Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathology > CVS Path > Flashcards

CVS Path Flashcards

1
Q

Epi of Rheumatic Fever

2

A
  1. Kids

2. Endemic in LEDCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pathogenesis of Rheumatic Fever

A
  • Untreated Strep Throat
  • Causative Organism: Group A haemolytic Strep Pyogenes
  • After latency period of 2-6w
  • Anti-strep antibodies attack the heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causative organism of Rheumatic fever

A

Group A haemolytic strep Pyogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Latency period between strep throat and rheumatic fever

A

2-6w

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Initial infection before rheumatic fever

A

Strep throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Major Diagnostic Criteria for Rheumatic Fever

A

JONES

  1. Polyarthritis
  2. Pancarditis
  3. Subcutaneous Nodules
  4. Erythema Marginatum
  5. Sydenham’s Chroea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Minor diagnostic criteria for rheumatic fever

A
  1. Lab abnormalities (raised CRP)
  2. ECG abnormalities (prolonged PR)
  3. Fever
  4. Arthralgia
  5. Recent streptococcal infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you diagnose Rheumatic fever?

A

Clinically

2 Major criteria

OR

1 major and 2 minor criteria (one of which must be ‘Recent Strep Infection’)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is pancarditis?

A

Inflammation of the whole heart (all layers)

Perimyoendocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How would you know there is pericarditis present in rheumatic fever?

A
  • Pleural rub on auscultation

- Diffuse saddle shaped ST elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Signs of myocarditis in rheumatic fever

A

Aschoff bodies

- Giant cell granulomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Signs of endocarditis in rheumatic fever

A

Valve disease
- Vegetations on valve leaflets

Anitschow cells

  • Perivascular
  • Chromatin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Causes of valve disease

4

A
  1. Age related degeneration (calcification)
  2. Function changes (IHD)
  3. Rheumatic fever
  4. Infective endocarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of aortic stenosis

2

A

Calcific degeneration

Rheumatic Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ix aortic stenosis

A

Doppler USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Complications of aortic stenosis

5

A

LV hypertrophy
Angina

Syncope

LV failure
Sudden death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Causes of aortic regurgitation (incompetence)

A

Aortic root dilatation

Rheumatic valve disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Complications of Aortic incompetence

2

A

LV dilation

HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Risk factors for aortic stenosis

A

Bicuspid aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Causes of aortic root dilatation

A

Aortitis

Idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Causes of Mitral stenosis

A

Rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Complications of mitral stenosis

A

LA Hypertrophy

Pulmonary oedema

RV hypertrophy (Because more difficult to pump to lungs now)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Causes of mitral incompetence (regurgitation)

4

A

Floppy valve (degeneration)

Rheumatic fever

Dilated mitral valve annulus

Papillary muscle dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Complication of mitral regurgitation

A

LA dilation

AF

Mural thrombus

Embolic stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Most common cause and causative organism of infective endocarditis

A

Recurrent gingivitis

Viridans streptococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How does the causative agent get to the heart valves to cause infective endocarditis?

A

Bacteraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Complications of Infective endocarditis

5

A
  1. Cusp or chordae rupture
  2. Valvular incompetence (damage)
  3. Myocarditis
  4. Thromboembolism
  5. Fever, malaise, weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Predisposing factors for Infective endocarditis

4

A
  1. Structural abnormalities
    - Incompetent valves
  2. Prosthesis
    - Prosthetic valves
    - PCI
  3. Bacteraemia
    - IV drug use
    - Sepsis
  4. Immunosuppression
    - DM
    - Alcoholism etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Main signs of infective endocarditis

7

A

Finger clubbing
Janeway lesions
Splinter haemorrhages
Osler’s Nodes

Poor dental hygiene

Roth Spots

PUO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is Haematuria a sign of in the setting of infective endocarditis?

A

Thromboembolism

Resulting in renal infarcts

Resulting in Glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is bronchopneumonia a sign of in the setting of Infective endocarditis?

A

Pulmonary infarct

As result of Tricuspid valve endocarditis

Resulting in thromboembolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Roth spots

A

Red spots with white centre

Seen in retina

in Infective Endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Splinter Haemorrhages

A

Lots of tiny blood clots

Run vertically

Under the nails

In infective endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Janeway Lesions

A

Painless, red, flat, papules on palms of hands and soles of feet

Infective endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Osler’s Nodes

A

Tender raised red spots on hands

Infective endocarditis

36
Q

Define ‘True Aneurysm’

A

Localised, permanent, abnormal dilatation of a blood vessel

37
Q

Define False Auneurysm

A

The vessel wall is completely breeched

Blood leaks out

Blood is contained by the surrounding adventitia and perivascular soft tissue

38
Q

Cause of false aneurysm

A

Trauma (Surgical—> PCI)

39
Q

Typical location of false aneurysm

A

Femoral A. (During PCI)

40
Q

Cause of saccular or diffuse aneurysm

A

Atherosclerosis

Inflammatory disorders

41
Q

Location of saccular or diffuse aneurysm

A

Abdominal Aorta
Thoracic aorta
Cerebral artery

42
Q

Describe Saccular aneurysm

A

True aneurysm

Focal outpouching in the vessel wall

43
Q

Describe Diffuse aneurysm

A

True aneurysm

Involve whole circumference of the vessel wall

44
Q

Describe Dissecting aneurysm

A

Then aneurysm is within the vessel between the layers

45
Q

Cause of Dissecting aneurysm

A

Connective Tissue disorders (Marfan’s)

