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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
Finding on the heart valves in stenosis (3)
Aschoff bodies (neutrophils) Anitschkow (macrophages) vegetation on the chordae tendinae
26
Two types of regurgitation?
Aortic | Mitral --> mitral prolapse
27
Cause of Aortic regurgitations? (2)
Infections | Aortic dilation - syphilis, RA and marfans
28
Cause of mitral regurgitation? Myoxomatous? Risk of infective thromboembolims?
Myoxomatous - degeneration of the mitral valve Connective tissue disorder infections Degenerative calcification (risk of infective thromboembolims)
29
Left to right shunt congenital heart defects? (3)
Ventral septal defects Atrial septal defects (patent foramen ovale Patent ductus arteriosus
30
Affects of left to right shunt congenital heart defects? | - Should repair as the child ages
No cyanosis Pulmonary hypertension Volume overload
31
Right to left shunt congenital heart defects (3)
Transposition of the aorta Truncus arteriosus Tetralogy of fallot
32
Tetralogy of fallot includes
Overriding aorta Left ventricular hypertrophy Obstruction to the right ventricle Ventral septum defect
33
Effects of right to left shunt congenital heart defects? | - will require surgery to amend
Cyanosed baby Risk of venous embolism (legs) High stroke risk
34
Obstructive congenital heart defects?
Coarctation of the aorta | Pulmonary valve stenosis
35
Two locations of the coarctation (narrowing) of the aorta and the effect it has
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
Congenital heart defects gene mutations? | Chromosomes affect?
Transcriptional factor genes = TBX5 | Chromosome 22p11.2 deletion (di George)
37
Dysmorphies associated with heart defects
``` Trisomies 21 - downs syndrome 13 - Patau syndrome 18 - Edwards XO - Turner's ```
38
Risk factors for peripheral vascular disease (virchow's triad) (6)
``` Smoking Obesity diabetes Hypertension Age Menopausal women ```
39
Signs of Peripheral vascular disease (4) - arterial issues
Pain - intermittent claudication (on exercise) Pale loss of function Gangrene
40
Giant cell Arteritis - what is it?
Chronic granuloma formation in large and small arteries | Usually in the temporal artery
41
Giant cell arteritis - what causes it?
Immune mediated? Like vascualitis
42
Signs of Giant cell arteritis - sudden onset (6)
``` fleeting blindness (can lead to permanent) Facial pain Headache Jaw claudication Fatigue Weight loss ```
43
Treatment for Giant Cell arteritis (3)
Biopsy Corticosteroids Anti TNF
44
Infective endocarditits - causes --> what makes infection more likely?
Highly virulent organism in already damaged/ deformed heart tissue eg. previous infection, congenital heart defect, artificial vavles)
45
Infections/ condition the lead to Injective Endocarditis? (4)
Upper respiratory infection Vascular catheter bowel malignancy Soft tissue infection
46
Organism that cause infective endocarditis (4)
Strep Viridans Staph aureus Coagulase negative Staph Candida
47
Direct effect of infective endocarditis (5)
``` Take over heart tissue Thrombi from the vegetation Aneurysms abscesses sepsis and fever ```
48
Signs of infective endocarditis | From Jane
``` 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
Causes of Rhuematic fever | Usually first infected age 5 - 15
Group A strep URTI --> immune response that cross reactive with self antigens on heart tissue
50
Rhuematic fever causes: Localised effects (2) Signs/ Sympt (5)
Mitral stenosis + veruccae (vegetations) ``` Fever carditis arthritis left atrial dilation Thrombi and emboli ```
51
Pericarditis
Infection of pericardium
52
Acute effects of pericarditis | Type of fluid =?
``` Accumulation of fluid in the pericardium Serous = non infective Pus = immune cells Haemorrhage = TB or cancer Caseous = fungal ```
53
Chronic pericarditis? effects
Fibrosis of the pericardium Adhesion constrictive (heart failure)
54
Side effects of pericarditis (surgical emergency)
cardiac tamponade --> pressure on heart caused by accumulation of fluid in pericardium
55
Cause of Pericarditis? (6)
``` Cosackie B virus autoimmune - Rheumatoid or SLE Post MI Ureamia neoplasm Trauma ```
56
Signs/ Sympts of pericarditis? (6)
sharp chest pain - - E = moving A = leaning forward - R = shoulders and Back Frictional rub (extra heart sound) Reduced heart sound Fever
57
Cardiomyopathy? Result in (3)?
disease of the heart muscle tissue Arrhythmia Heart failure emboli
58
4 types of cardiomyopathy?
Dilated hypertrophic Restrictive Arrhythmogenic right ventricular dysplasia (ARVD)
59
How to diagnose cardiomyopathy (3 things) Due to there being no obvious cause?
Rule out: Hypertension ischemic heart disease Congential abnormality
60
Dilated cardiomyopathy - what is it? causes (3)? age?
enlarged flabby/ loose heart --> systolic dysfunction Genetic, autoimmune or chronic alcoholism 20 - 50 years
61
Hypertrophic cardiomyopathy - what is it? cause?
Thickness, stiffness and refusal to dilate --> diastolic dysfunction 100% genetic
62
Restrictive cardiomyopathy (rare) what? cause?
Normal thickness BUT no dilation --> diastolic dysfunction | Amyloid and sarcoidosis
63
Arrhythmogenic right ventricular dysplasia (ARVD) | what? age?
Sudden death in young individual | Fibrofatty replacement of heart tissue
64
Myocarditis
Inflammation of the myocardium (muscle layer of the heart)
65
Causes of Myocarditis (12)
``` Coxackie A and B Influenza HIV CMV N. meningococcus Lyme disease candida Chlamydiae Rickettsiae Lupus drugs transplant ```
66
Cytokines/ inflammatory damage in Myocarditis results in?
Electrical and mechanical malfunction | Clotting problems
67
Signs of Myocarditis? (4)
Chest pain Heart failure sudden death arrhythmias

Year 2: Clinical Pathology (10 decks)

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