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HUD > Cardiovascular Pathology > Flashcards

Cardiovascular Pathology Flashcards

1
Q

What cardiovascular problem is finger clubbing linked to?

A

Congenital heart defect

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2
Q

What cardiovascular problem is a pale nail bed associated with?

A

Anaemia

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3
Q

What cardiovascular problem are splinter haemorrhages associated with?

A

Bacterial endocarditis

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4
Q

What is the cause of gingival hypertrophic?

A

Nifedipine antihypertensive medication

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5
Q

What is the cause of xanthelasma - yellow plaque around eyes?

A

Elevated cholesterol

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6
Q

What is the normal range of heart rate?

A

60-100 bpm

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7
Q

What are the possible causes of chest pain?

A

Respiratory
Cardiac disease
Trauma
Psychological

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8
Q

What are the differential diagnosis of chest pain?

A

Unstable angina: pain at rest
Myocardial infarction: pain at rest >15 mins
Aortic dissection: sever sudden pain, asymmetric pulse
Pericarditis: pain worse on inspiration
Pneumothorax: sudden pleuritic pain, SOB
Pulmonary embolism: pleuritic pain, SOB
Oesophageal rupture: pain after vomit, pain swallowing
Da Costas syndrome: left stabbing pain, anxiety

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9
Q

What is the blood pressure threshold for hypertension?

A

> 140/90 mmHg

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10
Q

What are the two types of hypertension?

A

Primary: no specific cause, genetic, environmental, African
Secondary: narrowing of aorta, drugs (steroids), pregnancy, renal disease

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11
Q

What are the pathological changes of hypertension?

A

Arteriolar sclerosis
Left ventricle enlarges
Atheroma formation, arteries narrow - ischaemic HD
Aneurysms

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12
Q

What are the clinical features of hypertension?

A

Asymptomatic until target organs affected
Dizziness, epistaxis
Predisposes stroke

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13
Q

What is the treatment for hypertension?

A

Primary: lifestyle modifications
Secondary: treatment of cause
Antihypertensive drugs: vasodilation, low cardiac output ABCD: ACE, beta blocker, ca channel, diuretic

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14
Q

What are the four types of hypertensive patient?

A

Normotensive
Controlled - be aware, treat as normal
High BP in practice - defer treatment and refer
Malignant - referred urgently to hospital

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15
Q

What is the dental relevance of hypertension?

A

Stressful environment
Postoperative bleeding
Oral side effects of medication
Do not carry out treatment on >160/10
Breathless laid flat

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16
Q

What are the oral side effects of hypertension drugs?

A

ACE: lichenoid, loss of taste, burning
Beta: xerostomia, lichenoid
Ca: salivation, gingival hyperplasia
Diuretic: xerostomia, altered taste

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17
Q

What is the most common cause of ischaemic heart disease?

A

Coronary atheroma (plaques)

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18
Q

What are the pathological effects of IHD?

A

Atheromatous plaque restricts blood flow
Formation of thrombus
Narrowed lumen
Myocardial infarction

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19
Q

What are the clinical features of IHD?

A

Angina - crushing chest pain
Radiates to neck, jaw, teeth, left arm
Resolves with rest

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20
Q

What are the two classifications of angina?

A

Stable - responds to rest and medication
Unstable - gets progressively worse and occur at rest

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21
Q

What is the treatment of IHD?

A

Lifestyle, underlying abnormalities, surgical stents
Nitrates
Aspirin
GTN spray - use before
Beta blocker
Ca channel
Nicorandil - unstable angina, ulcers

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22
Q

What is the dental relevance of IHD?

A

Emergency: GTN 0.5mg sublingually, 300 mg chewed aspirin
Presents with tooth ache, jaw pain

23
Q

What are the oral side effects of angina medication?

A

Aspirin - bleeding
Beta - mucosal
Ca - gingival hyperplasia
Nicorandil - mucosal, ulcers

24
Q

When should you consider myocardial infarction?

A

Crushing chest pain lasting more than 15 mins

25
Q

What are the signs and symptoms of MI?