Bicuspid aortic valve

Uncontrolled HTN

Atherosclerosis

Trauma

46
Q

Typical location of Dissecting aneurysms

A

Aorta and main branches

47
Q

Describe capillary / microaneurysm

A

Saccular outpouchings in capillaries

48
Q

Causes of Capillary / Microaneurysms

A

HTN

Pericyte cell loss in DM (resulting in diabetic retinopathy)

49
Q

Typical locations of capillary / microaneursyms

A

Cerebral capillaries

Retinal Capillaries

50
Q

Describe mycotic aneurysm

A

Aneurysm caused by a bacterial infection of the vessel wall

51
Q

Causes of Mycotic aneurysm

A

Infection (eg. Infective Endocarditis)

Septic emboli

52
Q

Typical location for mycotic aneurysm

A

Any vessel

53
Q

Consequences of aneurysms

A

Rupture —> Haemorrhage —> shock —> hypo-perfusion of vital organs —> end organ failure

Compression of adjacent structures

Thromboembolism formation

54
Q

How is Myocarditis diagnosed?

A

Dallas criteria:

  1. On histological examination there is:
    - Myocyte death
    - Inflammatory infiltrate (T lymphocytes)
  2. Ischaemia did not cause this
55
Q

Causes of Myocarditis

9

A

Coxsackie
ECHO
Adenovirus (Kids)

Diphtheria
Meningococcus

Trypanosomiasis (Africa)
Chagas’ Disease (America)

Ionising radiation

Adriamycin

56
Q

Complications of Pericarditis

A

Pericardial Effusion

Leading to Cardiac tampondae

Leading to obstructive shock and death

57
Q

Pathogenesis of Cardiac tampondae

A

The pericardium is inflamed

The vessels become more permeable

Fluid leads out of the vessels and fills the potential space between the visceral and parietal pericardial layers (effusion)

This compresses the heart

Heart can’t fill properly

58
Q

Complications of caseous or purulent / suppurative pericardial effusion

A

Constrictive pericarditis

Due to healing by fibrosis

59
Q

Cause of caseous pericarditis

A

Fungi

Mycobacterium

60
Q

Cause of blood stained pericardial effusion

A

Malignancy

61
Q

Morphological features of shock in the Brain

A

Neuronal damage

62
Q

Morphological features of shock in the Heart

A

Sub-endocardial necrosis

63
Q

Morphological features of shock in the Kidneys

A

Acute Tubular Necrosis

64
Q

Morphological features of shock in the lungs

A

Diffuse alveolar necrosis

65
Q

Morphological features of shock in the Liver

A

Fatty change

Zone 3 necrosis

66
Q

Morphological features of shock in the GIT

A

Haemorrhagic enteropathy

67
Q

Types of shock

A
  1. Distributive
  2. Hypovolaemic
  3. Cardiogenic
  4. Obstructive
68
Q

Causes of Pericarditis

A

Viral
Bacterial (TB

Post MI
Dressler’s

Carcinoma (metastatic spread)

Uraemia

Systemic disease

Cardiac surgery

69
Q

Factors that determine whether ischaemia or infarction develops

4

A

Nature of blood supply

  • Dual vs end-organ
  • Anastamoses
  • Arcades

Rate of occlusion

Vulnerability of tissue to hypoxia

Oxygen content of the blood

70
Q

What affects the oxygen content of blood?

A

Anaemia

Altitude

Hyperventillation/ Hypoventillation

71
Q

What are the 2 tyes of infarct morphology?

A

Red

Pale

72
Q

Describe Red infarcts

A

Location:
- Loose, previously congested tissues with dual blood supply

Cause: Venous occlusion

Pathology: Re-perfusion damage

Eg: PE in lung

73
Q

Describe pale infarcts

A

Location:

  • Solid organs
  • End-organs

Blood supply: Single

Eg. Heart, spleen, kidney

74
Q

Causes of ischaemia and infarction

7

A

Thrombus
Embolus
Hyperviscosity
Atheroma

Spasm
Vasculitis

Compression

75
Q

What does Virchow’s Triad predict?

A

Thrombosis

76
Q

Virchow’s Triad

A

Changes in intimal surface of vessel wall

Changes in pattern of blood flow

Changes in blood constituents

77
Q

Signs of arterial thrombosis in the limbs

5

A 
Pale
Perishingly Cold
Pulselessness 
Paraesthesia
Paralysis
78
Q

Signs of venous thrombus formation in a limb

3

A

Red
Tender
Swollen

79
Q

Fate of a thrombi

4

A
  1. Lysis and resolution
  2. Organisation
  3. Recanalisation
  4. Embolism
80
Q

Types of embolism

A
  1. Thromboembolism
  2. Atheromatous embolism
  3. Amniotic fluid embolism
  4. Gas embolism
  5. Fat embolism
  6. Tumour
  7. Foreign body
  8. Infective agents
81
Q

Layers of an artery from inside out

6

A

Endothelium

Intima

Internal elastic lamina

Media

External elastic lamina

Adventitia

82
Q

Pathogenesis of ischaemia

A

Reduction in blood supply

Increased metabolic demand of tissue

Reduced oxygen carriage

83
Q

Morphological appearance of Ischaemic tissue depends on:

A
  • Extent of infarction

- Time since infarction

84
Q

How do you measure myocardial necrosis?

Why?

A

Troponin

It is a myocardial enzyme that is released

85
Q

Key histological features following myocardial infarction @:

<24hrs
>24hrs
D-W
W-Mths

A

< 24hrs : Electron microscopy shows swollen mitochondria

> 24hrs:

  • Pale infarct
  • Inflammation at periphery
  • Monocytes lose striations

d-w:
- Macrophages

Mths:

  • Repair by organisation and fibrosis
  • Akinetic segment

Pathology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions