Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Lecom pathology year 2 > Chapter 12- The Heart > Flashcards

Chapter 12- The Heart Flashcards

1
Q

What are syndromes of ischemic heart disease usually due to

A

Atherosclerosis of coronary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the term for chest pain that arises with exertion or emotional stress (no pain at rest)

A

Stable angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the hallmark of stable angina

A

Cellular swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the typical presentation of stable angina

A

Chest pain lasting less than 20 minutes that radiates to left arm or jaw; diaphoresis; SOB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the EKG finding with stable angina

A

ST segment depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the term for chest pain that occurs at rest

A

Unstable angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is unstable angina due to

A

Atherosclerotic plaque with thrombosis and incomplete occlusion of a coronary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the EKG finding with unstable angina

A

ST segment depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is prinzmetal angina due to

A

Coronary artery vasospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the EKG finding with prinzmetal angina

A

ST segment elevation due to transmural ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What part of the heart does MI usually involve

A

Left ventricle (usually spares RV and both atria)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe levels of troponin I

A

Rises 2-4 hrs after infarction; peaks at 24 hours and returns to normal in 7-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe levels of Ck-MB

A

Rises 4-6 hours after infarction; peaks at 24 hours; returns to normal by 72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is happening less than 4 hours after an MI

A

Carcinogenic shock, CHF, arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is happening 4-24 hours after infarction

A

Gross change (dark discoloration), micro change (coagulative necrosis), complication is arrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is happening 1-3 days after infarction

A

Gross change (yellow pallor), micro (neutrophils), complication is fibrinous pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is happening 4-7 days after infarction

A

Yellow pallor, macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is happening 1-3 weeks after infarction

A

Red border; granulation tissue with plump fibroblasts, collagen and blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is sudden cardiac death usually due to

A

Fatal ventricular arrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the most common etiology of sudden cardiac death

A

Acute ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What should you think of with heart failure cells

A

Left sided congestive heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is heart failure cells

A

Iron build-ups in macrophages (hemosiderin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is R sided heart failure usually due to

A

L-sided heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Is left or right sided heart failure associated with nutmeg liver

A

Right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are clinical presentations of eisenmenger syndrome

A

Right ventricular hypertrophy, polycythemia, clubbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the most common ASD

A

Ostium secundum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the ostium primum type of ASHD associated with

A

Down syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What congenital infection is associated with PDA

A

Congenital rubella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What type of murmur is heard with PDA

A

Machine like

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What should you think of with boot shaped heart

A

TOF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the features of TOF

A

Stenosis of RV outflow tract, RV hypertrophy, VSD, overriding aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What disorder is transposition of great vessels associated with

A

Maternal diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the presentation of truncus arteriosus

A

Early cyanosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is infantile coarctation of aorta associated with

A

PDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How does infantile coarctation of aorta present

A

Lower extremity cyanosis; associated with turners syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Wher does the coarctation in adult form coarctation of aorta occur

A

Lies distal to aortic arch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the presentation of adult coarctation of aorta

A

HTN in upper extremity and hypotension with weak pulses in lower extremity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the jones characteristics associated with acute rheumatic fever

A

Joint (migratory polyarthritis), heart (pancarditis-shaped like an “o”), nodules (subcutaneous), erythema marginatum, sindenhemps (in muscle) corona

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What should you think of with ashoff bodies

A

Pancarditis of acute rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What should you think of with anitchcall cells

A

Acute rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What valve is almost always involved in chronic rheumatic valvular disease

A

Mitral valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What should you think of with fish mouth appearance of valves

A

Chronic rheumatic valvular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is aortic stenosis usually due to

A

Fibrosis and calcification from wear and tear; presents in late adulthood (60yo+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What murmur is associated with aortic stenosis

A

Systolic ejection click followed by a crescendo-decrescendo murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the term for backflow of blood from aorta into LV during diastole

A

Aortic regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are some things that can cause aortic regurgitation

