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CV > CV1 > Flashcards

CV1 Flashcards

1
Q

A berry aneurysm ruptures. What kind of cranial bleed is there?

A

SAH

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2
Q

What are the complications of HTN?

A
  • Cornoary Artery Disease
  • LVH
  • HF
  • Atrial fib
  • Aortic disssectino
  • AA
  • STroke
  • CKD
  • retinopathy
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3
Q

Proteins are leaking into the vessel wall.

A

HTN hyaline arteriosclerosis

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4
Q

Vaso vasorum sclerosis

A

Aortic dissection from hyaline arteriosclerosis

Tertiary syphilis

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5
Q

Pt has incresaed C Reactive protein in the presence of vascular disease. What does this mean?

A

If you have atherosclerosis and increased C Reactive protein, it means you’ll get cardiovascular failure.

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6
Q

Bx shows cholesterol crystals,/clefts, needle like spaces

A

Atherosclerosis

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7
Q

You see calcificatino fo aortic arch that looks like tree bark.

A

Syphilitic heart disease

Tree bark - calcifications that happen to the entire aorta

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8
Q

You see cystic medial degeneration.
This is cysts and necrosis in the media layer of a large artery
What is increased?

A

= aneurysm from loss of connective tissu

Things that cause aneurysms:
- HTN –> Hyaline arteriosclerosis –> Aneurysm

  • Marfan’s can also cause CMD;
  • Syphils
  • Atherosclerosis

Proteoglycans in aorta

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9
Q

Which vascular pathology is located between the renal arteries and the bifurcation?

10 cm from aortic arch?

A

AAA

aortic dissection - 10 cm

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10
Q

Which large artery disease can result in aortic valve insufficiency?

A

Takayasu arteritis

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11
Q

Polyarteritis nodosa, explain

A

Necrotizing infalmmation at renal arteries, when it heals, makes a string of pearls on imaging

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12
Q

Mucocutaneous lymph node syndrome affects what artery? What unique cliniical presentation does it come with

A

AKA Kawasaki disease
coronary artery

Conjunctivitis, rash on palms and soles

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13
Q

What is leukocytoclastic vasculitis

and what is it’s morph

A

Microscopic polyangiitis

fibrinoid necrosis

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14
Q

Aphthous ulcers, genital ulcers, uveitis. What is diagnostic?

A

Behcet disease - neutrophilic inflammation

HLAB51

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15
Q

A female patient has fingers that turn blue when she gets stressed out, what’s she got?

A

primary Raynaud

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16
Q

What things cause 2 Raynaud phenomenon?

A

SLE, Scleroderma, thromboangiitis obliterans

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17
Q

Pt presents with needle tracks in their arm and cardiac arrest., what happened?

A

Epi, cocaine OD; myocardial vasospasm (cardiac Raynaud)

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18
Q

Milky chylous accumulations in body cavities from rupture of what

A

Lymphedema

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19
Q

Describe Sturge Weber

A

Port wine stains
trigeminal nerve
- Mental retarded, seizure, hemiplegia

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20
Q

CD31; where does this arise?

A

Angiosarcoma

Skin breast liver

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21
Q

What causes high output cardiac failure?

A

Arterioveno shunt

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22
Q

A baby has a nevus flammeus, what are you worried about? What areas of the body should you look at?

A

Sturge Weber Syndrome; port wine stains.

brain for skull radiopacities, leptomeningieal angiomatosis masses

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23
Q

A pregnant patient presents with spider telangiectasisas. What caused these?

A

Hyperestrogen

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24
Q

A pt with angiosarcoma may work around the following chemicals

A

PVC, Arsenic, thorotrast

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25
Q

An alcoholic mother has her child and the child is messed up. What heart defect?

A

VSD

fetal alcohol syndrome

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26
Q

Baby born with rubella. what heart defect he got?

A

Patent ductus arteriosus

Pulm a steno
septal

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27
Q

A pt has transposition of great vessels, what did the mother likely have?

A

Maternal diabetes

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28
Q

Turner Syndrome associations

A

Coarctation fo the aorta

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29
Q

Pts have prinzmetal variant angina is caused by what toxins?

A

Cocaine alcohol triptans

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30
Q

When do MI deaths occur?

A

within 1 hour due to arrhythmia
or
2-4 days when macrophages come weaken the wall and rupture the myocardium

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31
Q

Hypertensive patients die from what?

A
  • Stroke

- Renal failure

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32
Q

What’s the path from HTN to aortic dissection?

A

HTN –> hyaline arteriosclorosis –> Vaso vasorum sclerosis –> aortic dissection

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33
Q

Homeless pt has swallowing/breathing problems with a persistent cough. PMH sig for HTN. Auscultation reveals a systolic whooshing sound.

A

Systolic whooshing - aortic valve insufficiency

Impingement of thoracic AA on esophagus and laryngeal nerves.

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34
Q 
alcohol?
Rubella?
Down?
Diabetic
Marfan
Turner
A 
OH2: VSD
Rubella: PDA
21: VSD & endocardial cushion cells
DM: Transposition 
Marfan: MVP
Turner: Coarctation
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35
Q

Pt has a fever but grams are negative. What is the main source of vasculitis without infection?

A

Drugs
SLE
immune complexes

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36
Q

What do ANCAs do?

A

Activate neutrophil –> granule release and ROS

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37
Q

Which vasculitis is associated with immune T cells?

A

Giant cell temporal arteritis
Granulomastosis with polyangiitis
Takayasu as well

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38
Q

A pt presents and yous ee intimal thickening, fragmentation of the lamina and granulomatous inflammation on bx of a large artery. What clinical symptoms will yousee?

A

Giant cell arteritis

Vision loss, headache

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39
Q

Aortic valve insufficiency can be caused by

A

AOrtic dissection
Thoracic aortic aneurysm
takayasu arteritis

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40
Q

Pulseless disease is whatguy

A

Takayasu

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41
Q

A pt presents with a systemic vasculitis. PMH Hep B. Which vessels are affected?

A

LUngs SPARED

mostly renal

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42
Q

A pt with suspected vasculitis has a cavitation in the lung

A

Granulomatosis with polyangiitis wegener

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43
Q

What tumors can cuse SVC and IVC syndromes?

A

SVC - Bronchogenic cacinoma, mediastinal alymphoma,

IVC - RCC HCC

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44
Q

What venous dilation can cause hemoptysis, GI bleeds, ematuria, epistaxis

A

Hereditary hemorrhagic telangiectasia

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45
Q

NOTCH 1

NOTCH 2

A

NOTCH 1 - bicuspid aortic valve

NOTCH 2 = tetraology

46
Q

What type of angina has ST depression? ST elevation?

A

ST depression = unstable

St elevation = prinzmetal

47
Q

What is contraction band necrosis

A

reperfusion injury of Ca coming in and hypercontracting muscle

48
Q

What can cause sudden cardiac death?

A
  • CAD ischemia –> fatal arrhythmia
  • Cardiomyopathy
  • Congenital channelopathies
  • Myocarditis
  • myocardial hypertrophy
49
Q

Mitral annular calcifications, what is it?

What does it do the valve?

A

Females with MVP, get thrombus or bacterial endocarditis;
calcifican in a fibrous annulus

Does no thing sto the valve.

50
Q

Mitral stenosis is usually caused by what

A

Chronic rheumatic heart disease

51
Q

how do you tell the difference between rheumatic fever aortic stenosis and regualr?

A

mitral valve issues and fusion of aortic valve commissures

52
Q

You see fusion of commissures of the aortic valve

A

chronic rheumatic disease

53
Q

A pt’s tricuspid valve is messed up. Cultures are negative. Sxs include flushing, diarrhea, dermatitis, bronchoconstriction

A

5HIAA carcinoid syndrome =

ONLY right sided valvular fibrosis bc lungs get rid of 5 HIAA

54
Q

A pt has onion skin fibrosis with necrotizing arteriolitis

A

Malignant hypertension = hyperplastic arteriosclerosis

55
Q

What protects patients from atherosclerosis

A

ESTROGEN;

so post menopausal women get shafted

56
Q

What 3 things can cause Thoracic aortic aneurysm?

