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PCM Exam 2 > Cardiovascular Pathology 4 > Flashcards

Cardiovascular Pathology 4 Flashcards

1
Q

“box car” shaped nuclei of myocytes is indicative of?

A

hypertrophied cardiac cells

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2
Q

what is cor pulmonale?

A

disease of RIGHT SIDED cardiac chambers secondary to pulmonary parenchymal or pulmonary vascular diseases

pulmonary disease comes first THEN leads to heart problems

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3
Q

the right ventricle is ___________ in acute cor pulmonale

A

dilated but NO HYPERTROPHY

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4
Q

most common cause of chronic cor pulmonale is ______

A

COPD

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5
Q

what are some causes of chronic cor pulmonale?

A
  • COPD (main)
  • obesity
  • idiopathic pulmonary fibrosis
  • cystic fibrosis
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6
Q

what is the morphology of the heart in chronic cor pulmonale?

A
  • right ventricle is hypertrophied and can be associated with right atrial hypertrophy +/- dilation
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7
Q

what is the predominant types of cells you see on histology of viral myocarditis caused most commonly by coxsackie virus?

A

interstitial inflammation with mainly lymphocytes and a few plasma cells

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8
Q

inflammation of the myocardium can also be secondary to necrosis (ischemia), how can you tell on histology the inflammation of the heart is due to that or from a virus like coxsackie?

A

the predominant cells seen on inflammation due to ischemia/necrosis is PMN’s but with viral myocarditis the predominant cells is lymphocytes

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9
Q

myocarditis (caused most commonly by ______) can lead to _______ cardiomyopathy →

A

coxsackie;

dilated cardiomyopathy → chronic CHF

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10
Q

what is the main cause of sudden cardiac death?

A

ventricular arrhythmias

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11
Q

complications of viral myocarditis:

A
  • dilated cardiomyopathy

- arrhythmia leading to SCD

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12
Q

most common out come of viral myocarditis

A

most recover completely

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13
Q

parasitic causes of myocarditis

A
  • trichinella spirali (trichinosis) and is the most common helminth associated w/ myocarditis
  • Trypanosoma Cruzi (chaga’s disease)
  • toxoplasmosis (toxoplasma Gondi)
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14
Q

mixed inflammatory infiltrate composed of neutrophils, lymphocytes and plasma cells are indicative of myocarditis caused by _____

A

fungal (and also seen with myocarditis caused by trypanosoma cruzi)

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15
Q

which drugs can cause non infectious myocarditis?

A
  • methydopa

- sulfonamides

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16
Q

high proportion of ______ along with ____ and ____ would be seen on histology in myocarditis caused by drugs

A

high proportion of eosinophils, w/ macrophages and lymphocytes

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17
Q

what is the cause of death in patients with giant cell myocarditis?

A

arrhythmia and CHF

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18
Q

what conditions are giant cell myocarditis associated with?

A

SLE and thyrotoxicosis

idiopathic etiology

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19
Q

what is the cause of primary cardiomyopathy?

A

unknown; must exclude myocardial diseases caused by: ischemia, HTN, valvular lesions, congenital anomalies and inflammatory disorders

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20
Q

what are the types of cardiomyopathy

A
  • dilated/congestive
  • hypertrophic/ obstructive
  • restrictive
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21
Q

dilated cardiomyopathy is associated with systolic/diastolic dysfunction

A

systolic; will see eccentric hypertrophy

22
Q

thiamine deficiency and chronic anemia is associated with ______ cardiomyopathy

A

dilated

23
Q

peripartum cardiomyopathy is a form of _____ cardiomyopathy and is due to (3) :

A

dilated

pregnancy associated: volume overload, HTN, nutritional deficiencies

24
Q

what are some histological findings in DCM?

A
  • hypertrophied myocytes with enlarged nuclei
  • interstitial and endocardial fibrosis
  • subendocardial scars
25
Q

arrhythmogenic right ventricular cardiomyopathy is due to a defect in __________ leading to

A

desmosomal adhesion proteins

thin RV because the myocytes replaced with fat leading to right sided HF and arrhythmia → SCD

26
Q

a young patient dies suddenly and on autopsy you see that the RV is full of fat. What is an associated disease with this cause of death

A

COD: arrhythmogenic right ventricular cardiomyopathy

associated with Naxos Syndrome

27
Q

the primary problem in hypertrophic cardiomyopathy is _______

A

diastolic filling; the LV is markedly hypertrophied but it is not able to dilate during diastole → ↓ SV

28
Q

what would you expect to se on a gross specimen of a heart of someone who had hypertrophic cardiomyopathy

A

small LV chamber

29
Q

intermittent left ventricular outflow obstruction due to _______ is sometimes seen in what type of cardiomyopathy

A

due to anterior leaflet of MV;

seen in hypertrophic cardiomyopathy

30
Q

_______ mutations in the sarcomere proteins is associated with hypertrophic cardiomyopathy

A

missense (GAIN of function)

31
Q

what proteins are mutated in hypertrophic cardiomyopathy?

A

sarcomere proteins:

  • β myosin heavy chain (most common)
  • myosin binding protein C
  • cardiac troponin T
32
Q

person has a_______ of function mutation in the β myosin heavy chain, causing ________

A

gain of function; myocyte HYPERcontractility → fibroblast proliferation and hypertrophy

33
Q

what type of cardiomyopathy will you see marked fibrosis?

A

hypertrophic; will see pale areas on histology

34
Q

on a gross image, you see a “banana like” configuration of the ventricular cavity, what mutation is this type of cardiomyopathy associated with?

A 
hypertrophic cardiomyopathy (shape is due to the asymmetric septal hypertrophy) 
mutations: β myosin heavy chain, myosin binding protein C, cardiac troponin T
35
Q

endocardial plaques or sclerosis in the left outflow tract is seen in ______

A

hypertrophic CM

36
Q

exertion dyspnea is a presenting symptom of ______ cardiomyopathy

A

dilated; due to the ↓ CO and the ↑ pressure of the LV causes ↑ pulmonary venous pressure

37
Q

harsh ejection systolic murmur is a clinical feature of ______ cardiomyopathy

A

hypertrophic

38
Q

restrictive cardiomyopathy is associated with ________ dysfunction

A

DIASTOLIC and systolic

39
Q

restrictive cardiomyopathy is characterized by _______ leading to diastolic dysfunction

A

↓ compliance of the ventricles due to STIFF WALLS

40
Q

______ fibrosis is a hallmark feature of hypertrophic cardiomyopathy

A

myocardial

41
Q

______ fibrosis is seen in restrictive cardiomyopathy

A

endomyocardial

42
Q

etiologies associated with restrictive cardiomyopathy

A
  • endomyocardial fibrosis
  • Loffler’s syndrome
  • radiation fibrosis
  • amyloidosis
  • metastatic tumors
43
Q

amyloidosis is associated with which cardiomyopathy

A

restrictive

44
Q

describe the size of the atria and ventricles seen in gross image of someone with restrictive CM

A
  • atria are dilated

- ventricles are usually normal or slightly enlarged

45
Q

patchy variable interstitial fibrosis is seen in _____ CM

A

restrictive

46
Q

describe the endomyocardial fibrosis seen in RCM

A
  • dense fibrosis of the endocardium and subendocardium from apex to AV valves
47
Q

______ endomyocarditis has endocardial fibrosis with large mural thrombi

A

Loeffler’s endomyocarditis (type of RCM)

48
Q

which type of RCM is seen in children and young adults and in Africa and the tropics?

A

endomyocardial fibrosis

49
Q

what is a indicator of Loeffler’s endomyocarditis?

A
  • peripheral hypereosinophilia, abnormal degranulated eosinophils
50
Q

what is the cause of fibrosis in Loeffler’s endomyocarditis?

A

MBP from eosinophils will cause endocardial damage, necrosis and fibrosis

PCM Exam 2 (32 decks)

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