A

Aortic root dilation (syphilitic aneurysm) or valve damage (IE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the clinical presentation of aortic regurgitation

A

Early blowing diastolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the clinical presentation of mitral valve prolapse

A

Mid-systolic click followed by regurgitation murmur; usually asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is the term for reflux of blood from LV into LA during systole

A

Mitral regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is mitral regurgitation usually a complication of

A

Mitral valve prolapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What type of murmur is heard with mitral regurgitation

A

Holosystolic blowing murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What does mitral regurgitation result in

A

Volume overload and left sided HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is the most common overall cause of infectious endocarditis

A

S. Viridans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What does S. viridans IE result in

A

Small vegetations that do NOT destroy valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is the most common cause of IE in IV drug users

A

S aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What does S aureus caused IE result in

A

Large vegetations that destroy valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the major cause of IE in prosthetic valves

A

S. Epidermidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is the leading cause of IE in patients with underlying colorectal carcinoma

A

S. Bovis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What are some causes of endocarditis with negative blood cultures

A

Hemophilus, actinobacillus, Cardiobacterium, Eikenella, Kingella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Where do the vegetations appear with nonbacterial thrombotic endocarditis

A

Mitral valve along lines of closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is the term for sterile vegetations associated with SLE

A

Libyan-sacks endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is the result of Libman sacks endocarditis

A

Mitral regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is the most common form of cardiomyopathy

A

Dilated cardiomyopathy

64
Q

What are some complications of dilated cardiomyopathy

A

Mitral and tricuspid regurgitation and arrhythmia

65
Q

What drug is associated with dilated cardiomyopathy

A

Cocaine

66
Q

What is mutated in hypertrophic cardiomyopathy

A

Sarcomeres proteins

67
Q

What is common cause of sudden death in young athletes

A

Hypertrophic cardiomyopathy

68
Q

What is found on biopsy of hypertrophic cardiomyopathy

A

Myofiber hypertrophy with disarray

69
Q

When is filling restricted with restrictive cardiomyopathy

A

Restricts filling during systole

70
Q

How does restrictive cardiomyopathy present

A

CHF

71
Q

What is the classic finding on EKG with restrictive cardiomyopathy

A

Low voltage EKGs; diminished QRS amplitudes

72
Q

What is the term for a cardiac tumor of benign mesenchymal proliferation with a gelatinous apperance

A

Myxoma

73
Q

What is the most common primary cardiac tumor in adults

A

Myxoma

74
Q

What is the presentation of myxoma

A

Pedunculated mass in LA (causes syncope due to obstruction of mitral valve)

75
Q

What is the term for benign hamartoma of cardiac muscle

A

Rhabdomyoma

76
Q

What is the most commmon primary cardiac tumor in kids

A

Rhabdomyoma

77
Q

What cardiac tumor is assocated with tuberous sclerosis

A

Rhabdomyoma

78
Q

What are some common metastasis to the Heart

A

Breast and lung carcinoma, melanoma, lymphoma

79
Q

What is the collagenous ventricularis largely responsible for

A

Mechanical integrity of the valve

80
Q

What is the pacemaker of the heart

A

SA node

81
Q

What is systolic dysfunction

A

Progressive deterioration of myocardial contractile function

82
Q

What is diastolic dysfunction

A

Inability of the chamber to expand and fill during diastole

83
Q

How are the sarcomeres in pressure overload hypertrophy arranged

A

Concentric increase in wall thickness, sarcomeres in parallel

84
Q

How are the sarcomeres arranged in volume over load hypertrophy

A

Sarcomeres in series

85
Q

What are some major pathologic indications of pulmonary edema

A

Heart failure cells, Kerley B lines

86
Q

What happens with systolic failure in left sided heart failure

A

Insufficient ejection fraction

87
Q

What happens with diastolic failure in L-sided heart failure

A

LV is abnormally stiff and cannot relax during diastole (unable to increase output during exercise)

88
Q

What transcription factors are important for the first heart field and what does the first heart field give rise to

