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My pathology III > Cardio III - Q2,2 > Flashcards

Cardio III - Q2,2 Flashcards

1
Q

myocarditis is what

A

inflammation of the heart muscle itself, not just the lining

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2
Q

Who mostly has Rheumatic heart disease

A

those over 50 or those from other countries.

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3
Q

what causes Rheumatic heart disease

A

its an autoimmune reaction fo an infection, americans rarely get it because we use lots of antibiotics.

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4
Q

what autoimmune things can cause myocarditis

A

Rheumatic heart disease, Lupis, rheumatoid arthritis, transplant rejection and Drugs

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5
Q

what infectious agents can cause myocartditis

A

Borrelia burgdorferi, coxsackie virus, CMV, toxoplasmisis, trichinosis, chagas

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6
Q

what is the number one virus/infectious agent to cause myocarditis***

A

coxsackie virus**

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7
Q

what toxins could cause myocarditis

A

alcohol, chemo

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8
Q

what is the primary WBC if the problem is a virus

A

lymphocyte

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9
Q

what two things can valvular disease cause

A

stenosis and or insufficiency

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10
Q

why are valves so subjective to problems

A

they do not have their own blood supply so they don’t get as much benefit from the immune system.

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11
Q

what is stenosis

A

failure to open completely, it impedes flow foreward

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12
Q

sound of stenosis

A

woshing sound, either diastolic or systolic.

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13
Q

what can cause stenosis

A

hardening or stiffening of the valve with possible calcificationa

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14
Q

what is valve insufficiency

A

failure of the valve to close

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15
Q

what does valve insufficiency cause

A

regurgitation of blood, it flows backwards

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16
Q

what are the sounds associated with insufficiency?

A

murmurs and clicks

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17
Q

what is severity of stenosis and insuficiency dependiend on?

A
  1. degree of impairment, 2. which valve(s), 3. rate of involvement, 4. compensation
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18
Q

Compare valvular disease from infection to mitral stentosis due to RHD

A

sudden destruction of aortic valve can cause rapidly fatal cardiac failure from regurg while long developing mitral stensosis if remarkeabley well tolerated

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19
Q

What are the most frequently noted valvular abnormalities?

A

aquired stenosis of aortic and mitral valves - 2/3 of vavlular disease

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20
Q

When do mitral regurg sounds happen

A

systole

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21
Q

When do mitral stenosis sounds often happen

A

diastole

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22
Q

when do murmurs show

A

may or may not have symptoms,

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23
Q

what is the most common cause of stenosis or insufficiency in the USA

A

ageing

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24
Q

which valve is most likely to have a problem?

A

the aortic valve, its under the greatest stress and pressure

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25
Q

what is the order from most likely to least likely valve to have a problem

A

aortic, mitrial, pulmonary, tricuspid.

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26
Q

what is the most common valvular disease?

A

aortic stenosis, unless you concider mitral valve prolaps a disease

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27
Q

which side of the heart is most likely to have valve problems?

A

the left side - more pressure

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28
Q

What is the number one cause of valve disease in the world (not USA)

A

Rheumatic heart disease,

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29
Q

what is the likely reason Rheumatic heart disease doesn’t cause as much valve disease in the USA/

A

because strep viridans seems to be less virulent in our part of the world.

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30
Q

what is more serious quick or slow progression of valve disease

A

the same amount of valve damage over days to weeks is more dangerous than the same amount of damage that happened over 30 years. Compensations happen.

31
Q

is Rheumatic heart disease ususally acute or chronic?

A

RHD is ususally chronic developing over years.

32
Q

what would cause a pan systolic murmer?**

A

patentent ductus arterious - murmer over the entire heart sounds, S1 and S2

33
Q

Patent ductus arterious is what***

A

when the lung bipass in a baby doesn?t close upon birth.

34
Q

what is a congenital cause of stenosis?

A

When the 3 valve flaps are only two (aortic)

35
Q

three main reasions for valve disease

A
  1. infection, autoimmune (RH), cancer
36
Q

what does holosystolic mean

A

over entire systolic time

37
Q

Aortic stenosis is the most common valvular disease, What are the two main types?

A

Aquired aortic stenosis(infection, autoimmune, cancer etc) , then congenital 3 flaps is 2.

38
Q

why is a bicuspid valve where you should have a tricuspid valve bad

A

you get more wear and tear on the bicuspid valve

39
Q

what is mitral annular calcification

A

calcified depositis around fibrous ring of mitral valve (left). May lead to stenosis but often doesn’t effect valvular function

40
Q

mitral stenosis causes what sound

A

A mid systolic click ususally found incidentally on physical exam

41
Q

what % of the US population has mitral valve prolapse, gender and age

A

3 %, the cause is unknown., mostly women between 20-40

42
Q

what is mitral valve prolapse?

A

when one or both mitral leaflets are floppy and they prolapse and balloon back into left atrium during systole.

43
Q

what is one of the most common forms of vascular disease

A

myxomatous degeneration of the mitral valve ( mitral valve prolapse)

44
Q

what is a possible cause of MVP

A

cellular defect in connective tissue

45
Q

sequelle of MVP

A

may lead to serious complacations.

46
Q

how is mitral valve prolapse identified?

A

echocardiogram.

47
Q

are people with MVP symptomatic?

A

mostly a symptomatic but have SOB or easy fatiguability

48
Q

name 4 complications of MVP

A

infective endocarditis, mitral insufficiency, stroke/systemic infarct, arrhythemas

49
Q

what is the most common valvular disease?

A

aortic stenosis

50
Q

when do people get rheumatic fever acutely

A

between 5-17

51
Q

what causes Rheumatic fever

A

an acute immun-modulated multi system inflammatory disease that usually happens withing a few weeks following and episode of Group A strep pharyngitis

52
Q

what is the bacteria that causes the immume response that causes Rheumatic fever

A

Group A beta hemolytic strep

53
Q

can any group A beta hemolytic strep cause Rheumatic fever

A

nope, only the throat kind, not the skin type.

54
Q

why are antibiotics used for strep throat?

A

because the quicker the infection is cleared up, the least likely to have an immune response.

55
Q

what are the odds of getting Rheumatic heart disease

A

Very few get the rheumatic fever from untreated strep throat3%, and even fewer of those go on to get rheumatic heart disease, its pretty rare.

56
Q

What is the antibody that causes the immune respones in RF***

A

anti-streptococcal M proteins anticbodies that cross react with myosin

57
Q

what is the pathoneumonic feature of pan-carditis in the case of Rheumatic heart disease

A

aschoff bodies.

58
Q

what are the cardiac manifestations of RF

A

focal inflammatory involvment of 3 layers of heart called Pan carditis.

59
Q

How do antibiotic change the acute course of RF

A

Its doesn’t, the acute course of RF doesn’t change, its and immune response not infectin.

60
Q

what is the group A beta hemolytic strep in the throat that causes RF***

A

Strep pyogenes***

61
Q

how is strep spread

A

direct contact with oral or respiratory secretions, the bug attaches to epithelium of upper respiratory tract.

62
Q

how is strep diagnoses

A

Rapid strep test, elevated antistreptolysin O titer.

63
Q

what is pathoneumonic of rheumatic heart disease***

A

aschoff Bodies, nodules found in heart of individuals with RF, also in rest of body

64
Q

what are are aschoff bodies?

A

pathoneumonic for RHD, granulomatous structures consisting of fibrinous material, lymphocytes, and occasional plasma cell and macrophage that surround necrotic tissue

65
Q

aschoff bodies do they have infectious material in them

A

nope, just a collection of our own WBCs around enlarged cells or islands of collagen and lymphocytes withing surrounding myocytes

66
Q

What valve issue is often found with Rheumatic heart disease

A

mitral stensosis in particular

67
Q

What is the classic look of the mitral stenosis of RHD, if looking at disected heart

A

There is a typical fish mouth shape.

68
Q

what is a leading cause of mitral valve stenosis and valve replacement in the US?

A

chronic RHD

69
Q

effects of chronic RHD

A

valve stenosis (mitral mostly) regurg, atrial dilation, arrhythmias, ventricular dysfunction

70
Q

how long after acute episode of RF does stenosis, valve fusion /damage happen

A

2-10 years after, and each episode of Actue RF after progressively damages valves

71
Q

what is the most common sign and symptoms of acute rheumatic fever

A

polyarthritis

72
Q

what are the common non cardiac manifestations of Rheumatic heart disease

A

polyarthritis* chorea, erythema marginatum* and subcutaneous nodules, (often diagnostic)

73
Q

common non diagnostic non cardiac manifestations of RHD

A

abdominal pain, arthraligase, fever and penmonia

74
Q

what is erythema marginatum (erythema annulare)

A

rash that occurs in 5-13% of patients with acute RF. Trunk and proximal limbs, serpiginous ring

My pathology III (3 decks)

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