Cardiovascular

Question 1

What is the definition of hemorrhagic infarction?

Answer 1

• They are INFARCTS
• COMMONLY Caused by VEIN OCCLUSION
• RBCs entering AREA of Infarct OR ARTERY Occlusion of Organ WITH Collaterals / Dual Circulation

Question 2

What stages does atherosclerosis have when it comes to blood vessel changes?
Describe it.

Answer 2

• TYPE 1 = Initial Lesion where there’s ISOLATED MF Foam Cells
• TYPE 2 = FATTY STREAK Lesion, where there’s mainly INTRACELLULAR LIPID Accumulation
• TYPE 3 = INTERMEDIATE Lesion, where there’s TYPE 2 Changes AND EXTRACELLULAR Lipid Pools
• TYPE 4 = ATHEROMA Lesion, where there’s TYPE 2 Changes AND a CORE of EXTRACELLULAR Lipid Pools
• TYPE 5 = FIBROATHEROMA Lesion, where’s MULTIPLE LIPID Cores, and FIBROTIC Layers
• TYPE 6 = COMPLICATED Lesion, where there’s Surface DETECT / Hematoma-Haemorrhage / Thromb

Question 3

What are the main risk factors for developing atherosclerosis?

Answer 3

Major Controllable
- Hyperlipidemia
- Arterial Hypertension
- Cigarette Smoking
- Diabetes Mellitus
———————————————————————
Major Un-controllable
- Age, as RF’s INCREASE with Risk
- Males
- Genetic Predisposition = Familial Hypercholesterolemia
———————————————————————
Minor
- LACK of Exercise
- Type A Personality (STRESS)
- Obesity
- Oral Contraceptives
- Gout
- HIGH Carbohydrate Intake

Question 4

Describe the gross & histological changes in atherosclerosis

Answer 4

1) FATTY STREAKS / DOTS
- Grossly, the Lesion is FLAT, YELLOW, 1mm in ELONGATED Beaded Streaks

• Histo, they’re CLOSELY-PACKED:
  0 Foam Cells
  0 Lymphoid Cells
  0 Lipid-Containing SM Cells

2) GELATINOUS LESIONS
- Grossly, they DEVELOP in the INTIMA of AORTA

• Histo, they’re a FOCI of INCREASED Ground Substance

3) ATHEROMATOUS PLAQUE
- Grossly it’s 1-2cm RAISED WHITE Fibrous Cap with YELLOW Centre CORE

• Histo, it’s a FIBROUS Cap mixed of
  0 MFs
  0 Foam Cells
  0 Lymph
• Central Core consists of Lipid Material, Cholesterol Cleft + Fibrin Debris

4) COMPLICATED PLAQUE
- Grossly consists of:
0 Calcification
0 Ulceration
0 Thrombosis
0 Haemorrhage
0 Aneurysm Formation

• Histo, there are Calcium Salts in NECROTIC Area

Question 5

Systemic hypertension- the major organs involved and how the kidneys are

Answer 5

Systemic HT = HIGH Blood Pa in Systemic Arteries

Considered if Resting BP is MORE than 140 / 90 mmhg

Organs Involved = Eyes, Arteries, Heart, NS + Kidneys

Kidneys:
- Medium-Sized Renal Arteries / Arterioles show INITIMAL Proliferation AND HYALINISATION of Muscular Media

• PRODUCES Focal Areas of ISCHAEMIA with SCARRING LOSS of Tubules
• Cortical Surfaces are FINELY Granular
• Normal in Size OR Slightly ENLARGED
• SPECKLED Cortex with SMALL Pin-Point Haemorrhages

Question 6

Organ changes related to Hypertension

Answer 6

DAMAGE TO:

1) Arteries:
- Cause DAMAGE + NARROWING as it DAMAGES the CELLS of Artery’s INNER LINING , becoming LESS Elastic, LIMITING BF

• ## Cause ANEURYSM, where SECTION of Wall ENLARGES + BULGES, which could POTENTIALLY RUPTURE, leading to LIFE-THREATENING Bleeding2) Heart:
• CAD = Narrowed + Damages Arteries, can cause TROUBLES Supplying Blood to Heart
• ENLARGED Left Heart = HIGH BP causes Heart to WORK HARDER to pump to rest of body, causing LEFT VENTRICLE to THICKEN
• ## Heart FAILURE = STRAINED Heart can cause heart Muscle to WEAKEN + WORK LESS Efficiently3) Brain:
• TRANSIENT ISCHAEMIC ATTACK = Mini-stroke where there’s TEMPORARY DISRUPTION of Blood Supply to the Brain
• STROKE = When PART of Brain is DEPRIVED of Oxygen + Nutrients, causing Brain Cells to DIE
• ## DEMENTIA = Narrowed / Blocked Arteries can LIMIT BF to the Brain leading to a CERTAIN TYPE of Dementia (Vascular)4) Kidneys:
• ## GLOMERULOSCLEROSIS = Tiny BVs in Kidneys become SCARRED + UNABLE to Effectively FILTER FLUID + WASTE from the blood5) Eyes:
• RETINOPATHY = DAMAGE to the RETINA can lead to BLEEDING in the eye, blurred vision / complete loss
• OPTIC NEUROPATHY = When the OPTIC NERVE becomes DAMAGED, leading to BLEEDING in eye + Vision Loss

Question 7

Myocardial infarction definition and complications
- Types of pericarditis

Answer 7

DEFINITION = MI is IRREVERSIBLE NECROSIS of the Heart Muscle + is SECONDARY TO Prolonged ISCHAEMIA, DUE to CAD

COMPLICATIONS:
- Arrhythmias
- Congestive HF
- Cardiac Aneurysm WITH Mural Thrombosis
- Pericarditis (Inflammation of Pericardial Layer)

TYPES OF PERICARDITIS
1) ACUTE = Serous / Fibrinous / Purulent / Fibro-purulent / Haemorrhagic

2) CHRONIC = Tuberculous / Chronic Adhesive / Chronic Constrictive / Pericardial Plaques