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Pathology > Chapter 8 ( Cardiac ) > Flashcards

Chapter 8 ( Cardiac ) Flashcards

1
Q

Subendocardial ischemia is represented on EKG by ?

A

ST segment depression

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2
Q

Mechanism of stable angina ?

A

Atherosclerosis of coronary artery with >70% stenosis

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3
Q

Mechanism of unstable angina ?

A

Rupture of an atherosclerotic plaque with thrombosis and incomplete occlusion of a coronary artery

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4
Q

Transmural ischemia is represented on EKG by ?

A

ST segment elevation

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5
Q

Papillary muscle of the LV is supplied by ?

A

Right coronary artery

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6
Q

The most sensitive and specific marker for MI ?

A

Troponin I

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7
Q

Mechanism of contraction band necrosis ?

A

Reperfusion of irreversibly damaged cells results in Ca influx , leading to hypercontraction of myofibrils

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8
Q

Reperfusion injury mechanism ?

A

Return of oxygen and inflammatory cells may lead to free radicle generation , further damaging myocytes

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9
Q

Complications of MI that can occur in the first 4 hours ?

A

Cariogenic shock
Congestive heart failure
Arrhythmia

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10
Q

Gross changes , microscopic changes and complications of 4-24 hours after MI ?

A

Gross : dark discoloration
Micro : Coagulative necrosis
Complications : arrhythmia

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11
Q

Gross changes , microscopic changes and complications of 1-3 days after MI ?

A

Gross : yellow pallor
Micro : Neutrophils
Complications : Fibrinous pericarditis ( with transmural infarction )

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12
Q

Gross changes , microscopic changes and complications of 4-7 days after MI ?

A 
Gross : yellow pallor 
Micro : Macrophages 
Complications : rupture of 
Ventricular free wall
Interventricular septum 
Papillary muscle ( in right coronary artery occlusion )
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13
Q

Gross changes , microscopic changes and complications of 1-3 weeks after MI ?

A

Gross : red border emerges as granulation tissue enters from edge of infarct
Micro : Granulation tissue with plump fibroblasts , collagen , blood vessels

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14
Q

Gross changes , microscopic changes and complications of months after MI ?

A 
Gross : white scar 
Micro : Fibrosis 
Complications : 
Aneurysm 
Mural thrombus 
Dressler syndrome
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15
Q

Causes of sudden cardiac death ?

A 
Most common : Acute ischemia 
Less common :
Mitral valve prolapse 
Cardiomyopathy 
Cocaine abuse
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16
Q

Heart failure cells ?

A

Hemosidren-laden macrophages founded in alveoli when the small congested capillaries due to left sided heart failure burst

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17
Q

Nutmeg liver ?

A

Cardiac hepatomegaly

Congestion of the hepatic veins gives the liver it nutmeg ( red ) color

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18
Q

Most common congenital heart defect ?

A

VSD

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19
Q

VSD associated with what ?

A

Fetal alcohol syndrome

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20
Q

Most common type of ASD ?

A

Ostium secundum ( 90% of cases )

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21
Q

Ostium primum is associated with ?

A

Down syndrome

22
Q

Important complication of ASD ?

A

Paradoxical emboli

23
Q

PDA is associated with ?

A

Congenital rubella

24
Q

PDA complicated by Eisenmenger syndrome results in ?

A

LOWER EXTREMITY cyanosis

25
Q

Ttt of PDA ? Its mechanism ?

A

Indomethacin

Decreases PGE resulting in PDA closure ( as PGE maintains the patency of the ductus arteriosus )

26
Q

Fallot tetralogy components ?

A

1- PS
2- right ventricular hypertrophy
3- VSD
4- aorta that overrides the VSD

27
Q

TGA is associated with ?

A

Maternal diabetes

28
Q

Ttt of TGA ?

A

Surgical correction

PGE can be administered to maintain a PDA until definitive surgical repair is performed

29
Q

Tricuspid atresia is associated with ?

A

ASD

30
Q

Infantile form of coarctation of aorta ( before PDA ) is presented by ?

A

LOWER EXTREMITY cyanosis

31
Q

Infantile form of coarctation of aorta is associated with ?

A

Turner syndrome

32
Q

Adult form of coarctation of aorta is associated with ?

A

Bicuspid aortic valve

33
Q

Adult form of coarctation of aorta is characterized by what on x ray ?

A

Notching of ribs

34
Q

Mechanism of acute rheumatic fever ?

A

Molecular mimicry

Bacterial M protein resembles proteins in human tissues

35
Q

Components of Aschoff bodies ?

A

1- Foci of chronic inflammation
2- Antischkow cells : reactive histiocytes with slender wavy nuclei
3- Giant cells
4- Fibrinoid material

36
Q

How to differentiate AS caused by Rheumatic valve disease from AS caused by wear and tear ?

A

1- coexisting mitral stenosis
2- fusion of the aortic valve commissures
Both of which aren’t found with AS caused by wear and tear

37
Q

Mechanism of MAHA with AS ?

A

RBCs are damaged producing schistocytes while crossing the calcific valve

38
Q

Mechanism of mitral valve prolapse ?

A

Myxoid degeneration ( accumulation of ground substance ) of the valve making it floppy

39
Q

The most common overall endocarditis ?

A

Streptococcus viridans

40
Q

Staphylococcus epidermidis associated with which cause of endocarditis ?

A

Endocarditis of prosthetic valves

41
Q

Streptococcus bovis is associated with which cause of endocarditis ?

A

In patients with underlying colorectal carcinoma

42
Q

Non bacterial thrombotic endocarditis is associated with ? Mechanism ?

A

Hypercoagulable state
Adenocarcinoma
Sterile vegetations arise on the mitral valve along lines of closure causing MR

43
Q

Most common form of cardiomyopathy ?

A

Dilated cardiomyopathy

44
Q

Causes of dilated cardio myopathy ?

A 
PH GAMD
1- Pregnancy 
2- Hemochromatosis 
3- Genetic mutation (AD)
4- Alcohol abuse 
5- Myocarditis ( due to Coxackie A or B ) 
6- Drugs ( Doxorubicin )
45
Q

Mechanism of Hypertrophic cardiomyopathy ?

A

Genetic mutations in sarcomere proteins , most common form is autosomal dominant

46
Q

Characteristic finding in biopsy of hypertrophic cardiomyopathy ?

A

Myofiberhypertrophy with disarray

47
Q

Loeffler syndrome ?

A

Endomyocardial fibrosis with eosinophilic infiltrate and eosinophilia

48
Q

EKG classic findings of restrictive cardiomyopathy ?

A

Low voltage EKG

Diminished QRS amplitude

49
Q

Most common primary cardiac tumor in adults ?

A

Myxoma ( benign mesenchymal tumor )

50
Q

Most common primary cardiac tumor in children ?

A

Rhabdomyoma ( benign hamartoma of cardiac muscle )

51
Q

Rhabdomyoma is associated with ?

A

Tuberous sclerosis

Pathology (18 decks)

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