A

TBX5, hand1; mainly LV

89
Q

What transcription factors are involved in the second heart field and what does the second heart field give rise to

A

Hand2, FGF-10; outflow tract, RV, most of atria

90
Q

What genes are involved in ASD or conduction defects

A

NKX2.5

91
Q

What gene is involved in ASD or VSD

A

GATA4

92
Q

What genes are involved in TOF

A

ZFPM2 or NKX2.5

93
Q

What genes are involved in alagille syndrome (pulmonary artery stenosis or TOF)

A

JAG1 or NOTCH2

94
Q

What gene is involved in char syndrome (PDA)

A

TFAP2B

95
Q

What gene is involved in Holt-Oran syndrome

A

TBX5

96
Q

What is the main culprit legion in Digeorge syndrome

A

TBX1

97
Q

What are the multiple deficits associated with Digeorge syndrome

A

CATCH-22: cardiac abnormality, abnormal face, thymic aplasia, cleft palate, hypocalcemia, on chromosome 22

98
Q

What is the most common genetic cause of congenital heart disease

A

Trisomy 21

99
Q

What do ASD typically increase

A

Only RV and pulmonary outflow volumes

100
Q

What do VSD and PDA cause increase in

A

Pulmonary blood flow and pressure

101
Q

What type are most VSDs

A

Membranous

102
Q

Where do infundivular VSD occur

A

Below pulmonary valve or within muscular septum

103
Q

What CHD can lead to paradoxical embolism

A

Right to left shunts

104
Q

What CHD produces ventriculoarterial discordance

A

Transposition of great arteries

105
Q

Describe the murmur with subaortic stenosis

A

Prominent systolic murmur and sometimes thrill

106
Q

What is subaortic stenosis caused by

A

Thickened ring or collar of dense endocardial fibrous tissue below the level of the cusps

107
Q

What is the term for congenital aortic dysplasia with thickening of ascending aortic wall and consequent luminal constriction

A

Supravalvular aortic stenosis

108
Q

What disorder is supravalvular aortic stenosis sometimes part of

A

Chromosome 7 deletion disorder

109
Q

What is the leading cause of death worldwide for both men and women

A

Ischemic heart disease

110
Q

What is the dominant cause of ischemic heart disease

A

Insufficient coronary perfusion relative to myocardial demand

111
Q

What does stable angina result from

A

Increases in myocardial oxygen demand that outstrip the ability of stenosis coronary arteries to increase O2 delivery

112
Q

What is unstable angina caused by

A

Plaque disruption that results in thrombosis and vasoconstriction, and leads to severe but transient reductions in coronary blood flow

113
Q

What type of MIs are most common

A

Transmural

114
Q

What do LAD infarcts involve

A

Anterior wall of LV near the apex; anterior portion of ventricular septum; apex circumferential

115
Q

What part of the Heart does Right coronary infarcts involve

A

Inferior/posterior wall of LV; posterior portion of ventricular septum; inferior/posterior RV free wall

116
Q

What is the most common trigger for fatal arrhythmias

A

Acute myocardial ischemia

117
Q

What is the cause of arrhythmias in most cases

A

Ischemic injury

118
Q

What is pulmonary hypertensive heart disease (cor pulmonale) characterized by

A

RV hypertrophy, dilation and potentially right sided Heart failure

119
Q

What is calcification aortic stenosis usually the consequence of

A

Age associated wear and tear

120
Q

What does calcification stenosis of congenitally bicuspid aortic valve involve loss of function mutations in

A

NOTCH1

121
Q

What is the most frequent site of calcific deposits in calcific stenosis of congenitally bicuspid aortic valve

A

Raphe

122
Q

What overload does stenosis cause

A

Pressure overload

123
Q

What overload does insufficiency/regurgitation cause

A

Volume overload

124
Q

What degeneration is key in mitral valve prolapse

A

Myxomatous degeneration

125
Q

What is the characteristic anatomical change in mitral valve prolapse

A

Interchordal ballooning (hooding) of mitral leaflets or portions thereof

126
Q

What are common complications of mitral valve prolapse

A

Infective endocarditis, MI, stroke, arrhythmias

127
Q

How many minor and major criteria of jones criteria must be met for rheumatic fever

