CR1.3 Pathology of heart disease Flashcards
Name the only bicuspid valve and what structures does it seperate.
Mitral valve seperates the left ventricle and left artium.
Define oedema.
Accumulation of fluid within interstitial spaces or body cavities.
List four causes of oedema.
- Increased hydrostatic pressure (e.g. congestion)
- Reduced oncotic pressure
- Lymphatic obstruction
- Sodium / Water retention
Describe the differences between transudate and exudate.
- Transudate results from increased pressure and is a passive process
- Exudate is an inflammatory process and results in increased vascular permeability
- Fibrin and inflammatory cells are present in exudate and absent in transudate
- Plasma protein leak is absent in transudate and present in exudate
Chronic passive congestion and consumption of RBCs by macrophages.
Heart Failure (HF) cells in left sided failure.
Explain the difference between hyperemia and congestion.
Hyperemia is increased flow (e.g. exercise, inflammation) and congestion is decreased outflow (e.g. local obstruction, congestive heart failure). Active hyperaemia is localised (e.g. blushing) and passive hyperemia is also known as congestion.
List the six common signs of hemorrhage.
- Hematoma (implies mass effect)
- Dissection
- Petechiae (1 - 2 mm) N.B. non-blanching
- Purpura (<1 cm)
- Ecchymoses (>1 cm)
- Hemo- (i.e. blood accumulation within a cavity such as hemothorax)
List four fate of thrombi.
- Propogation (downstream)
- Embolization (detached from primary)
- Dissolution
- Organisation and recanalization.
What is the difference between red and pale infarction.
Hemorrhagic (red) and anemic (pale).
Define shock and list three types.
Shock is a life-threatening condition of circulatory failure.
- Cardiogenic shock (acute, chronic heart failure)
- Hypovolaemic shock (hemorrhage or leakage)
- Distributive shock (sepsis or anaphylaxis) –> vasodilation
Describe the pathology of “Nutmeg Liver”.
The hepatic vein drains into the inferior vena cava and the right side of the heart. Right side heart failure causes acute passive congestion in the liver. Increased pressure in the hepatic vein causes vessel dilation and hemorrhage in the liver and looks red.
Label these pictures with signs of hemorrhage.
- Subungual hematoma
- Petechiae
- Hematoma
Outline the Jones criteria for Acute Rheumatic Fever.
The Jones criteria.
Two major or one major and two minor manifestations or 3 minor + evidence of preceding Group A streptococcus infection.
Major:
- Carditis
- Polyarthritis (i.e. migrating polyarthritis of the large joints)
- Sydenham chorea (i.e. neurological disorder purposeless rapid movements)
- Erthema marginatum
- Subcutaneous nodules
Minor:
- Fever
- Arthralgia (i.e. pain in a joint)
- Lab tests (e.g. elevated C reactive protein, erthrocyte sedimentation rate)
- Prolonged PR interval
- Previous RF or rheumatic heart disease
Complete this table for infective endocarditis.
Explain the modified Duke criteria for the diagnosis of infective endocarditis.
Modified Duke Criteria: used for the diagnosis of infective endocarditis.
Two major OR one major + three minor OR five minor criteria.
Major:
- blood culture positive for typical micro-organism
- single positive blood culture for Coxiella burnetii (atypical micro-organism)
- Evidence of endocardial involvement on echocardiogram (e.g. abscess)
- New valvular regurgitation
Minor:
- predisposition (e.g. IV drug use)
- fever
- vascular phenomena (e.g. major arterial emboli, Janeway lesions)
- immunologic phenomena (e.g. Osler’s nodes, Roth’s spots, rheumatoid factor)
- microbiological evidence
N.B. Vasculitis (e.g. Janeway lesions) versus emboli (Roth spots and Osler’s nodes)
Complete this table.
