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Systems 1 > CV Path 6 > Flashcards

CV Path 6 Flashcards

1
Q

disease of small arteries and arterioles usually seen in patients with diabetes and HTN

A

arterioLOsclerosis

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2
Q

– variants of arterioLOsclerosis result in vessel wall thickening and luminal narrowing with concomitant downstream ischemic injury

A

hyperplastic and hyaline

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3
Q

least clinically significant arteriosclerosis

A

Monckeberg medial calcific sclerosis

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4
Q

arteriosclerosis that has no stenosis

A

Monckeberg medial calcific sclerosis

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5
Q

Monckeberg medial calcific sclerosis is age-related (> 50 years) degenerative process involving – with extension into media

A

internal elastic lamina of muscular arteries

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6
Q

The calcific deposit do not encroach on vessel lumen for –

A

Monckeberg medial calcific sclerosis

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7
Q

Monckeberg medial calcific sclerosis is radiographically visible and physically palpable but difficult –

A

to feel pulse

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8
Q

atherosclerosis is the disease of – arteries in which the basic lesion is the atheroma

A

elastic and large muscular

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9
Q

fibrofatty plaque within the intima, having a core of lipid and a covering fibrous cap

A

atheroma

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10
Q

leading cause of death in industrialized nations

A

atherosclerosis

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11
Q

death from atherosclerosis results from –

A

plaque rupture, thrombus formation, occlusion of arteries

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12
Q

prevalence of atherosclerosis

A

~100%

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13
Q

atheromatous plaque that starts in childhood

A

fatty streak (pre-atherosclerotic lesion)

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14
Q

fatty streak begins as –

A

yellow, flat spots

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15
Q

fatty streaks coalesce into –

A

elongated streaks (> 1 cm)

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16
Q

what does fatty streaks consist of?

A

lipid-laden macrophages
smooth muscle cells
few lymphocytes
little extracellular lipid in fine meshwork of fibrous and elastic tissue

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17
Q

fibrous plaque =

A

raised plaque

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18
Q

what does fibrous plaque consist of?

A

macrophages
smooth muscle cells
other leukocytes in connective tissue stroma
lipids

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19
Q

Is a complicated plaque clinically significant?

A

yes

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20
Q

what is complicated plaque?

A 
fibrous plaque
\+
calcification
ulcercation
hemorrhage
rupture
thrombosis
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21
Q

atherosclerosis is an – disease of the wall of medium and large arteries that is precipitated by elevated levels of low-density lipoprotein cholesterol in blood

A

inflammatory

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22
Q

what is atherogenesis?

A

response to injury hypothesis

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23
Q

complications of atherogenesis that leads to thrombus formation

A

plaque rupture or erosion

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24
Q

In coronary arteries, thrombus occludes the lumen –>

A

myocardial infarction (heart attack)

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25
Q

In carotid arteries, thrombi emobolize and cause –

A

cerebrovascular accidents (stroke)

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26
Q

leading cause of death in both males and females in industrialized nations

A

ischemic heart disease

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27
Q

ischemic heart disease encompasses several conditions related to – (imbalance between supply and demand)

A

myocardial ischemia

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28
Q

majority of ischemic heart disease cases result from – due to coronary atherosclerotic disease

A

reduction of coronary blood flow

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29
Q

4 groups of ischemic heart disease

A

angina
myocardial infarction
sudden cardiac death
chronic IHD with heart failure

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30
Q

groups of ischemic heart disease that is an irreversible change

A

myocardial infarction

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31
Q

MI: myocardium is particularly sensitive to ischemic injury and will undergo –

A

necrosis within 30 min

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32
Q

two patterns of MI

A

subendocardial and transmural

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33
Q

subendocaridal MI is ischemic necrosis limited to –

A

inner 1/3 to 1/2 ventricular wall

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34
Q

subendocardial MI is usually due to sufficiently – in the setting of severe coronary atherosclerosis

A

prolonged and severe reduction of blood pressure

35
Q

subendocardial MI may also be due to – which become lysed before full thickness necrosis occurs

A

plaque disruption with superimposed thrombus

36
Q

MI where ischemic necrosis involves >50% of the ventricular wall thickness

A

transmural

37
Q

transmural MI is usually associated with – and superimposed occlusive thrombus

A

rupture of unstable atherosclerotic plaque

38
Q

MI: subendocardial myocardium is the most susceptible area to ischemic injury and will become necrotic first because –

A

it is farthest away from the blood supply

39
Q

each coronary artery has a specific – hence MI will have a specific area of injury

A

perfusion territory

40
Q

anterior 2/3 IVS and anterior LV free wall

A

left anterior descending artery

41
Q

lateral wall LV and anterolateral papillary muscle

A

left circumflex artery

42
Q

posterior 1/3 IVS, posterior LV, posteromedial papillary muscle

A

right coronary artery

43
Q

MI 1-3 days myocardial infarct exhibits –

A

dark mottling with yellow-tan areas

44
Q

MI 7-10 days myocardial infarct exhibits –

A

central yellow-tan softening with hyperemic border

45
Q

MI 24 hrs microscopic

A

coagulative necrosis

46
Q

MI 1-3 days microscopic

A

acute inflammation

necrosis with neutrophils, neovascularization

47
Q

MI 3 days - 2 weeks microscopic

A

granulation tissue

48
Q

MI > 8 weeks

A

dense fibrosis

49
Q

bleed into pericardial sac

A

cardiac tamponade

50
Q

chronic ischemic heart disease is the dev of progressive heart failure due to long-term –

A

ischemic myocardial injury

51
Q

chronic heart disease aka

A

ischemic cardiomyopathy

52
Q

in chronic heart disease, coronary arteries exhibit –

A

moderate to severe atherosclerosis

53
Q

in chronic heart disease, the heart becomes

A

enlarged and hypertrophied

54
Q

in chronic heart disease, there are mutifocal areas of –

A

myocardial fibrosis

55
Q

many cases of chronic heart disease is associated with history of –

A

angina pectoris or prior myocardial infarcts

56
Q

primary cardiac tumors/neoplasms are rare and most are –

A

benign

57
Q

examples of primary cardiac tumors

A

myxomas
fibroma
rhabdomyoma

58
Q

malignant primary cardiac tumor

A

-sarcoma, lymphoma

59
Q

non-neoplastic

A

thrombus and papillary fibroelastoma

60
Q

what are more common metastatic neoplasms or cardiac tumors?

A

metastatic neoplasms

61
Q

metastatic neoplasms usually involve –

A

pericardium (may involve myocardium)

62
Q

most common tumors that metastasize to the heart

A

carcinomas of lung and breast
malignant melanoma
lymphomas and leukemia

63
Q

most common primary tumor in adults

A

cardiac myxoma

64
Q

90% of cardiac myxoma is located within –

A

atria (L:R = 4:1)

65
Q

cardiac myxoma is thought to derive from differentiation of –

A

primitive multipotential mesenchymal cells

66
Q

10% patients with myxomas
autosomal dominant inheritance
tumor syndrome

A

Carney complex

67
Q

cardiac myxoma can cause valve obstruction by –

A

“ball-valve” mech

68
Q

for cardiac myxomas, strokes due to – may occur

A

embolization

69
Q

curative for cardiac myxomas

A

surgical removal

70
Q

favored site of origin for cardiac myxoma

A

fossa ovalis in atrial septum

71
Q

cardiac myxoma is almost always –

A

single, exophytic, polypoid, sessile (+/- hemorrhage)

72
Q

cardiac myxoma histopatholy is composed of – embedded within abundant myxoid stroma

A

stellate or globular myxoma cells

73
Q

most common primary cardiac tumor of children

A

cardiac rhabdomyoma

74
Q

cardiac rhabdomyoma is a tumor of –

A

striated muscle

75
Q

cardiac rhabdomyoma is thought to represent a – rather than a true neoplasm

A

hamartoma

76
Q

cardiac rhabdomyoma is well-defined – mass

A

uncapsuled white/gray nodular

77
Q

cardiac rhabdomyoma is usually –

A

multiple

78
Q

histologically, cardiac fhabdomyoma is –

A

large polygonal cells with abundant glycogen vacuoles (spider cells)

79
Q

most common primary malignant cardiac tumor

A

cardiac angiosarcoma

80
Q

cardiac angiosarcoma usually affects —

A

right atrium

81
Q

cardiac angiosarcoma may hematogenously spread to –

A

lung and liver

82
Q

in cardiac angiosarcoma, vascular spaces are lined by atypical appearing –

A

malignant endothelial cells

83
Q

in cardia angiosarcoma, immunohistochemistry is positive for –

A

markers of endothelial cell differentiation

Systems 1 (22 decks)

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