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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
In carotid arteries, thrombi emobolize and cause --
cerebrovascular accidents (stroke)
26
leading cause of death in both males and females in industrialized nations
ischemic heart disease
27
ischemic heart disease encompasses several conditions related to -- (imbalance between supply and demand)
myocardial ischemia
28
majority of ischemic heart disease cases result from -- due to coronary atherosclerotic disease
reduction of coronary blood flow
29
4 groups of ischemic heart disease
angina myocardial infarction sudden cardiac death chronic IHD with heart failure
30
groups of ischemic heart disease that is an irreversible change
myocardial infarction
31
MI: myocardium is particularly sensitive to ischemic injury and will undergo --
necrosis within 30 min
32
two patterns of MI
subendocardial and transmural
33
subendocaridal MI is ischemic necrosis limited to --
inner 1/3 to 1/2 ventricular wall
34
subendocardial MI is usually due to sufficiently -- in the setting of severe coronary atherosclerosis
prolonged and severe reduction of blood pressure
35
subendocardial MI may also be due to -- which become lysed before full thickness necrosis occurs
plaque disruption with superimposed thrombus
36
MI where ischemic necrosis involves >50% of the ventricular wall thickness
transmural
37
transmural MI is usually associated with -- and superimposed occlusive thrombus
rupture of unstable atherosclerotic plaque
38
MI: subendocardial myocardium is the most susceptible area to ischemic injury and will become necrotic first because --
it is farthest away from the blood supply
39
each coronary artery has a specific -- hence MI will have a specific area of injury
perfusion territory
40
anterior 2/3 IVS and anterior LV free wall
left anterior descending artery
41
lateral wall LV and anterolateral papillary muscle
left circumflex artery
42
posterior 1/3 IVS, posterior LV, posteromedial papillary muscle
right coronary artery
43
MI 1-3 days myocardial infarct exhibits --
dark mottling with yellow-tan areas
44
MI 7-10 days myocardial infarct exhibits --
central yellow-tan softening with hyperemic border
45
MI 24 hrs microscopic
coagulative necrosis
46
MI 1-3 days microscopic
acute inflammation | necrosis with neutrophils, neovascularization
47
MI 3 days - 2 weeks microscopic
granulation tissue
48
MI > 8 weeks
dense fibrosis
49
bleed into pericardial sac
cardiac tamponade
50
chronic ischemic heart disease is the dev of progressive heart failure due to long-term --
ischemic myocardial injury
51
chronic heart disease aka
ischemic cardiomyopathy
52
in chronic heart disease, coronary arteries exhibit --
moderate to severe atherosclerosis
53
in chronic heart disease, the heart becomes
enlarged and hypertrophied
54
in chronic heart disease, there are mutifocal areas of --
myocardial fibrosis
55
many cases of chronic heart disease is associated with history of --
angina pectoris or prior myocardial infarcts
56
primary cardiac tumors/neoplasms are rare and most are --
benign
57
examples of primary cardiac tumors
myxomas fibroma rhabdomyoma
58
malignant primary cardiac tumor
-sarcoma, lymphoma
59
non-neoplastic
thrombus and papillary fibroelastoma
60
what are more common metastatic neoplasms or cardiac tumors?
metastatic neoplasms
61
metastatic neoplasms usually involve --
pericardium (may involve myocardium)
62
most common tumors that metastasize to the heart
carcinomas of lung and breast malignant melanoma lymphomas and leukemia
63
most common primary tumor in adults
cardiac myxoma
64
90% of cardiac myxoma is located within --
atria (L:R = 4:1)
65
cardiac myxoma is thought to derive from differentiation of --
primitive multipotential mesenchymal cells
66
10% patients with myxomas autosomal dominant inheritance tumor syndrome
Carney complex
67
cardiac myxoma can cause valve obstruction by --
"ball-valve" mech
68
for cardiac myxomas, strokes due to -- may occur
embolization
69
curative for cardiac myxomas
surgical removal
70
favored site of origin for cardiac myxoma
fossa ovalis in atrial septum
71
cardiac myxoma is almost always --
single, exophytic, polypoid, sessile (+/- hemorrhage)
72
cardiac myxoma histopatholy is composed of -- embedded within abundant myxoid stroma
stellate or globular myxoma cells
73
most common primary cardiac tumor of children
cardiac rhabdomyoma
74
cardiac rhabdomyoma is a tumor of --
striated muscle
75
cardiac rhabdomyoma is thought to represent a -- rather than a true neoplasm
hamartoma
76
cardiac rhabdomyoma is well-defined -- mass
uncapsuled white/gray nodular
77
cardiac rhabdomyoma is usually --
multiple
78
histologically, cardiac fhabdomyoma is --
large polygonal cells with abundant glycogen vacuoles (spider cells)
79
most common primary malignant cardiac tumor
cardiac angiosarcoma
80
cardiac angiosarcoma usually affects ---
right atrium
81
cardiac angiosarcoma may hematogenously spread to --
lung and liver
82
in cardiac angiosarcoma, vascular spaces are lined by atypical appearing --
malignant endothelial cells
83
in cardia angiosarcoma, immunohistochemistry is positive for --
markers of endothelial cell differentiation

Systems 1 (22 decks)

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