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Year 2: Clinical Pathology > Cardio Pathology > Flashcards

Cardio Pathology Flashcards

1
Q

Ischemic heart disease includes? (4)

A

MI
Angina pectoris
Chronic ischemic heart disease –> failure
Sudden cardiac death

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2
Q

Stable angina?

A

exacerbated only on exercise

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3
Q

% obstruction at which the vessel can’t vasodilate

A

75

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4
Q

Parthenogenesis of IHD
Fixed coronary obstruction (typical angina)?
Plague destruction result in? (2)

A 
Endothelial dysfunction
Atherosclerotic plague = fixed coronary obstruction
Plague distribution results in:
1) thrombosis - mural OR complete
2) Healing = severe coronary obstruction
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5
Q

Complications of IHD (6)

A 
Arrhythmias
Cardiac tamponae
Aneurysm
thromboembolism
congestive heart failure
Pericarditis
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6
Q

Prevention of IHD

A

anti platelets
Anti-hypertensives
Anti-diabetic medicines

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7
Q

Treatment for IHD (2)

A

Coronary artery bipass

Percutaneous coronary intervention (stents)

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8
Q

Congestive heart failure (2 types)

A

Left sided

Right sided

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9
Q

Hypertension is caused by (2 things)

A

Increased peripheral resistance

Increased cardiac output

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10
Q

Primary hypertension (90% of cases) - causes

A

lifestyle causes = obesity, smoking,

Genetic causes = metabolic disease

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11
Q 
Secondary hypetension (5% cases) - causes (5)
Disease that result in the stimulation of the renin angiotensin system
A 
Cushings - high cortisol
Conns - high aldosterone
Renal vascular disease
Coarctation of the aorta
Drugs: NSAIDs, steroids OCP
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12
Q

What is an aneurysm?

A

localized abnormal dilation of the aorta or heart

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13
Q

3 types of aneurysm?

All can rupture

A 
True = all 3 layers of the wall involved
False = Breach in one of the walls --> extravascular hematoma 
Dissection = breach the wall in two place and sit in between the layers --> double barreled aorta
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14
Q

Congestive heart failure?

A

inability for the heart to pump enough blood to met metabolic needs

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15
Q

Insidious congestive heart failure?

A

Chronic heavy workload

eg. Hypertension and valve disease

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16
Q

Sudden congestive heart failure?

A

Haemodynamic stress

eg. Fluid overload or large MI

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17
Q

Left sided heart failure - Ventricle changes

A

Hypertrophy (due to high blood pressure)
THEN
Dilation (due to not enough nutrients reaching the larger muscle)

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18
Q

Left sided heart failure –> effects (3)

A

Hypoprofusion to the
1) kidneys = raised creatinine and urea
2) Brain = coma, irritability
Pulmonary back pressure = pulmonary oedema, cynosis, orthopnoea, nocturnal dysponea

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19
Q

Right side heart failure - causes (2)

A

Secondary to LSHF

Cor Pulmonale - Chronic Lung disease eg. tumor, COPD

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20
Q

Right side heart failure - effects (3)

A

Systemic congestion = peripheral oedema, transudates

Portal congestion = splenomegaly, engorged liver

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21
Q

Two types of valvual hear disease

A

Stenosis

Regurgitation

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22
Q

Mitral stenosis is caused by?

A

Rheumatoid fever - Group A strep sore throat –> pericarditis –> mitral stenosis

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23
Q

Aortic stenosis - causes by?

A

Calcification of congenitally deformed valve

Senile calcification of the normal heart valve

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24
Q

Effect of stenosis of heart valves? (4)

A

Pressure increases X2
Left ventricular heart failure (BUT no hypertension)
Murmur
Angina (increased demand)

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25
Q

Finding on the heart valves in stenosis (3)

A

Aschoff bodies (neutrophils)
Anitschkow (macrophages)
vegetation on the chordae tendinae

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26
Q

Two types of regurgitation?

A

Aortic

Mitral –> mitral prolapse

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27
Q

Cause of Aortic regurgitations? (2)

A

Infections

Aortic dilation - syphilis, RA and marfans

28
Q

Cause of mitral regurgitation?
Myoxomatous?
Risk of infective thromboembolims?

A

Myoxomatous - degeneration of the mitral valve
Connective tissue disorder
infections
Degenerative calcification (risk of infective thromboembolims)

29
Q

Left to right shunt congenital heart defects? (3)

A

Ventral septal defects
Atrial septal defects (patent foramen ovale
Patent ductus arteriosus

30
Q

Affects of left to right shunt congenital heart defects?

- Should repair as the child ages

A

No cyanosis
Pulmonary hypertension
Volume overload

31
Q

Right to left shunt congenital heart defects (3)

A

Transposition of the aorta
Truncus arteriosus
Tetralogy of fallot

32
Q

Tetralogy of fallot includes

A

Overriding aorta
Left ventricular hypertrophy
Obstruction to the right ventricle
Ventral septum defect

33
Q

Effects of right to left shunt congenital heart defects?

- will require surgery to amend

A

Cyanosed baby
Risk of venous embolism (legs)
High stroke risk

34
Q

Obstructive congenital heart defects?

A

Coarctation of the aorta

Pulmonary valve stenosis

35
Q

Two locations of the coarctation (narrowing) of the aorta and the effect it has

A

Proximal in patent ductus arteriosus = cyanosis of the lower body
Distal to closed patent ductus = hypertension in upper body and hypotension in the lower body (collateral system develops)

36
Q

Congenital heart defects gene mutations?

Chromosomes affect?

A

Transcriptional factor genes = TBX5

Chromosome 22p11.2 deletion (di George)

37
Q

Dysmorphies associated with heart defects

A 
Trisomies
21 - downs syndrome
13 - Patau syndrome
18 - Edwards
XO - Turner's
38
Q

Risk factors for peripheral vascular disease (virchow’s triad) (6)

A 
Smoking
Obesity
diabetes
Hypertension
Age
Menopausal women
39
Q

Signs of Peripheral vascular disease (4) - arterial issues

A

Pain - intermittent claudication (on exercise)
Pale
loss of function
Gangrene

40
Q

Giant cell Arteritis - what is it?

A

Chronic granuloma formation in large and small arteries

Usually in the temporal artery

41
Q

Giant cell arteritis - what causes it?

A

Immune mediated? Like vascualitis

42
Q

Signs of Giant cell arteritis - sudden onset (6)

A 
fleeting blindness (can lead to permanent)
Facial pain
Headache
Jaw claudication
Fatigue
Weight loss
43
Q

Treatment for Giant Cell arteritis (3)

A

Biopsy
Corticosteroids
Anti TNF

44
Q

Infective endocarditits - causes –> what makes infection more likely?

A

Highly virulent organism in already damaged/ deformed heart tissue
eg. previous infection, congenital heart defect, artificial vavles)

45
Q

Infections/ condition the lead to Injective Endocarditis? (4)

A

Upper respiratory infection
Vascular catheter
bowel malignancy
Soft tissue infection

46
Q

Organism that cause infective endocarditis (4)

A

Strep Viridans
Staph aureus
Coagulase negative Staph
Candida

47
Q

Direct effect of infective endocarditis (5)

A 
Take over heart tissue
Thrombi from the vegetation
Aneurysms
abscesses
sepsis and fever
48
Q

Signs of infective endocarditis

From Jane

A 
F- fever
R - roth spots (retinal)
O - olser nodes (hands - finger pads)
M - heart murmurs
J - jane way lesions (palms of hands)
A - anaemia
N - nails = splinter heamorrhages
E - emboli
49
Q

Causes of Rhuematic fever

Usually first infected age 5 - 15

A

Group A strep URTI –> immune response that cross reactive with self antigens on heart tissue

50
Q

Rhuematic fever causes:
Localised effects (2)
Signs/ Sympt (5)

A

Mitral stenosis + veruccae (vegetations)

Fever
carditis
arthritis
left atrial dilation
Thrombi and emboli
51
Q

Pericarditis

A

Infection of pericardium

52
Q

Acute effects of pericarditis

Type of fluid =?

A 
Accumulation of fluid in the pericardium
Serous = non infective
Pus = immune cells
Haemorrhage = TB or cancer
Caseous = fungal
53
Q

Chronic pericarditis? effects

A

Fibrosis of the pericardium
Adhesion
constrictive (heart failure)

54
Q

Side effects of pericarditis (surgical emergency)

A

cardiac tamponade –> pressure on heart caused by accumulation of fluid in pericardium

55
Q

Cause of Pericarditis? (6)

A 
Cosackie B virus
autoimmune - Rheumatoid or SLE
Post MI
Ureamia
neoplasm
Trauma
56
Q

Signs/ Sympts of pericarditis? (6)

A

sharp chest pain -

  • E = moving A = leaning forward
  • R = shoulders and Back

Frictional rub (extra heart sound)
Reduced heart sound
Fever

57
Q

Cardiomyopathy? Result in (3)?

A

disease of the heart muscle tissue
Arrhythmia
Heart failure
emboli

58
Q

4 types of cardiomyopathy?

A

Dilated
hypertrophic
Restrictive
Arrhythmogenic right ventricular dysplasia (ARVD)

59
Q

How to diagnose cardiomyopathy (3 things)

Due to there being no obvious cause?

A

Rule out:
Hypertension
ischemic heart disease
Congential abnormality

60
Q

Dilated cardiomyopathy - what is it? causes (3)? age?

A

enlarged flabby/ loose heart –> systolic dysfunction
Genetic, autoimmune or chronic alcoholism
20 - 50 years

61
Q

Hypertrophic cardiomyopathy - what is it? cause?

A

Thickness, stiffness and refusal to dilate –> diastolic dysfunction
100% genetic

62
Q

Restrictive cardiomyopathy (rare) what? cause?

A

Normal thickness BUT no dilation –> diastolic dysfunction

Amyloid and sarcoidosis

63
Q

Arrhythmogenic right ventricular dysplasia (ARVD)

what? age?

A

Sudden death in young individual

Fibrofatty replacement of heart tissue

64
Q

Myocarditis

A

Inflammation of the myocardium (muscle layer of the heart)

65
Q

Causes of Myocarditis (12)

A 
Coxackie A and B
Influenza
HIV 
CMV 
N. meningococcus
Lyme disease
candida
Chlamydiae
Rickettsiae
Lupus
drugs
transplant
66
Q

Cytokines/ inflammatory damage in Myocarditis results in?

A

Electrical and mechanical malfunction

Clotting problems

67
Q

Signs of Myocarditis? (4)

A

Chest pain
Heart failure
sudden death
arrhythmias

Year 2: Clinical Pathology (10 decks)

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