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Pathology 1st aid > Cardio Path > Flashcards

Cardio Path Flashcards

1
Q

Right to left shunts

A 
Tetrology of Falot
Transposition of great vessels
Persistent Truncus arteriosus
Tricuspid atresia
Total Anomalous pulmonary venous return (TAPVR)
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2
Q

Left to right shunts

A

VSD > ASD > PDA

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3
Q

Close PDA

A

Indomethacin

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4
Q

Eisenmenger’s Syndrome

A

uncorrected ASD, VSD, PDA causes shunt reversal due to PHTN

L to R –> R to L

Causes clubbing, cyanosis, polycythemia

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5
Q

Tetrology of Falot

A

PROVe

Pulmonary stenosis
RVH
Over-riding Aorta
VSD

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6
Q

why do tetrology of falot pts. squat?

A

Increase TPR –> decreases shunt so that blood goes to lungs and is oxygenated

combats cyanosis

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7
Q

D-Transposition of the great vessels

A

Failure of aorticopulmonary septum to spiral

Aorta attached to RV
Pulmonary a attached to LV

Must have shunt to be compatible with life

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8
Q

Coarctation of aorta associated with

A

Turner Syndrome–infantile

Bicuspid Aortic Valve–Adult

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9
Q

Infantile coarctation of aorta

A

stenosis proximal to insertion of ductus arteriosus

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10
Q

Adult coarctation of aorta

A

Stenosis distal to insertion of ductus arteriosus

Rib notching–collateral circulation of vertebral aa.
HTN in UE
Weak pulses in LE

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11
Q

Why is PDA kept open?

A

Low O2 tension

PGE synthesis

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12
Q

PDA Heart sound

A

machine like murmur

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13
Q

Rx’s for open/close PDA

A

Open–PGE

Close–Indomethacin

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14
Q

22q11 mutation associated with

A

Truncus arteriosus

Tet of fallot

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15
Q

Down syndrome associated with

A

ASD
VSD
AV septal defect (endocardil cushion)

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16
Q

Turner Syndrome associated with

A

Coarctation–preductal

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17
Q

Marfan Syndrome associated with

A

Aortic insufficiency and dissection

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18
Q

Infant of diabetic Mom

A

Transposition of great vessels

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19
Q

HTN

A

> 140/90

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20
Q

Malignant HTN

A

> 180/120

∆ in pressure is what mediates the damage

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21
Q

Xanthelasma

A

Lipid laden macrophages deposited in skin of eylids

sign of hyperlipidemia

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22
Q

Arcus Senilis

A

Lipid deposition in cornea

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23
Q

Tendinous Xanthoma

A

Lipid deposition in tendons–achilles #1

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24
Q

Monckeberg arteriosclerosis

A

Calcifications in the media of aa.

radial and ulnar especially

DOE NOT obstruct flow

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25
Q

Thickening of small arteries due to essential HTN or DM

A

Hyaline Arteriolosclerosis

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26
Q

Onion skinning of arteries due to malignant HTN

A

Hyperplastic arteriolosclerosis

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27
Q

Fibrous plaques and atheromas in INTIMA of large/medium arteries

A

Atherosclerosis

narrows lumen

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28
Q

Mediators of Smooth mm. migration in atherosclerosis

A

PDGF

FGF

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29
Q

Atherosclerosis most common locations

A

bifurcations

  1. Abdominal Aorta
  2. coronary aa.
  3. popliteal aa.
  4. carotid aa.
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30
Q

Hypertensive Marfan with a history of sexual promiscuity and multiple syphilis infections COD

A

Thoracic Aortic Aneurysm

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31
Q

Longitudinal intramural tear forming a false lumen of aorta

A

Aortic Dissection

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32
Q

Aortic Dissection presentation

A

Tearing feeling radiating to back
mediastinal widening on CT
Pericardial tamponade, aortic rupture, death

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33
Q

Atherosclerosis
ST depression on EKG
retrosternal pain with exertion

A

Stable angina

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34
Q 
CP at rest
ST elevation (Not MI)
A

Prynzmetal angina

coronary vasospasm

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35
Q

Thrombosis with incomplete coronary artery stenosis
ST depression
Worsening CP with minimal exertion

A

Unstable/crescendo angina

Basically an MI that hasn’t infarcted

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36
Q

Coronary Steal Syndrome

A

vasodilator aggrevates ischemia by taking blood flow from stenosis to an area of higher profusion

Pressure gradient

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37
Q

Sudden Cardiac Death

A

Death from Cardiac causes w/in 1 hour of onset

lethal arrhythmia–most common

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38
Q

Chronic Ischemic Heart disease

A

progressive onset of CHF due to chronic ischemic myocardial damage

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39
Q

MI ∆’s 4-12 hrs

A

Early Coag necrosis
edema
hemorrhage
wavy fibers

Risk of Arrhythmia

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40
Q

MI ∆ 12-24 hrs.

A

Contraction bands
release of necrotic contents into blood
Neutrophils start to invade

Arrhythmia risk

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41
Q

MI ∆ 1-3 days

A

Neutrophils
extensive coag necrosis
acute inflammation

risk of fibrinous pericarditis

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42
Q

MI ∆ 3-14 Days

A

Macrophages
granulation tissue at margins (red border)

Risk of free wall rupture

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43
Q

2+ weeks post MI ∆’s

A

gray/white gross appearance

Contracted scar complete

risk of Dressler’s Syndrome

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44
Q

Dx reinfaction

A

CK-MB

returns to normal in 48 hrs. where trops stay up for 7-10 days

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45
Q

MI with lots of necrosis
entire wall effected
ST elevation

A

Transmural

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46
Q

MI with < 50% ischemic necrosis of ventricle wall

ST depression of EKG

A

Subendocardial infarct

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47
Q

Dressler’s Syndrome

A

Autoimmune phenomenon –> fibrinous pericarditis

several weeks post MI

48
Q

S3
Dilated heart on US
Balloon appearance of heart on Chest xray
ECCENTRIC hypertrophy

A

Dilated cardiomyopathy

sarcomeres added in series

49
Q

Dilated Cardiomyopathy causes

A 
Alcohol abuse
wet beriberi
Coxsackie B
Cocaine
Chagas Disease
Doxorubicin
hemochromatosis
peripartum cardiomyopathy
50
Q

Dilated Cardiomyopathy Tx

A 
Na restriction
ACE-I
diuretics
digoxin
heart transplant
51
Q

Sudden death in athlete
outflow tract obstruction
asymmetric CONCENTRIC hypertrophy
Syncope

A

Hypertrophic Cardiomyopathy

Sarcomeres added in //

52
Q

Hypertrophic Cardiomyopathy Tx

A

ß Blockers

CCB’s (non-dihydro)

53
Q

Hypertrophic Cardiomyoathy asssociated with

A

ß myosin heavy chain mutation

Friedrich’s Ataxia

54
Q

Mechanism of outflow tract obstruction with Hypertrophic cardiomyopathy

A

IV septum is hypertrophied and too close to mitral valve leaflets –> leaflets then obstruct outflow –> Syncope

55
Q

Loeffler’s Syndrome

A

endomyocardial fibrosis with prominant eosinophilic infiltrates

seen in restrictive obliterative cardiomyopathy

56
Q

restrictive/obliterative cardiomyopathy causes

A 
sarcoidosis
amyloidosis
postradiation fibrosis
enoscardial fibroelstosis
Loeffler Syndrome
hemochromatosis
57
Q

Rx that reduce mortality of CHF

A

ACE-I
ß-Blocker
ARBs
Spironolactone

Hydralazine with Nitrate in some pts.

58
Q

Rx for Sx relief in CHF

A

Thiazides or loops

59
Q

Hemosiderin Laden Macrophages in lung

A

Left Heart Failure buzz

60
Q

Orthopnea

A

SOB when supine

61
Q

RHF Signs

A

Nutmeg liver
JVD
Peripheral edema

62
Q

LHF signs

A

pulmonary edema
paroxysmal nocturnal dyspnea
orhopnea

63
Q

Sx of endocarditis

A 
Fever
Roth spots (retina)
Osler Nodes (digits)
new murmur
Janeway Lesions (palms and soles)
anemia
splinter hemorrhage on nail bed
64
Q

Endocarditis bugs

A

Acute–S. aureus

Subacute–S. Viridans

65
Q

Post dental procedure endocarditis

A

S. viridans (mutans)

66
Q

Endocarditis

Colon Cancer

67
Q

Prosthetic Valve endocarditis

A

S. epidermidis

68
Q

Who gets endocarditis on right side (tricuspid)?

A

IV druggies

S. aureus, Pseudomonas, Candida

69
Q

Most common valve for endocarditis

70
Q

Rheumatic Fever cause

A

Strep Pyogenes

Abs to M protein attack heart (type II)

71
Q

Rhematic Fever Dx

A

Aschoff bodies–granuloma with giant cells

Anitschkow’s cells–activated hitiocytes

elevated ASO titers

72
Q

Early and late manifestations of Rheumatic fever

A

Early–MVP

Late–Mitral stenosis

73
Q

Rhematic Fever Sx

A

JONES

Joints, heart, Nodules, erythema marginatum, syndenham’s chorea

74
Q

Fibrinous pericarditis causes

A

Dressler’s Syndrome
Uremia
Radiation

loud friction rub

75
Q

Seous Pericarditis

A

Viral
SLE
RA

76
Q

Suppurative/Purulent pericarditis

A

bacterial infxns

pneumococcus, strep

77
Q

Pulsus Paradoxus

A

decrease in systolic blood pressure by > 10 mmHg during inspiration

Seen with cardiac tamponade, croup, sleep apnea, pericarditis

78
Q 
JVD
Increased venous pressure
hypotension
Tachycardia
pulsus paradoxus
A

Cardiac Tamponade

79
Q

Tree Bark appearance of aorta

calcification of aortic root and ascending arch

disrupted vasa vasorum with atrophy of vessel wall

A

3º syphilis

80
Q

most common 1º cardiac tumor

81
Q

Myxoma most common site

A

left atrium

ball valve obstruction of LA –> syncope

82
Q

most common 1º cardiac tumor in kids

A

Rhabdomyoma

83
Q

Rhabdomyoma is associated with

A

Tuberous Sclerosis

84
Q

Most common heart tumor overall

A

Mets from melanoma and lymphoma

85
Q

Kussmaul’s sign

A

icreased JVD on inspiration instead of decrease

constrictive pericarditis, restrictive cardiomyopathies, right atrial or ventricular tumors

86
Q

Raynaud’s Syndrome

A

Secondary to disease process

SLE, CREST, Mixed CT disease

87
Q

old woman
jaw claudication
unilateral headache
elevated ESR

A

Temporal (Giant Cell) Arteritis

effects carotid artery vessels

88
Q

Temporal (Giant Cell) Arteritis associated with

A

polymyalgia rheumatica

89
Q

Temporal (Giant Cell) Arteritis Tx

A

High Dose corticosteroids

Prevent blindness–ophthalmic Artery occlusion

90
Q 
Asian female < 40
Weak UE pulse
fever
night sweats
arthritis 
myalgias
skin nodules
occular disturbances
high ESR
A

Takayasu’s Arteritis

91
Q

Takayasu Arteritis description

A

Granulomatous thickening of aortic arch and proximal great vessels

92
Q

Takayasu Arteritis Tx

A

Corticosteroids

93
Q 
Young adult
HBV+
Melena and GI pain
HTN 
Renal Damage
neurologic dysfunction
cutaneous erruptions--different age lesions
A

Polyarteritis nodosa

94
Q

Polyarteritis nodosa vessels effected

A

visceral and renal vessels

not pulmonary artery

95
Q

Polyarteritis nodosa Tx

A

Corticosteroids

Cyclophosphamides

96
Q 
Asian Child (< 4)
Strawberry tongue
cervical lymphadenitis
hand/foot erythema
desquamating rash
A

Kawasaki Disease

97
Q

Kawasaki Disease COD

A

Coronary Arty aneurysm –> MI

98
Q

Kawasaki Disease Tx

A

Aspirin (only time to give to kid)

IV Ig

99
Q 
Heavy Smoker male > 40
Intermitent claudication 
autoamputation of digits
superficial nodular phlebitis
Raynaud's phenomenon
A

Buerger’s Disease

100
Q

Buerger’s Disease Tx

A

Quit Smoking

101
Q

p-ANCA+
Necortizing vasculitis of lung, kidney, skin

Pauci-immune GN
palpable purpura
No granulomas

A

micorscopic polyangiitis

102
Q

micorscopic polyangiitis Tx

A

Cyclophosphamide

corticosteroids

103
Q 
Hemoptysis 
hematuria
RBC casts in urine
c-ANCA+
Chronic sinusitis and otitis media
A

Wegener’s Granulomatosis

104
Q 
IgE
Eosinophils
Asthma
peripheral neuropathy
p-ANCA+
Granulomas
Palpable purpura
A

Churg Strauss Syndrome

105
Q

Most common childhood systemic vasculitis

A

Henoch-Schoenlein Purpura

106
Q

Henoch-Schoenlein Purpura Sx

A

Palpable purpura on buttocks and legs
arthralgia
abd. pain, melena, multiple lesion same age

107
Q

Strawberry hemangioma

A

benign capillary hemangioma of infancy

regresses by 5-8 yrs

108
Q

Cherry hemangioma

A

benign capillary hemangioma of elderly

does not regress

109
Q

Pyogenic granuloma

A

polypoid capillary hemangioma
ulcerates and bleeds

due to trauma & pregnancy

110
Q

Cystic Hygroma

A

Cavernous hemangioma of neck

Associated with Turner Syndrome

111
Q

Glomus Tumor

A

benign painful tumor under fingernail

modified smooth mm. cells of glomus

112
Q

Bacillary angiomatosis

A

AIDs pt. with Bartonella henselae

mistaken for Kaposi’s

113
Q

Angioarcoma

A

malignant blood vessel of breast, head, neck

associated with radiation Tx of breast cancer, Hodgkin’s,

aggressive

114
Q

Lymphangiosarcoma

A

Lymphatic malignancy

post radical mastectomy pts. from persistent lymphedema

115
Q

Kaposi’s Sarcoma

A

HHV-8
AIDs pt.

endothelial malignancy of mouth, GI, respiratory tract

116
Q

Port wine stain (naveus flemus) on face

ipsilateral leptomeningeal angiomatosis

Seizures

early onset glaucoma

A

Sturge-Weber Disease

117
Q

Sturge-Weber Disease vessel size effected

A

capillary size

Pathology 1st aid (11 decks)

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