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3 Patho > CVS 2 > Flashcards

CVS 2 Flashcards

1
Q

Diagnostic criteria for SHHD

A

LVH, concentric
HTN
Absence of other CVS lesions that could cause hypertrophy (valves)

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2
Q

Microscopic examination reveals myocytes aligned circumferentially. What disease?

A

Cor pulmonale

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3
Q

RV dilation without hypertrophy (after pulmonary embolization)

A

acute cor pulmonale

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4
Q

Chronic RV pressure –> RV hypertrophy. Main feature of what disease?

A

chronic cor pulmonale

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5
Q

Microscopic examination revealed:

1) increase in transverse diameter of myocytes
2) box-like appearance of myocytes
3) diffused interstitial fibrosis

A

systemic hypertensive heart disease

SSHD

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6
Q

Most common type of CMP

A

dilated CMP

congestive CMP

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7
Q

CMP associated with B-MHC gene

A 
hypertrophic CMP
(obstructive)
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8
Q

CMP with decreased ejection fraction, CO and hypocontracting heart

A

dilated CMP

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9
Q

CMP with decreased cardiac compliance –> impaired ventricular filling, decrease LV ejection fraction

A

restrictive CMP

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10
Q

In acute cor pulmonale, RV dilation by lead to _____ regurgitation

A

tricuspid

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11
Q

Characteristic of this CMP:

Hypertrophied IV septum too close to mitral valve –> leads to obstruction

A

hypertrophic CMP

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12
Q 
Causes of this type of CMP include: AABBCCD
Alcohol
Adrimycin
Beriberi
B12 def.
Coxsackie B
Cobalt
Doxorubicin
A

dilated CMP

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13
Q

What type of CMP is associated with pregnancy?

A

dilated CMP

also classified as peripartum CMP

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14
Q

Banana-like ventricular cavity –> obstruction of blood flow. What CMP?

A

hypertrophic CMP

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15
Q

Major causes of this CMP:

sarcoidosis, amyloidosis, post-radiation fibrosis

A

restrictive CMP

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16
Q

Mural thrombi common in this CMP

A

dilated CMP

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17
Q

CMP with massive hypertrophy but without ventricular dilatation

A

hypertrophic CMP

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18
Q

Thick fibroelastic tissue in endocardium of young children

A

endocardial fibroelastosis (type of R CMP)

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19
Q

endomyocardial fibrosis with a prominent eosinophilic infiltrate

A

Loffler’s syndrome (type of R CMP)

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20
Q

Most common etiologic agent of myocarditis

A 
viruses:
Coxsackie A and B
enterovirus
CMV
HIV
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21
Q

Parasitic etiologies of myocarditis:

A

Chagas disease
txoplasmosis
trichinosis

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22
Q

Bacterial etiologies of myocarditis

A

Lyme disease

diphtheria

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23
Q

Myocarditis with these features:
edema
mononuclear infiltrates
myocyte degeneration and necrosis

A

acute viral myocarditis

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24
Q

aka Fiedler’s myocarditis

A

giant cell myocarditis

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25
Q

Myocarditis with these features:
macrophage and eosinophil infiltrate
little to no necrosis
no granulomas

A

hypersensitivity myocarditis

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26
Q

Methyldopa can cause this myocarditis

A

hypersensitivity myocarditis

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27
Q

Most common chromosomal defect resulting in CHD

A

trisomy 21

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28
Q

Trisomies that are highly associated with CHD

A

13, 15, 18, 21

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29
Q

Infections causing CHDs

A

rubella

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30
Q

Teratogen causing CHD

A

thalidomide

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31
Q

Early cyanotic (blue baby) CHDs are usually

A

R to L shunt

unoxygenated blood bypass pulmonary circulation and sent to systemics

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32
Q

Most common CHD

A

VSD

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33
Q

Most common asymptomatic CHD

A

ASD

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34
Q

Direction of low shunted from LA to RA

A

ASD

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35
Q

Most common type of ASD

A

secundum ASD

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36
Q

CHD that can manifest pulmonary congestion due to volume overload in RV

A

VSD

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37
Q

Indomethacin used to treat this CHD

A

PDA

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38
Q

CHD has this characteristic machinery-like murmur

A

PDA

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39
Q

Late clinical manifestation of ASD

A

ASD pulmonary HTN occurs in the 2nd or 3rd decade of life

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40
Q

Most common type of ASD

A

secundum ASD

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41
Q

Type of ASD where defect is located near entrance of SVC.

May be associated with total anomalous pulmonary venous return (TAPVR)

A

sinus venosus

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42
Q

CHD due to fenestrated fossa ovale

A

secundum ASD

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43
Q

CHD due to incomplete closure of AV septum and associated with cleft of anterior mitral valve

A

primum ASD

primum ASD + cleft of anterior mitral valve = partial AVSD)

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44
Q

Most VSD occur in this part of the septum

A

membranous (superior) VSD

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45
Q

Type of VSD located below pulmonary valve

A

infundibular VSD

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46
Q

Type of VSD located near atrioventricular valve

A

membranous VSD

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47
Q

Type of VSD showing Swiss-cheese septum

A

muscular VSD

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48
Q

Type VSD with high incidence of spontaneous closure

A

muscular VSD (50%)

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49
Q

CHD where there is a single large common AV valve and free communication of all four chambers

A

Complete AVSD

50
Q

Shunting of blood from aorta to pulmonary artery

A

Patent ductus arteriosus PDA

51
Q

PDA may be beneficial in:

A

TGV

TOF

52
Q

Maintains patency of ductus arteriosus

A

PGE

53
Q

Right to Left shunts?

A 
5 T's
Tetralogy
Transposition
Trucus
Tricuspid
TAPVR
54
Q

Main problem in TOF. Causes the cyanosis and most common reason for R to L shunting.

A

Pulmonary stenosis

55
Q

TOF components

A
  1. Pulmonary stenosis
  2. RVH
  3. Aorta overriding VSD
  4. VSD
56
Q

Blue baby CHD characterized by RV hypoplasia

A

Tricuspid Atresia (absent tricuspid valve is obviously the most important characteristic)

57
Q

Results from unequal division of AV canal

A

Tricuspid atresia

58
Q

Pulmonary artery and aorta are a single great artery in this CHD.

A

PTA (patent Truncus Arteriosus)

59
Q

Due to failure of the aorticopulmonary septum to spiral during embryogenesis

A

TGV

60
Q

Lesion most associated with PTA

A

VSD

61
Q

Patient learns to compensate for symptoms by squatting.

A

TOF

compression of femoral arteries –> increased TPR –> decreased right to left shunt

Compression causes pressure.

62
Q

Pulmonary veins drain into right heart circulation (SVC, coronary sinus, etc.). What CHD?

A

TAPVR

63
Q

CHD featuring RVH and LV hypoplasia

A

TGV

RV becomes systemic ventricle
LV wastes because no blood flows here

64
Q

Boot-shaped heart

A

RVH seen in TOF

65
Q

Cyanotic CHD featuring hypoplastic LA with right-sided dilation and hypertrophy,

A

TAPVR

The pulmonary veins drain into right side (cause of dilation and hypertrophy) instead of LA (hypoplasia)

66
Q

TGV is incompatible with life unless paired with these defects

A

PDA, ASD, VSD

There has to be a shunt to allow mixing of blood since the systemic and pulmonary circulations are separated.

67
Q

What CHD? Inability of the great vessel to rotate during embryogenesis resulting in an incomplete migration of the great vessels to their normal positions.

A

TOF

68
Q

Congenital narrowing or constriction of the aorta

A

Coarctation of aorta

69
Q

COA type associated with Turner syndrome

A

Infantile type

70
Q

In TGV aorta arises from where? pulmonary artery from where?

A

Aorta arises from RV

Pulmonary artery from LV

71
Q

COA type where stenosis is distal to ligamentum arteriosum (closed ductus arteriosus).

A

Adult type has a postductal constriction

Infantile type has a preductal constriction

72
Q

COA + PDA manifests symptoms when?

A

Early childhood.

Without COA, adulthood.

73
Q

Hypertension in upper extremities and weak pulse in lower extremities.

A

Adult COA or postductal COA

The pressure is higher proximal to the coarctation point (thus higher BP for upper circulation and lower BP for abdominal aorta)

74
Q

Most common valvular defect

A

calcific aortic valve stenosis

Usually acquired and the result of wear and tear.