A

2 major or 1 major and 2 minor + evidence of preceding strep infection

128
Q

What should you think of when you see maccallum plaques

A

Acute rheumatic fever

129
Q

What is the term for erythematous or hemorrhagic non-tender lesions on palms or soles (non-painful)

A

Janeway lesions

130
Q

What is the term for subcutaneous nodules in the pulp of the digits

A

Osler nodes

131
Q

What is the term for retinal hemorrhages in the eyes (round white spots surrounded by hemorrhage)

A

Roth spots

132
Q

Who are noninfectious vegetations usually encountered in

A

Debilitated patients (ie cancer or sepsis)

133
Q

What does carcinoid heart disease primarily affect

A

Endocardium and valves of right heart

134
Q

Describe the lesions of carcinoid heart disease

A

Distinctive, glistening white intimal plaque-like thickening of the endocardial surfaces of the cardiac chambers and valve leaflets

135
Q

What mutation is common in dilated cardiomyopathy

A

TTN (gene that encodes titin)

136
Q

What is progression of myocarditis to dilated cardiomyopathy strongly associated with

A

Alcohol use

137
Q

What is the most common manifestation of iron excess

A

Dilated cardiomyopathy

138
Q

What disorder is characterized by LV contractile dysfunction following extreme psychological stress, which leads to apical ballooning

A

Takotsubo cardiomyopathy

139
Q

What is the term for inherited disease of mycoardium causing RV failure and rhythm disturbances with sudden death

A

Arrhythmogenic RV cardiomyopathy

140
Q

What is the disorder that is characterized by arrythmogenic RV cardiomyopathy and hyperkeratosis of plantar palmar skin surfaces specifically associated with mutations in the gene encoding the desmosome-associated protein plakoglobin

A

Naxos syndrome

141
Q

Describe the RV in arrhythmogenic RV cardiomyopathy

A

Due to loss of myocytes, accompanied by extensive fatty infiltration and fibrosis

142
Q

What genetic disorder is characterized by myocardial hypertrophy, poorly compliant LV myocardium leading to abnormal diastolic filling and intermittent ventricular outflow obstruction

A

Hypertrophy cardiomyopathy

143
Q

What is typically mutated in hypertrophy cardiomyopathy

A

Mutations in sarcomere (beta-MHC)

144
Q

What should you think of when there is banana-like configuration of the ventricular cavity

A

Hypertrophy cardiomyopathy

145
Q

Describe the auscultation heard with hypertrophy cardiomyopathy

A

Harsh systolic ejection murmur caused by ventricular outflow obstruction as anterior mitral leaflet moves toward the ventricular septum during systole

146
Q

How is endomyocardial fibrosis most common in

A

Children and young adults in Africa

147
Q

What does loeffler endomyocarditis result in

A

Edomyocardial fibrosis, typically with large mural thrombi; often also peripheral eosinophilia

148
Q

What is inhabited in the mechanics of hypertrophic and restrictive cardiomyopathy

A

Compliance (diastolic dysfunction)

149
Q

What is the most common viral cause of myocarditis

A

Coxsachie viruses A and B

150
Q

What is the most common helminthic cause of myocarditis

A

Trichinosis

151
Q

What are the activating mutations involved in myxomas

A

GNAS1

152
Q

What is the favorite site for myxoma

A

Fossa ovalis of atrial septum

153
Q

What should you think of with wrecking ball effect

A

Pedunculated form of myxoma

154
Q

What are localized, well-circumscribed, benign tumors composed of mature fat cells

A

Lipomas

155
Q

What should you think of as sea-anemone lesions

A

Papillary fibroelastoma

156
Q

What do the lesions involved in papillary fibroelastoma consist of

A

Cluster of hairlike projections

157
Q

What should you think of with spider cells

A

Rhabdomyoma

Lecom pathology year 2 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions