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CP > Cardiovascular Pathology > Flashcards

Cardiovascular Pathology Flashcards

1
Q

How many people live with CVD in the UK?

A

7 Million

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2
Q

The group of syndromes resulting from myocardial ischaemia are collectively known as

A

Ischaemic Heart Disease

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3
Q

What is IHD usually caused by?

A

coronary artery atherosclerosis

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4
Q

What makes up acute coronary syndrome?

A

MI

Unstable angina

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5
Q

How does prinzmetal angina differ from other types of angina?

A

It is caused by vasospasm rather than atherosclerosis

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6
Q

What are risk factors for IHD?

A

High BP
High HDL
Low TC:HDL ratio

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7
Q

In what layer does the atherosclerotic plaque develop?

A

Intima

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8
Q

What are the types of MI?

A

Transmural- across the full thickness of the wall

Subendocardial- across the inner 1/3rd that is least well perfused

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9
Q

What type of necrosis occurs in myocardium?

A

Coagulative

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10
Q

STEMIs are associated with which type of MI? Will there be cardiogenic shock?

A

Transmural

Yes

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11
Q

When will the following changes occur in the myocardium:

Yellow with haemorrhagic edge, myocyte necrosis and macrophages

A

Day 3-4

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12
Q

What are complications of an MI?

A 
Heart failure
Arrhythmia
Pericarditis 
Cardiac tamponade 
Cardiogenic shock
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13
Q

What is Beck’s triad?

A

Hypotension
Distended JVD
Muffled heart sounds

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14
Q

What is Virchow’s Triad?

A

Hypercoagubility
Altered blood flow
Endothelial cell injury

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15
Q

Troponins T&I can be seen in what condition?

A

IHD

peak at 12 hours but can also be seen in PE, HF and myocarditis

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16
Q

Creatinine Kinase MB (CKMB) peaks when?

A

10-24 hours

It is also found in skeletal muscle

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17
Q

Myoglobin, Aspartate transaminase and Lactate dehydrogenase isoenzyme 1 are blood markers of what?

A

IHD

Lactate is detectable for up to 14 days after an MI

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18
Q

What group is affected more by hypertension?

A

Africans

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19
Q

BP=

A

Cardiac output x Peripheral resistance

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20
Q

What does the RAAS regulate?

A

blood volume and systemic vascular resistance

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21
Q

Where is renin produced?

A

Juxtaglomerular apparatus in the kidneys

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22
Q

Where can AII be formed?

A

Lungs (primarily)
Heart
Brain

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23
Q

What does aldosterone do?

A

Stimulates reabsorption of salt and water at the kidneys

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24
Q

What does AII to?

A

stimulates aldosterone release
causes vasoconstriction
stimulates release of ADH to increase fluid retention
facilitates noradenaline release

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25
Q

Renal artery stenosis, polyarteritis nodosa and aortic coarctation can

A

cause secondary hypertension

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26
Q

BP over 180/120 shows signs of

A

malignant hypertension

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27
Q

A ‘flea bitten’ kidney, SAH and lacunar infarcts are

A

complications of hypertension

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28
Q

In left sided hypertensive heart disease, what occurs

A

hypertrophy of LV in response to pressure overload

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29
Q

Cor pulmonlae refers to

A

right sided hypertensive heart disease that causes:

RV hypertrophy and HF secondary to pulmonary artery hypertension caused by disorders of the lung

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30
Q

What are diseases of the lung parenchyma that can cause Cor Pulmonale?

A

COPD, CF, Pneumoconiosis, Bronchiectasis, Pulmonary interstitial fibrosis

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31
Q

Kyphoscoliosis, Pickwickian syndrome and neuromuscular diseases are causes of

A

Cor pulmonale

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32
Q

A breach in the vascular wall leading to an extravascular haematoma that communicates with the intravascular space is known as

A

a false aneurysm

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33
Q

Dissecting aneurysms occur

A

between the walls of the artery

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34
Q

Which type of double barreled aorta is associated with the descending aorta alone?

A

Type B

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35
Q

What are the main causes of aneurysms?

A

Atherosclerosis

Cystic medial degeneration (associated with Marfan)

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36
Q

Insiduous HF is caused by

A

hypertension and valve diseases

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37
Q

HF is more common in

A

those over 40
males
postmenopausal women

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38
Q

Sudden HF is cause by

A

a large MI and fluid overload

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39
Q

What are other causes of HF?

