preserved systolic

93
Q

Histological hypertrophy?

A

Disarray of myocytes

94
Q

Is hypertrophic cardiomyopathy genetic?

A

Yes 100%

95
Q

Murmur in cardiomyopathy?

A

Systolic ejection

96
Q

n atheletes can be caused by what?

A

Hypertrophic and or arrythmogenic right ventricular cardiomyopathy

97
Q

Restrictive cardiomyopathy affects what part of heart?

A

Myocardium is non compliant decrease in ventricular compliance

98
Q

Cause of arrythmogenic right ventricular cardiomyopathy?

A

Fibrofatty replacement if right ventricle- disorder of cell-cell desmosomes exercise = detachment and death of cells

99
Q

Myocarditis infective causes?

A

Coxsackie, chaga disease (south america), diptheria borellia (lymes)

100
Q

Histology of vasculitis?

A

Blue dots in blood vessel

101
Q

Most common form of vasculitis?

A

Giant cell arteritis

102
Q

Pathology of giant cell artertitis?

A

Chronic granulamatous, large to medium arteries- esp in head

103
Q

Importance of recognising temporal arteritis?

A

Can involve opthalmic artery = blindness :(

104
Q

Morphology of GCA?

A

Intimal thickening, ganulamatoud inflammation, multinucleated giant cells

105
Q

Classic symptoms of temporal arteritis?

A

pain tneder temporal region, and jaw claudication (paind on eating in temples)

106
Q

How much artery to sample with temporal artery?

A

2-3cm!

107
Q

Main risk factor for rupture of AAA

A

Size >6cm

108
Q

What is a dissecting aneurysm?

A

Tear in wall, blood tracks between layers

109
Q

Dissecting aneurysm symptoms?

A

Tearing pain radiating to left shoulder

110
Q

What is charcot bouchard aneurysm?

A

Occur in intracerebral cappilaries in hypertensive disease

111
Q

Tertiary syphillis can cause what aneurysms?

A

Ascending thoracic aneurysm

112
Q

False aneurysm?

A

Blood filled space around a vessel, usually following traumatic rupture or perforating injury

Sam Clin Path (9 decks)

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