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PATHOLOGY II > chapter 10 > Flashcards

chapter 10 Flashcards

1
Q

MC mechanism of heart disease

A

contractile (pump) failure

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2
Q

causes of heart failure

A

decrease cardiac output (MC), increase tissue demands

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3
Q

causes of decreased cardiac output

A
  1. systolic dysfunction
  2. diastolic dysfunction
  3. Valvular dysfunction
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4
Q

systolic dysfunction

A

weak contraction

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5
Q

diastolic dysfunction

A

failure of relaxation/filling. MC in females

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6
Q

Valvular dysfunction

A

stenosis, endocarditis

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7
Q

Forward heart failure

A

insufficient output = hypoxia

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8
Q

Backward heart failure

A

venous congestion. increase venous volume/ pressure

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9
Q

T/F Forward heart failure is almost always combined with Backward heart failure

A

True

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10
Q

Fran-Starling mechanism

A

increased ventricular stretch = stronger contraction

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11
Q

Neurohumoral mechanisms

A

NE: increase HR and contractility, R-A-A system
ANP: vasodilation

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12
Q

Cardiac hypertrophy

A

overload -> cardiac hypertrophy. increased O2 consumption

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13
Q

Eccentric heart

A

large lumen in left ventricle

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14
Q

concentric heart

A

thick muscle wall in leftventricle

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15
Q

Most common cause of left sided heart failure

A

Ischemic heart disease

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16
Q

decreased out put in left sided heart failure leads to

A

pulmonary edema. (R-A-A system)

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17
Q

Right sided heart failure MC results from…

A

Left sided failure

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18
Q

right sided heart failure resulting from pulmonary Hypertension

A

cor pulmonale

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19
Q

valve disorder resulting in right sided heart failure involve which valves

A

pulmonary or tricuspid

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20
Q

Congenital heart disease accounts for what percent of all birth defects

A

30%

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21
Q

causes of congenital heart disease

A

fetal chromosomal abnormalities, maternal diabetes, infections, teratogens

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22
Q

right-to-left shunts

A

blood bypasses lungs, cyanosis

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23
Q

Causes of right-to-left shunts

A

tetralogy of fallot, transposition of great arteries

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24
Q

left-to-right shunts

A

pulmonary hypertenstion, ASD VSD PDA

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25
Q

which shunt is more common

A

left-to-right

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26
Q

`What does coarctation mean

A

congenital narrowing

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27
Q

Most likely to get Aortic coarctation

A

Males and turner syndrome

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28
Q

Infantile (pre-ductal) Aortic coarctation

A

proximal to PDA

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29
Q

Adult (post-ductal) Aortic coarctation

A

infolding near the ligamentum arteriosum.

MC asymptomatic

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30
Q

coronary artery disease makes up what percent of Ischemic heart disease cases

A

90%

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31
Q

dysfunction occurs when during Ischemic heart disease

A

1-2 minutes

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32
Q

necrosis occurs when during Ischemic heart disease

A

20-40 minutes

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33
Q

Angina pectoris

A

“chest pain”

Ischemia, NO CELLULAR DEATH

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34
Q

when does Angina pectoris occur

A

with >70% occlusion

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35
Q

Angina pectoris with > 90% occlusion

A

unstable angina (at rest)

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36
Q

Stable (typical) angina

A

Episodic, exertional.

Relieved at rest with vasodilators

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37
Q

Variant angina (prinzmetal)

A

Vasospasm at rest.

responds to vasodilators.

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38
Q

unstable Angina pectoris is aka

A

crescendo angina or pre-infarction angina

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39
Q

characteristics of unstable Angina pectoris

A

Increased frequency,intensity, and duration of pain.

90% coronary occlusion

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40
Q

MC cause of myocardial infarction

A

acute coronary artery thrombosis 90%

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41
Q

MC artery involved in myocardial infarction

A

left anterior descending coronary artery

42
Q

MC cause of sudden cardiac death

A

Ventricular fibrillation 80-90%

43
Q

In myocardial infarction is the angina relieved by nitroglycerine

A

NO

44
Q

Laboratory markers of myocardial infarction

A

Creatine kinase and cardiac troponins

45
Q

T/F Patients having an acute myocardial infarction present a strong pulse?

A

false. fast and weak pulse

46
Q

Sudden Cardiac death is MC a lethal arrhythmia that involves what part of the heart

A

Left ventricle

47
Q

What is the MC arrhythmia involved in Sudden Cardiac death

A

V-fib (80-90%)

48
Q

Commotio cordis

A

(baseball player)

blow to the sternal region that disrupts heart rhythm. Causing arrythmia and SCD.

49
Q

Is there structural damage with Commotio cordis

A

NO

50
Q

Is Commotio cordis reversible

A

yes with drfibrillation

51
Q

who is at risk for Commotio cordis

A

adolescent males (underdeveloped chest)

52
Q

“silent killer”

A

systemic hypertensive heart disease

53
Q

what does systemic hypertensive heart disease produce

A

left sided heart disease

54
Q

Cor pulmonale

A

pulmonary HTN that leads to right sided heart failure

55
Q

Valvular Stenosis

A

narrowing, failure to completely open

56
Q

Valvular Insufficiency

A

failure to completely close

57
Q

MC cause of aortic valve stenosis

A

calcific aortic stenosis

58
Q

what kind of hypertrophy is present with calcific aortic stenosis

A

concentric hypertrophy

59
Q

What does Rheumatic valvular disease occur after

A

Group A B-hemolytic streptococcal pharyngitis

60
Q

Rheumatic valvular disease

A

inflammation of all parts of heart, but valvular inflammation and scaring produces the most important clinical features

61
Q

Rheumatic valvular disease MC dx

A

5-15 years old

62
Q

Acute Rheumatic valvular disease

A

Aschoff bodies**

63
Q

MC cause of infective endocarditis

A

bacteremia

64
Q

Symptoms when infective endocarditis is lethal

A

arrhythmia, renal failure

65
Q

acute infective endocarditis

A

sestructive, virulent, difficult to treat.

previously normal valve

66
Q

cause of acute infective endocarditis

A

staph aureus

67
Q

subacute infective endocarditis

A

easy to treat, previously abnormal tissue

68
Q

cause of subacute infective endocarditis

A

strep viridans

69
Q

MC prosthetic cardiac valves

A

mechanical

70
Q

mechanical prosthetic cardiac valves

A

tilted disk device. anti-coagulation. can cause thrombosis, hemolysis

71
Q

Bioprosthetic cardiac valves

A

porcine, bovine, humans.

NO anti-coagulation. Ca+ can cause stenosis

72
Q

Cardiomyopathies are primary to

A

disorder of myocardium

73
Q

Cardiomyopathies are secondary to

A

systemic disorders (muscular dystrophy)

74
Q

T/F Most cases of Cardiomyopathies are idiopathic

A

True

75
Q

types of Cardiomyopathies

A

dilated (MC)
hypertrophic
restrictive (LC)

76
Q

Dilated Cardiomyopathies

A

characterized by progressive cardiac dilation and contractile dysfunction.

77
Q

risk for Dilated Cardiomyopathies

A

genetic, viral infxns, hemochromatosis, decreased thiamine, dystrophinopathy

78
Q

Hypertrophic Cardiomyopathies

A

is characterized by myocardial hypertrophy, defective diastolic filling and in 1/3 of cases ventricular outflow obstruction.

79
Q

Restrictive Cardiomyopathies

A

primary decrease in ventricular compliance, resulting in impaired ventricular filling during diastole

80
Q

three forms of Restrictive Cardiomyopathies

A

Amyloidosis, endomyocardial fibrosi, irradiation and idiopathic

81
Q

MC cause of myocarditis in USA

A

viral infections

9 (Coxsackievirus A & B, HIV, CMV, flu)

82
Q

Non-viral cause of myocarditis

A

SLE, Lyme disease, Chagas

83
Q

Morphology in myocarditis

A

normal or dilated

84
Q

Does myocarditis cause pain

A

its variable. sometimes its asymptomatic and others it causes pain and fever

85
Q

MC type of myocarditis

A

acute

86
Q

acute myocarditis has what type of cells

A

diffuse lymphocytes

87
Q

chronic myocarditis has what type of cells

A

multinucleate giant cells

88
Q

MC cause of pericarditis

A

viral

89
Q

secondary pericarditis caused by

A

MI, irradiation, rheumatic fever,SLE, CA

90
Q

severe pericarditis

A

cardiac tamponade. (pericardial compression which decreases filling)

91
Q

MC malignancy to the heart is due to what

A

metastasis to the heart

92
Q

MC CA to metastasize to the heart

A

lung

93
Q

MC primary cardiac benign neoplasms

A

myxoma

94
Q

MC primary malignant tumor

A

angiosarcoma

95
Q

Location of Myxomas

A

90% on the fossa ovalis in left atrium

96
Q

size of myxomas

A

large, up to 10 cm

97
Q

are myxomas benign or malignant

A

benign

98
Q

whats the appearance of a myxoma

A

“gelatinous appearance”

99
Q

MC long term limitation of cardiac transplants

A

allograft arteriopathy. ( 5 years 50%, 10 years 100%)

100
Q

complications of cardiac transplants

A

rejection and allograft arteriopathy

PATHOLOGY II (3 decks)

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