75
Q

Libman-Sacks endocarditis found in patients with:

A

SLE

76
Q

Serotonin-induced fibrosis of tricuspid and pulmonary valves causing Right-sided insufficiency

A

carcinoid heart disease

77
Q

Immune-mediated inflammatory disease folowing group A (beta hemolytic) strep

A

RF

78
Q

Pathognomonic for RF

A

Anitschkow cells - enlarged macrophages found within granular tissue in RF

79
Q

Heaped-up calcified masses within aortic cusps

A

calcific aortic valve stenosis

80
Q

Common in eldery women with myxomatous mitral valve and elevated LV pressure

A

mitral annular calcification

81
Q

Colonization or invasion of valves or mural endocardium by microbe forming bulky vegetations

A

infective endocarditis

82
Q

Marantic endocarditis aka

A

non bacterial thrombotic endocarditis

associated with malnutrition

83
Q

Antibodies aginst M protein (strep) react with glycoproteins of heart

A

RF

84
Q

Bulky, friable vegetations on valves

A

IE

85
Q

Necrotic vegetations on lines of valve closure

A

verrucae (RF)

86
Q

Major bacterial causes of IE

A

Strep viridans
Staph aureus (esp. IV drug users)
pneumococci
ricketssia/chlamydia

87
Q

Type of IE arising in previously diseased valve

A

subacute IE (usually by less virulent organisms like viridans)

88
Q

Defect that causes a mid-systolic click

A

MVP

89
Q

Irregular thickenings caused by regurgitation and induced by verrucae usually seen in LA

Seen in RF

A

MacCallum plaques

90
Q

Mechanical prosthetic valves are prone to:

A

thrombosis

91
Q

Fish mouth or buttonhole stenosis seen in:

A

RF

extreme narrowing of valve, usually MITRAL

92
Q

Roth spots can be seen in which heart disease?

A

subacute bacterial endocarditis

93
Q

x

A

x

94
Q

Associated with cancer and Trousseau syndrome

A

NBTE

95
Q

Non-tender erythematous/heemorrhagic lesions in palms or soles? What disease?

A

Janeway lesions

PATHOGNOMONIC of IE

96
Q

“caterpillar cells” aka

A

Anitschkow cells

97
Q

Irregular, stony, hard nodules behind MV leaflets

A

mitral annular calcification

98
Q

Splinter hemorrhage seen in what heart disease

A

IE

nails

99
Q

Sterile, nondestructive vegetations on valves

A

NBTE

100
Q

Central zone of degenerating, hypereosinophilic ECM infiltrated by lymphocytess, plasma cells, and plump activated macro phages are:

Found in what disease?

A

Aschoff bodies

acute RF

101
Q

Unequal-sized bicuspid valve with midline “raphe’ resulting from incomplete commissural separation during development.

A

congenital bicuspid aortic valve calcification

102
Q

CVS disease most associated with Marfan’s

A

MVP

103
Q

Most common valvular disease in INDUSTRIALIZED countries

A

MVP

104
Q

Bioprosthetic valves are prone to

A

deterioration and calcification

105
Q

Pericarditis caused by SLE, RHD, scleroderma, tumors

A

serous (noninfectious, inflammatory diseases)

106
Q

Pericarditis caused by Dressler syndrome

A

fibrinous

107
Q

Caseous pericardits caused by

A

tuberculous foci

108
Q

Soldier’s plaque seen in this pericarditis

A

chronic/healed

109
Q

Pericarditis caused by TB, tumor metastasis, bacteria

A

hemorrhagic

110
Q

Loud pericardial friction rub is heard in this pericarditis

A

fibrinous

111
Q

Viruses cause this form of pericarditis

A

serous

112
Q

When pericardial effusion affects heart function by restricting cardiac filling:

A

cardiac tamponade

113
Q

Bread and butter pericarditis

A

fibrinous

114
Q

Most common primary heart tumor in adults

A

myxoma

115
Q

Most common primary heart tumor in children

A

rhabdomyoma

116
Q

Causes wrecking ball effect to valve leaflets:

A

myxoma tumors

117
Q

Cardiac tumor associated with tuberous sclerosis

A

rhabdomyoma

118
Q

Spider cells

A

rhabdomyoma

119
Q

Left atrium tumor

A

myxoma

120
Q

Left ventricle tumor

A

rhabdomyoma

3 Patho (8 decks)

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