A

SOB
Radiates to neck teeth left arm
Nausea
Sweating, pale
Tachycardia
Manage same as angina

26
Q

What is a thrombus made up of?

A

Platelets
RBC
Fibrin

27
Q

What are the causes of deep vein thrombosis?

A

Virchows triad:
Stasis of normal blood flow
Damage to blood vessel wall
Composition change of blood

28
Q

What are the pathological effects of DVT?

A

Blood clot obstructs venous blood flow
Break off into emboli

29
Q

What are the clinical features of DVT?

A

One lower limb
Swelling
Tenderness and pain
Erythema

30
Q

What is the treatment for DVT?

A

Anticoagulant - warfarin
Resorbes clot

31
Q

What is the dental relevance of DVT?

A

Can lead to pulmonary embolism
Anticoagulant drugs require local haem measures

32
Q

How much blockage of arteries is considered atheroma/atherosclerosis?

A

More than 70% lumen occlusion

33
Q

What are the 3 stages of pathogenesis for an atheroma?

A

Initiation - influx cholesterol, plaque formation
Progression - oxidised LDL, fatty streaks, monocytes
Destabilisation - sclerosis, fibrous cap, rupture

34
Q

What are the three common causes of heart failure?

A

Due to problem with systole or diastole
Hypertension - LV fails
Valvular heart disease
Ischaemic heart disease - lack of blood and O2

35
Q

What is the pathology following heart failure?

A

Left ventricle - decreased blood to body, fluid builds up in the lungs
Right ventricle - fluid builds up in periphery of body
Congestive - left failure leads to right and then both

36
Q

What are the symptoms of heart failure?

A

Depends on which ventricle
SOB
Weight gain - left
Swelling in ankles, legs, abdomen - right

37
Q

What is the treatment for heart failure?

A

Lifestyle, surgical - valves/heart transplant
ACE - decrease cardiac workload
Diuretics - reduce fluid overload
Inotropic - increase contractility

38
Q

What is the dental relevance of heart failure?

A

Breathless if laid flat
Keep treatment short
Unstable refer to doctor

39
Q

What is the cause of congenital heart defect?

A

Diseases in first trimester
Familial

40
Q

What is the pathology following congenital heart defect?

A

Obstructive defects - narrowing of flow
Septal defects - hole in the heart, abnormal flow
Cyanotic defects - less oxygen than normal
Shunts - diverted blood

41
Q

What are the clinical effects of congenital heart defect?

A

Cyanosis - blue
Heart failure
Heart murmur
Chest infections

42
Q

What is the treatment for congenital heart defect?

A

Surgery

43
Q

What is the dental relevance of congenital heart disease?

A

Supine position makes them breathless

44
Q

What are the 4 requirements for rheumatic fever to occur?

A

Group A beta haemolytic streptococcal infection
Susceptible host
Pharyngeal site
Persistence of infection

45
Q

When does rheumatic fever occur?

A

2-3 weeks after strep sore throat
Cross reacting antibodies attack tissues

46
Q

Which parts of the heart does rheumatic fever affect?

A

Connective tissues
Valves - mitral

47
Q

What are the clinical features of rheumatic fever?

A

Fever
Poly arthritis
Murmur or endocarditis
Subcutaneous nodules
Chorea

48
Q

What is the treatment for rheumatic fever?

A

Bed rest
Analgesia
Treat strep infection
Aspirin
Corticosteroids if carditis

49
Q

What is the dental relevance of rheumatic fever?

A

Increased risk of endocarditis after treatment
No more antibiotic prophylaxis

50
Q

What are 50% of infective endocarditis caused by?

A

Streptococcus viridans
From dental treatment

51
Q

What is the pathology causing infective endocarditis?

A

Damaged/prosthetic heart valves
Congenial heart defect
Mitral valve affected

52
Q

What are the clinical features of infective endocarditis?

A

Local valvular damage - narrowing and murmur
Septic emboli
Finger clubbing
Flu, weight loss

53
Q

What is the treatment of infective endocarditis?

A

Antibiotic therapy

HUD (16 decks)

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