Cardiovascular disease 1

Question 1

Define ischaemic heart disease

Answer 1

inadequate blood supply to the myocardium

Question 2

What causes ischaemic heart disease?

Answer 2

• reduced coronary blood flow (due to atheroma/thrombus)
• myocardial hypertrophy, usually due to systemic hypertension
• any imbalance in supply/demand

Question 3

What is the most common cause of ischamic heart disease?

Answer 3

atheroma

Question 4

How quickly must myocardium be re-perfused in order to recovery?

Answer 4

15-20 minutes

Question 5

What is typical angina pectoris?

Answer 5

caused by a fixed luminal narrowing of a vessel, that will only cause difficulty at a certain level of work, predictable and not getting worse

Question 6

Which is the most vulnerable layer of the heart walls?

Answer 6

subendocardium

Question 7

What is a transmural infarct?

Answer 7

A severe blockage that causes cell death through the whole thickness of the wall - can only heal by scarring

Question 8

What is normal blood pressure?

Answer 8

120/80 mmHg

Question 9

What is a phaechromocytoma?

Answer 9

tumour of the adrenal medulla

Question 10

Define endocarditis

Answer 10

inflammation of the endocardium of the heart

Question 11

What are the two forms of endocarditis?

Answer 11

infective and non-infective

Question 12

What is infective endocarditis?

Answer 12

colonisation/invasion of heart valves or heart chamber endocardium by a microbe

Question 13

What are the vegetations of infective endocarditis formed from?

Answer 13

mixture of thrombotic debris and organisms

Question 14

What is the most common cause of infective endocarditis?

Answer 14

streptococcus viridans from the mouth

Question 15

What clinical features do you see in infective endocarditis?

Answer 15

fever, non-specific symptoms (flu-like etc), murmurs (with left sided IE)

Question 16

What is libman-sacks endocarditis associated with?

Answer 16

systemic lupus erthematosis (SLE)

Question 17

What is rheumatic fever?

Answer 17

acute, immunologically mediated, multi-system inflammatory disease following group A strep pharyngitis

Question 18

What is virtually the only cause of mitral valve stenosis?

Answer 18

rheumatic fever

Question 19

What criteria is used to diagnose rheumatic fever?

Answer 19

Jones criteria

Question 20

What is pericarditis?

Answer 20

inflammation of the pericardium

Question 21

What are the main causes of pericarditis?

Answer 21

• infections
• immunologically mediated processes
• miscellaneous conditions

Question 22

What causes a purulent/suppurative pericarditis?

Answer 22

infection

Question 23

What are the common causes of haemorrhagic pericarditis?

Answer 23

• neoplasia
• infections
• post cardiac surgery

Question 24

What is constrictive pericarditis?

Answer 24

heart encased in fibrous scar (limits cardiac function)

Question 25

Define cardiomyopathy

Answer 25

heart muscle disease

Question 26

What is dilated cardiomyopathy?

Answer 26

progressive dilation of heart causing contractile dysfunction

Question 27

What are the 2 main causes of cardiomyopathy?

Answer 27

genetic and alcohol

Question 28

What treatment can you give someone with dilated cardiomyopathy?

Answer 28

• cardiac transplantation

- long-term ventricular assist

Question 29

Do you get diastolic dysfunction in hypertrophic or dilated cardiomyopathy?

Answer 29

hypertrophic

Question 30

What is the only cause of hypertrophic cardiomyopathy?

Answer 30

genetics (mutations sacromeric proteins)

Question 31

How do you treat hypertrophic cardiomyopathy?

Answer 31

decrease heart rate and contractility (beta blockers)

reduction of the mass of the septum

Question 32

What is restrictive cardiomyopathy?

Answer 32

primary decrease in ventricular compliance

Question 33

Which cardiomyopathy is caused by disorder of cell-cell desmosomes?

Answer 33

arrythmogenic right ventricular cardiomyopathy

Question 34

Define vasculitis

Answer 34

inflammation of the vessel walls

Question 35

What is the most common form of vasculitis?

Answer 35

giant cell arteritis

Question 36

How is giant cell arteritis pathologically defined?

Answer 36

chronic granulomatous inflammation of large to medium-sized arteries, especially in the head

Question 37

How do you diagnose giant cell arteritis?

Answer 37

biopsy and histology - segmental disease so 2-3cm taken

Question 38

How do you treat giant cell arteritis?

Answer 38

corticosteroids

anti-TNF therapy

Question 39

Define aneurysms

Answer 39

localised, permanent, abnormal dilatations of a blood vessel

Question 40

What is the main risk factor for AAA rupture?

Answer 40

SIZE

Question 41

What is a dissecting aneurysm?

Answer 41

characterised by tear in the wall and blood tracks between intimal and medial layers

Question 42

What are the classical symptoms of dissecting aneurysms??

Answer 42

tearing pain in chest radiating to upper left shoulder

Question 43

When do Charcot-Bouchard aneurysms occur?

Answer 43

in intracerebral capillaries in hypertensive disease

Question 44

What are mycotic aneurysms?

Answer 44

weakening of arterial wall secondary to bacterial/fungal infection

Question 45

What is a false aneurysm?

Answer 45

blood filled space around a vessel, usually following traumatic rupture or perforating injury

Question 46

What are the 6 Ps of acute ischaemia?

Answer 46

pale, pulselessness, painful, paralysis, paraesthesia, perishing cold