A

Syphilis
Marfan
HTN

57
Q

Who’s at risk for Aortic dissection

A

HTN

Marfan

58
Q

transmulra necrotizing inflammatino at artery branch points

A

PAN

59
Q

Microabscess are located in the thrombi of what vasculitis?

A

Thromboangiitis obliterans (buerger disease)

60
Q

Geographic patterns of central necrosis

A

Wegener, granulomatosis with polyangiitis

61
Q

Palpable Purpura

A

Churg-Strauss Syndrome
Also? Microscopic polyangiitis

MOST USUALLY
Henoch Schenloin IgA

62
Q

pt has dilation of vessels in head, neck, arms, and cyanosis due to respiratory distress. What could they have?

A

SVC syndrome due to Bronchogenic carcinoma, mediastinal lymphoma or an AA

63
Q

mucin producing adenocacrinomas cause what? Where are they located?

A

Hypercoagulability –> Migratory thrombophlebitis

pancreas lung ovary

64
Q

Most common cause of arrythmia

A

ischemia

65
Q

A pt has RV dilation, but there is no hypertrophy. What is the cause?

What if there’s hypertrophy?

A

Acute, cor pulmonale; caused by a PE

Hypertrophy = chronic, which is caused by parenchymal disease, pulmonary isorders really.

66
Q

What puts a pt at risk for calcific valvular degeneration? Whats the pathophys

A

Old people wear and tear from
HTN inflammation hyperlipidemia

Osteoblast like cells deposit and stenose the valve.

67
Q

Pt has myxomatous degeneration from proteglycan deposits. Whatcha looking at?

A

Mitral valve prolapse

68
Q

Causes of mitral valve regurg?

A 
Progression from MVP 
LV dilation 
Infective endocarditis
Acute strep heart disease 
Papillary muscle rupture
69
Q

Pt presents with microangiopathic hemolytic anemia as a complication of what heart defect?

A

Aortic Stenosis

70
Q

Describe Rheumatic

A

When you get strep, make abs against it, but molecular mimicry of your body’s own M cells.
2-3 weeks later you have created enough antibodies that the antibodies attacking your body do some damage and you get the Jones Criteria. (Pancarditis)

Say you keep getting strep over and over, your body finally makes so many antibodies against M protein that it really takes out the mitral valve with fibrosis (so much fibrosis you get sticky commissures; fish mouth stenosis)
This fibrosis is sticky to infections, too so you can get infective endocarditis

So when do you get Aschoff and stuff? During the fever stage when you have pancarditis

71
Q

Patient is an IV drug user, gets infective endocarditis.

A

Staph aureus
Acute.

Tricuspid valve usually (Don’t TRI drugs)

72
Q

Pt has valve vegetations and destruction. Gram stain comes back (+) cocci in chains. What is going on? What is the history of teh pt that gets this? Which valve?

A

Subacute infective pericarditis

Left valve (usulaly bc of RHD)

Dental work, bad needles, bacteremia from sepsis.

73
Q

Pathology of NBTE?

A

Caused by:
mucinous adenocarcinoma, sepsis, catheters

Small packs of sterile balls on one side of leaflet, loosely attached, so cause emboli

74
Q

You see glistening white plaque like thickening on endocardial surface and valve leaflets. Which valve is it?

A

Right valve bc it’s carcinoid heart disease.

75
Q

Pt presents with regurg L intercostal space 2, right intercostal space 2. What is the morph? What are the causes?

A

Dilated cardiomyopathy

Interstittial fibrosis

  • Genetic
  • Coxsackie
  • Alcohol
  • Doxorubicin
  • hemoch
76
Q

An athlete dies on the floor, what is messed up genetically?

A

Sarcomere proteins’s B myosin heavy chain; causes a ventricular outflow obstruction and arrhythmia

77
Q

Pt has Nutmeg liver, & arrythmias, what isthe mutation?

WHat is Naxos syndrome?

A

RV HF with arrhythmias = arrhythmogenic RVC
mutation is desmosomes, the muscle myocardium is replaced by adipose and fibrosis

Arrhythmogenic RVC with hyperkeratosis of palmar surfaces., which has an additional mutation in plakoglobin gene

78
Q

Pt has dilated bilateral atria, but normal sized ventricles resulting in diastolic dysfunction. What causes this?

A

Amyloid
Radiation fibrosis
Endocardia fibroelastosis
Loeffler

79
Q

What can cause myocarditis?

A

Coxsackie a anb b

trypansoma cruzi chagas

80
Q

how can you tell the difference between dilated cardiomyopathy and myocarditis?

A

There’s fibrosis in cardiomyopathy,

only enlargement and:
lymphocytes - viral
eosinophils - hypersensitive

81
Q

GNAS1

PRKAR1A

A

Myxoma

82
Q

Complciations of crdiac transplant

A 
Allograft rejection (Lymphocytes, right away)
Allograft arteriopathy (5 years)
EBC associated B cell lymphoma
83
Q

Elevated sedimentation rate

A
  • Temporal giant cell

- PAN

84
Q

“Discrete foci of fibrinoid degeneration and mononuclear inflammatory cells” descrbies what?

A

Aschoff cbodies

85
Q

Necrotizing granulomas

A

Wecner)

Granulomatosis with polyangiitis

86
Q

Segmental thrombosing vasculitis

A

Buerger disease

87
Q

Lesions same age in this; lesions different stages in this

A

Same = microsocpic angiitis

Different:
PAN

88
Q

Polymyalgia rheumatica

A

temporal arteritis

89
Q

what drug inhibits microsomal transverse protein

A

Lomitapide

90
Q

which drug inhibits apoB

A

Mipomersen

91
Q

what drug inhibits Na+ late channels

A

ranolazine

92
Q

What are 2 main drugs that can cause noninfectious vasculitis?

A

PCN, streptokinase

93
Q

fibrinoid necrosis

A

Polyarteritis Necrosis

& Microscopic polyangiitis

94
Q

Pt has an upper prespiratory tract infection, has palpable purpura

A

IgA Henoch Schenloin

95
Q

What vasculature does hyaline arteriosclerosis occur in?

A

Small artery walls

96
Q

What can result in dilation of all 4 chambers?

A

myocarditis (caused by doxo, Chagas, Cox, Rheumatic fever, autoimmune, URI)

and dilated cardiomyopathy

97
Q

Rheumatic Fever

A

Lymphocytic infiltrate with focal necrosis of myocardial tissue

CHAGAS AND COXSACKIE
SLE

Rheumatic Fever

Kawasaki
URI
Borrelia
Cocaine
Doxorubicin
98
Q

Glycosaminoglycans in a gelatinous material is fuond in the heart

A

myxoma

99
Q

Tricuspid bois.

A

Carcinoid, IVDU IE, NBTE

100
Q

Machine like murmur

A

PDA

101
Q

MI or angina?

A

If there’s a thrombus = MI

102
Q

Unexpected side effect of verapamil

A

Hyperprolactinemia

103
Q

Statins worst side effects

A

hepatotoxicity and myopathy

104
Q

Which drug has a long half life and is not easily reversible

A

LMWH

105
Q

Which anticoagulation acts on the liver? Which one is acute, which one is chronic?

A

Warfarin

Heparin = acute
Warfarin = chronic
106
Q

What drugs inhibit Gp2b/gp3a?

What drugs inhibit P2Y2 ADP receptor?

A

GP2 - abciximab, eptifibatide, tirofiban

P2Y2 ADP = clopidogrels, tigra

107
Q

Mechanism of HIT

A

IgG abs form complex with heparin and platelet factor 4 to destroy platelets?

108
Q

A pt has strokes and TIAs in past. What can you combine with cilostazol and dipyraidamole to prevent CVA?

A

ASA

109
Q

how does necrosis with warfarin work

A

Microthrombi in small vessels

protein C deficiency

110
Q

Pregantn pt develops an hemangioma. Which

A

Pyogenic

111
Q

Pt has notched ribs

A

Coarctation of aorta

CV (3 decks)

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