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Cardiology > Cardiopathology > Flashcards

Cardiopathology Flashcards

1
Q

Hyaline Arteriolosclerosis causes? What is the MOA?

A

Benign HTN=>forces protein into the wallDM=>NEG of basement=>protein goes into vesel wall

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2
Q

Hyperplastic arteriolosclerosis is due to? MOA?

A

Malignant HTN=>High BP forces walls to thicken to contain BP

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3
Q

Fibrinoid Necrosis ARF w. flea bitten appearance (pinpoint hemorrhage) Cause?

A

Hyperplastic arteriolosclerosis

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4
Q

Glomeular scarring and shrunken kideny, MOA?

A

Hyaline arteriolosclerosis

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5
Q

Do Fatty Streaks predict where the atherosclerosis will happen?

A

NO

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6
Q

What are the modifiable risk factors of atherosclerosis?

A

Smoking, HTN, Hyperlipidemia, DM

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7
Q

MOA of Atherosclerosis?

A

Endothelial cell dysfunction=>macrophage and LDL accumulation=>foam cell formation=>fatty streaks=>smooth muscle cell migration (involves PDGF and FGF), proliferation, and extracellular matrix deposition=>fibrous plaque=>complex atheromas

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8
Q

Patients with atherosclerosis are symptomatic when the stenosis reaches?

A

70%

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9
Q

MC location of atherosclerosis, name 4 places?

A

Abdominal aorta>coronary artery>popliteal artery>carotid artery

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10
Q

Abdominal Pain and/or back pain is indicative of what in an aortic aneuyrsm?

A

Immiment rupture, leaking, dissection

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11
Q

Which aneurysm is associated with atherosclerosis?

A

Abdominal aortic aneurysm

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12
Q

An abdominal aorta >5cm will lead to what?

A

rupture

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13
Q

Which aneurysm is associated with cystic medial degeneration?

A

Thoracic Aortic Aneurysm

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14
Q

Where is abdominal aortic aneurysm most commonly found?

A

Below Renal Artery and above the aortic bifurcation

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15
Q

What two diseases are historically associated with thoracic aortic aneurysm?

A

Marfan and syphilis

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16
Q

In syphilitic aneurysm-> what is the cause? And what appearance of the aorta do you get?

A

Obliterative endarteritis of the vasa vasorum

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17
Q

Aortic Dissection is ripping through what wall?

A

Media wall

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18
Q

MCC of death in aortic dissection?

A

Pericardial tamponade

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19
Q

Aortic Dissections are due to what two preexisting conditions?

A
  1. Needs lots of pressure=>why it is found in proximal 10 cm of the aorta2. Needs pre-existing weakness of media=>MCC HTN
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20
Q

Stanford A involves? Stanford B involves?

A

Ascending aorta; Bottom aorta

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21
Q

Subendothelial infarction shows what on ECG?

A

ST segment depression

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22
Q

Prinzmetal or Variant Angina on ECG?

A

Transient ST elevation

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23
Q

Sudden Cardiac death is most commonly due to?

A

Lethal arrythmia

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24
Q

Explain 1 day, 1 week and 1 month

A

CN (arrythmia, and dark discolaration at 1 dayNeutrophils, macrophages=>inflammation (Yellow) and rupture/pericarditis 1 weekGT=Red a couple of weeks to monthScarring=>White (type 1 collagen) 1-6 months

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25
Q

Most sensitive and specific cardiac enzyme?

A

Troponin I

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26
Q

Troponin I rises after how many hours? For how long?CK-MB rises after? For how long?

A

Troponin: Rises after 4 hours and stays up for 7-10 daysCK-MB rises after 6-12 hours

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27
Q

CKMB is most useful in dx-ing what?

A

Reinfarction

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28
Q

Anteromedial and Anteroseptal is shown in which leads?

A

V1-V4

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29
Q

Lateral wall MI Lead? What is main artery supplying this wall?

A

I, avL; V5 and V6LCX

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30
Q

Inferior wall MI Leads? What artery supplies this wall?

A

II, III avFRCA

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31
Q

Autoimmune phenomenon resulting in fibrinous pericarditis? When do you see this?

A

Dressler Syndrome (6-8 weeks)

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32
Q

Reperfusion therapy is most important in STEMI (PCI>fibrinolysis) but it can cause two problems. What are these two problems?

A
  1. Contraction band necrosis (Ca2+ reenters the cell and causes contraction=>dense pink lines)2. Reperfusion injury=>generates free radicals (O2)
33
Q

MC Cardiomyopathy? What kind of a cardiomyopathy is this?

A

Dilated Cardiomyopathy; Systolic Cardiomyopathy

34
Q

Dilated cardiomyopathy Causes?

A

Alcohol abuse+wet BeriberiCox B virus (MC)Cocaine useChagas diseaseDoxorubicinhaving a Cid cardiomyopathy (pregos)

35
Q

Findings of Cardiomyopathy?

A

S3, systolic regurgitant murmur (mitral/tricuspid regurg)

36
Q

Hypertrophic Cardiomyopathy MCC? What kind of a defect is this disease?

A

AD B-myosin Heavy chain; diastolic

37
Q

Hypertrophic Cardiomyopathy Findings?

A

S4, systolic regurg (mitral regurg)

38
Q

What will you see in a bx of patient with Hypertrophic cardiomyopathy?

A

Bx: Myofibrillar disarray and fibrosis

39
Q

Restrictive cardiomyopathy what kind of a disease is it? What are major causes?

A

Diastolic Dysfunction-Osis

40
Q

Restrictive cardiomyopathy in kids is due to?

A

Endocardial fibroelastosis-thick elastic tissue

41
Q

Endomyocardial fibrosis with a prominent eosinophilic infiltrate. What is this describing?

A

Loeffler syndrome

42
Q

What will you see in the ECG of Restrictive Cardiomyopathy?

A

Low voltage ECG+Diminished QRS

43
Q

Hemachromatosis can cause what two cardiomyopathy?

A

Restrictive and Dilated Cardiomyopathy

44
Q

Left Heart Failure signs?

A

Orthopnea, PND, Pulmonary Edema

45
Q

Right Heart Failure signs?

A

Hepatosplenomegaly (nutmeg liver), JVD, Peripheral edema

46
Q

Hypovolemic Shock, what happens to the Skin,Preload, CO and Afterload?

A

Skin=cold; Decreased Preload=>Decreased CO=>Increased SVR

47
Q

In cardiogenic or obstructive shock,what happens to the Skin,Preload, CO and Afterload?

A

Skin=> Cold; CO=>decreased SVR=>increased Preload=>increased

48
Q

In distributive (septic)shock,what happens to the Skin,Preload, CO and Afterload?

A

Skin-warm=>SVR=>Decreased; Preload=>Decreased but CO increases (tachycardia)

49
Q

First sign of shock?

A

Tachycardia

50
Q

Bacterial endocarditis MC symptom?

A

Fever

51
Q

What do you see in a patient with bacterial endocarditis?

A

FROM JANEFeverRoth spotOsler Nodes (Ouch)MurmurJaneway lesionsAnemia of Chronic DiseaseNail-bed hemorrhageEmboli

52
Q

SubAcute is caused by what organism? MOA? Small or large vegetations? Low or High Virulence? What profession does it MC-ly affect?

A

Viridans StrepMOA: Affects previously damaged valvesSmaller VegetationsLow VirulenceDental proceduresMCC overall

53
Q

Acute is caused by what organism? MOA? Small or large vegetations? Low or High Virulence? What profession does it MC-ly affect?

A

S. AureusLarge VegetationsTricuspid valveIV drug userHigh Virulence

54
Q

With Strep Bovis what should you look for?

A

CRC

55
Q

S. Epi affects?

A

prosthetic valves

56
Q

If Culture is Neg in Bacterial Endocarditis, what organisms should you suspect?

A

HACEKHaemophilus,Actinobacillus, Cardiobacterium, Eikenella,Kingella

57
Q

Rheumatic Fever is caused by?

A

Group A Strep=rheumAtic fever

58
Q

Rheumatic Fever affects what kind of heart valves?

A

High PressureMitral>Aortic

59
Q

With an early lesion of rheumatic fever, what valvular disorder do you commonly see first? With Late?

A

Early: Mitral valve regurgLate: Mitral Stenosis (takes a long time to calcify the valve)

60
Q

MOA of Rheumatic Fever? HSR?

A

Molecular Mimicry; M protein cross reacts with self-antigenType II HSR

61
Q

Rheumatic Fever is associated with 3 Findings?

A
  1. Aschoff Bodies2. Anitschkow cells (wavy ovoid rod-like nucleus macrophages)3. Elevated ASO titers
62
Q

Explain the JONES criteria

A

JointHeartNodules in skinErythema marginatumSydenham chorea

63
Q

In Cardiac Tamponade, what are the findings?

A

Beck’s Triad (Hypotension, distended neck veins and distant heart sounds)

64
Q

Apatient with ball valve obstruction in left atrium and has multiple syncopal episodes. What is the Dx? Where is this pathology’s origin

A

Myxomas; mesechymal origin

65
Q

A 80 year old white female is diagnosed with avery aggressive blood vessel malignancy. What is this most likely to be associated with?

A

Vinyl chloride (PVC)

66
Q

Strawberry hemangioma vs Cherry Hemangioma

A 
Cherry Hemangioma (Cling on)
Strawberry Heamngioma goes away(strawberry is for "babies")
67
Q

An 70 y/o Eastern European Male w/hx of AIDS and transplanthas a purple plaque in the skin and mouth. What is agent causing this problem?

A

Kaposi Sarcoma;HHV-8=>invasion of endothelial cells

68
Q

AIDS patient with Abdominal Pain and hemorrhagic lesions?

A

HHV-8 kaposi sarcoma

69
Q

Rhabdomyomas are associated with?

A

Children and TSC

70
Q

In chronic Rheumatic fever=> what happens to the valves?

A

Fusion of commisures=>fish mouth

71
Q

Atherosclerosis can do what to the kidneys and its arteries? What should you avoid?

A

Renal Artery Stenosis
Unilateral atrophy of affected kidney
ACE inhibitors

72
Q

Pulmonary edema can lead to what kind of cells forming?

A

HF (hemosiderin-ladin macrophages)

73
Q

End result of SHOCK?

A

Multiple organ dystfunction syndrome

74
Q

In what disease, do you lean forward to make the pain go away and there is friction rub?

A

Acute Pericarditis

75
Q

Kussmaul sign?

A

Increased JVP on inspiration

76
Q

Do Kaposi Sarcomas blanch

A

NO

77
Q

Smoking increases risk for ischemic disease how?

A
  1. Promotes atherosclerosis

2. promotes aggregation

78
Q

Rheumatic Fever MCC of Death?

A

Myocarditis

79
Q

Dynamic Left Ventricle outflow obstruction?

A

Hypertrophic cardiomyopathy

Cardiology (12 decks)

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