A

Beriberi
anaemia
hyperthyroidism

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40
Q

Atrial natriuretic peptides are released in

A

cardiac dysfunction

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41
Q

Left sided HF is due to

A

pulmonary congestion

low CO and hypoperfusion of tissues

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42
Q

What are symptoms seen in left sided HF?

A 
Increased hydrostatic pressure in pulmonary circulation
Orthopnoea
PND
Blood tinged sputum 
'Wedge' pressure
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43
Q

What causes left sided HF?

A

Cor pulmonale or left heart failure

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44
Q

A nutmeg liver is seen in what condition?

What is it caused by?

A

Right sided HF

Passive congestion

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45
Q

Hydrothorax and distention of the jugular veins are symptoms of which sided HF?

A

Right

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46
Q

Aortic stenosis occurs via

A

calcification of a congenitally bicuspid valve
calcification in those over 70
rheumatic heart disease

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47
Q

What is the only cause of mitral stenosis?

A

Rheumatic heart disease

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48
Q

What causes a ‘collapsing pulse’?

A

Aortic regurgitation

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49
Q

What can cause aortic regurgitation?

A

Rheumatological disorders
Syphilis
Marfan’s

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50
Q

MVP is the main cause of

A

Mitral regurgitation

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51
Q

Fen-phen (appetite suppressant) induces valvular fibrosis that causes

A

Mitral regurgitation

52
Q

Problems with the chordae tendinae and papillary muscle can cause

A

mitral regurgitation

53
Q

myxamatous degeneration of the mitral valve is also known as

A

mitral valve prolapse

54
Q

MVP is associated with

A

Marfan syndrome

55
Q

Which congenital heart diseases are associated with a L to R shunt?

A

Ventricular septal defect
Atrial septal defect
Patent ductus arteriosus
AV septal defect

56
Q

Which congenital heart diseases are associated with a R to L shunt?

A 
ToF
Transposition of the great arteries
Truncus arteriosus
Tricuspid atresia
Total anomalous pulmonary venous connection
57
Q

What congenital heart defects are associated with DiGeorge syndrome?

A

conotruncus

58
Q

mutations of the TBX5 gene leads to

A

ASD, VSD

59
Q

mutations of the NKX2.5 and GATA4 genes leads to

A

ASD

60
Q

Congenital rubella syndrome can cause

A

Congenital heart diseases

61
Q

R to L shunts cause

A

cyanosis

62
Q

L to R shunts cause

A

pulmonary hypertension

63
Q

Eisenmenger syndrome is

A

where in a VSD, the L to R shunt is reversed to a R to L shunt with cyanosis

64
Q

Patent foramen ovale does not cause a

A

Atrial septal defect

65
Q

Secundum is the most common type of

A

ASD

66
Q

VSDs are common in

A

ToF

67
Q

A boot shaped heart is characteristic of

A

TOF

68
Q

The common features of TOF are

A

VSD
Overriding aorta
RV hypertrophy
Pulmonary stenosis

69
Q

What does survival with TOF depend on

A

the severity of the pulmonary stenosis

70
Q

Tet spells are experienced by babies when they

A

feed/cry

71
Q

Which direction is the shunt in TOF?

A

R to L

72
Q

Coarctation of the aorta is common in what condition

A

Turners syndrome

73
Q

In infants, what does coarctation of the aorta cause

A

cyanosis in lower half of the body (due to patent ductus arteriosus)

74
Q

In adults, what does coarctation of the aorta cause

A

hypertension in UL
hypotension in LL
notching on undersurface of the ribs
claudication and coldness

75
Q

What are the 6 Ps of acute ischaemia?

A 
pallor
pulseless
painful
paralysed
perishing cold
paraesthetic
76
Q

Chronic granulolmatous inflammation of arteries is known as

A

giant cell arteritis

77
Q

GCA is usually

A

immune mediated

78
Q

temporal arteritis is a form of

A

GCA

79
Q

GCA can be treated with

A

corticosteroids

anti-TNF therapy

80
Q

vegetations on valves is indicative of

A

endocarditis

81
Q

SLE and NBTE are causes of

A

non-infective endocarditis

82
Q

subacute infective endocarditis is caused by

A

organisms of a lower virulence

83
Q

When is S. viridans likely to cause infective endocarditis ?

A

late (60 days after surgery)

usually to damaged valves

84
Q

IVDUs are likely to get infective endocarditis from what organism?

A

S. aureus

85
Q

When are murmurs present in IE?

A

Left sided cases

86
Q

What are clinical signs of IE?

A

Splinter haemorrhages
Janeway lesions
Oslers nodes
Roth spots

87
Q

What causes rheumatic fever?

A

Group A streptococci

88
Q

Veruccae and Aschoff bodies are typical of

A

rheumatic fever

89
Q

‘Fish mouth’ and ‘buttonhole’ stenosis are seen in

A

on the mitral valve in rheumatic fever

90
Q

Diagnosis of rheumatic fever requires

A

Jones criteria

91
Q

Coxsackie B can cause what cardiovascular infection?

A

Pericarditis

92
Q

What is Dressler’s?

A

secondary form of pericarditis and occurs post MI (years later) and it is an autoimmune response

93
Q

What type of pericarditis is caused by non-infectious aetiologies?

A

Serous pericarditis

94
Q

What is the most common form of pericarditis?

A

Serofibrinous pericarditis

95
Q

Suppurative pericarditis can extend to cause

A

mediostino-pericarditis

96
Q

In which type of pericarditis is complete resolution rare

A

Suppurative pericarditis

97
Q

Neoplasia and cardiac tamponade can cause what type of pericarditis?

A

Haemorrhagic

98
Q

The treatment for what type of pericarditis is to remove the ‘shell’ by surgery?

A

Chronic pericarditis

The pericardial sac becomes fibrosed and leads to limited cardiac function

99
Q

What relieves pericarditis?

A

Sitting forwards

100
Q

What type of cardiomyopathy is associated with cytoskeleton protein gene mutations?

A

Dilated cardiomyopathy

101
Q

In what cardiomyopathy is there diastolic dysfunction with preserved systolic function?

A

Hypertrophic cardiomyopathy

102
Q

What can be used to treat hypertrophic cardiomyopathy?

A

beta-adrenergic blockers

103
Q

What is the rarest cardiomyopathy?

A

Restrictive

104
Q

A disorder of cell-cell desmosomes causes

A

Arrhythmic RV cardiomyopathy

105
Q

Chaga’s disease and Lyme disease can cause

A

myocarditis

106
Q

an inflammatory process of leptomeninges and CSF is known as

A

meningitis

107
Q

meningoencephalitis is

A

inflammation of the meninges and brain parenchyma

108
Q

What are the three forms of meningitis?

A

acute pyogenic (bacterial)
aseptic (viral)
chronic (TB, neurosyphilis and cryptococcis neoformans)

chronic meningitis is where CSF remains abnormal for >4 weeks

109
Q

Haematogenous spread of CNS infections is

A

the most common and usually via an arterial route (can also be retrograde)

110
Q

Direct implantation of CNS infections is normally

A

traumatic

111
Q

CNS infections can spread from local regions such as

A

the mastioid, frontal sinuses and infected teeth

112
Q

Clinical feature of meningitis include

A 
headache
irritability 
photophobia
fever
rash
113
Q

In the young, meningitis can be caused by

A 
S. agalactiae 
Listeria monocytogenes 
Klebsiella 
Salmonella 
H. influenzae
114
Q

What does the CSF look like in meningitis?

A

cloudy and turbid
100-2000 polymorphs
high protein

115
Q

Viral meningitis can start as

A

respiratory or intestinal infections

116
Q

What type of meningitis has an insidious onset and high frequency of complications?

A

Tubercular meningitis

117
Q

What commonly causes encephalitis?

A

viruses, especially Herpes

118
Q

What are the clinical features of encephalitis?

A

behavioural changes
Headache
seizures
focal neurological consciousness

119
Q

What can cause severe haemorrhage encephalitis affecting the temporal lobe?

A

Herpes encephalitis

120
Q

When is the rabies infection cycle complete?

A

When the virus replicates in the salivary glands

121
Q

What are symptoms of the prodromal phase of rabies?

A

fever
nausea
fatigue
burning

122
Q

what are symptoms of the furious phase of rabies?

A

agitation
disorientation
hydrophobia
seizures

123
Q

What are the last two phases of the rabies infection?

A

Dumb phase and coma phase

124
Q

What causes tabes dorsalis?

A

Neurosyphilis

125
Q

Brain abscesses are often

A

polymicrobial

126
Q

What pathogen commonly causes brain abscesses after trauma/surgery?

A

S. aureus

127
Q

How is a brain abscess managed?

A

Drainage

small abscesses can be treated with Abx

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