Cardio Path3

Question 1

what is the definition of peripheral vascular disease

Answer 1

narrowing of blood vessels (usually arteries) - restricts blood flow mostly in the legs

Question 2

what are the main causes of peripheral vascular disease and what is a protective substance

Answer 2

agents that damage endothelium - oxidative stress

oestrogen is protective

Question 3

what is the pathogenesis and clinical features of peripheral vascular disease

Answer 3

chronic or acute - gradual atherosclerosis - narrow artery - ischameia - cell damage and death

acute ischaemia - 6 p’s - pale, pulselessness, painful, paralysed, perishing cold, paraesthic
chronic leads to vascular necrosis

Question 4

what is another way to say vasculitis and what is the definition

Answer 4

giant cell arteritis

chronic granulomatous inflammation of large to small sized arteries, mainly in head (temporal arteritis)

Question 5

what deficiency can vasculitis lead to

Answer 5

blindness

Question 6

what are end stage problems caused by for vasculitis

Answer 6

type 4 hypersensitivity

Question 7

what is the pathogenesis of vasculitis

Answer 7

chronic granulomatous inflammation - narrow artery - ischameia - cell damage

Question 8

which main arteries are at risk in vasculitis

Answer 8

temporal, vertebral and opt;amic arteries

Question 9

what are the key clinical features of vasculitis

Answer 9

flu like symps - fatigue, weight loss, fever
pain at acute locations
blurred vision
stroke

Question 10

what is the definition of infective endocarditis

Answer 10

infection and inflammation of the endocardium - lining of the heart and mainly valves

Question 11

what are the causes of infective endocarditis

Answer 11

any route of bacteria into the blood stream - wounds, cancer, prosthetics
strep - viridians/bovis/gallolyticus
staph - aureus/epidermic

candida and aspergillius

Question 12

what is the pathogenesis of infective endocarditis

Answer 12

heart failure due to valve regurgitation

fibrin deposition - circulating bacteria colonise fibrin

Question 13

what are the key clinal features of infective endocarditis

Answer 13

fever
weight loss
murmurs left sided
immune conditions from infection

Question 14

which heart disease would you see splinter/subungual haemorrhages and jane way lesions, oilers nodes and roth spots

Answer 14

infective endocarditis

Question 15

what acronym is used for the symptoms of infective endocarditis

Answer 15

from jane 
fever 
roth - retinal haemorrhage 
oslers - nodules in digits 
murmus 
Janeway - lesions on palms
anaemia
nail haemorrhage 
emboli

Question 16

what is the definition and the types of pericarditis

Answer 16

inflammation of the pericardial sac
acute - serofibrinous
chronic - constrictive

Question 17

what are the causes of pericarditis

Answer 17

infections - eg coxsackie B (virus)
autoimmune
truma/radiation/surgery

Question 18

what is the difference between serous and serofibrinous acute pericarditis

Answer 18

serous - inflammation - clear fluid accumulation - non-infection cause such as autoimmune

fib - most common, serous fluid and fibrinous exudate

Question 19

what are the key clinical features of pericarditis

Answer 19

sharp central chest pain
pericardial friction rub (sound)
fever
cardiac tamponade

Question 20

what is definition of rheumatic fever

Answer 20

acute - immunological mediated - multi system inflammation following group A strep. pharyngitis
eg pyogenes

Question 21

what is the pathogenesis of rheumatic fever

Answer 21

hypersensitivity reactions (type 4) t cell mediated 
make antibodies against M protein on strep pyogenes which is sam eon heart skin and joints and cns

Question 22

what are the key clinical features of rheumatic fever

Answer 22

heart - pancarditis/endocarditis 
skin - nodules 
arthritic joints 
CNS chorea 
fever

Question 23

which disease would you find sydenhams chorea

Answer 23

rheumatic fever

Question 24

what is the definition of cardiomyopathies and give types

Answer 24

heart muscle disease and strictly speaking it is of uncertain cause 
4 types 
dilated 
hypertrophic 
restrictive 
arrhythmogenic

Question 25

what is the cause of cardiomyopathies

Answer 25

unknown but maybe genetic

Question 26

what is the pathogenesis of cardiomyopathies

Answer 26

heart failure
emboli
arrhythmias

Question 27

what are the key clinical features of the 4 cardiomyopathies

Answer 27

dilated cardiomyopathy - progressive dilation leading to thin wall ventricular chambers
heart enlarged, heavy and flabby

hypertrophic - impaired ventricular filling - relative ischaemia, chest pain, HF

restrictive - idiopathic or secondary to fibrosis, impaired ventricular filling - HF etc

arrythmogenic - young males and athletes - genetic. right ventricle myocyte adhesion impaired due to mutation in desmosome proteins - fibrofatty tissue forms - interferes with conduction

Question 28

what is the definition of myocarditis

Answer 28

inflammation of the myocardium

Question 29

what is the pathogenesis of myocarditis

Answer 29

inflammation of myocardium - electrical dysfunction = arrhythmia or mechanical dysfunction - HF