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Pathology > CVS Pathology > Flashcards

CVS Pathology Flashcards

1
Q

Arterial wall thickening and loss of elasticity (hardening)

A

Arteriosclerosis

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2
Q

The means of lipid transport in the blood plasma

A

Lipoproteins

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3
Q

The lesions in arterial walls which obstruct blood flow, weaken the underlying media, and rupture causing thrombosis are known as:

A

Atheromas (atherosclerotic plaques)

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4
Q

The build up of fats, cholesterol, and other substances in and on the arterial walls

A

Atherosclerosis

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5
Q

The surface of lipoproteins has molecules which are partly ____, while the center contains ____ molecules

A

Hydrophilic, hydrophobic

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6
Q

About __ to __% of the cholesterol present in the blood plasma is synthesized by body cells (endogenous). The remaining cholesterol is derived from the diet (exogenous)

A

50-80%

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7
Q

Cholesterol can/cannot be broken down by the body?

A

Cannot

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8
Q

Name some lipids of importance:

A
  • fatty acids
  • triglycerides
  • phospholipids
  • cholesterol
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9
Q

Very Low Density Lipoproteins (VLDL) are formed where?

A

Hepatocytes

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10
Q

What is the action of VLDL’s? (Very Low Density Lipoproteins)

A

Transport endogenous lipids

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11
Q

Low Density Lipoproteins (LDL’s) are derived from VLDL’s by the action of lipoprotein lipase. What is their job?

A

Deliver cholesterol to peripheral tissues

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12
Q

High Density Lipoproteins (HDL’s) are formed in hepatocytes and serve to do what?

A

Mobilize cholesterol (and existing atheromas) and transport them to the liver for excretion in the bile

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13
Q

Elevated LDL is a risk factor for ____

A

Atherosclerosis
NL <130mg/dL
High >160

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14
Q

The major cholesterol carrying lipoprotein in the blood plasma

A

LDL (Low Density Lipoprotein)

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15
Q

The role of Prostaglandin I2 is to?

A
  • vasodilation

- prevent platelet aggregation

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16
Q

PGI2 (prostaglandin I2) is produced by ___ cells

A

Endothelial

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17
Q

____ dysfunction initiates atherosclerosis

A

Endothelial

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18
Q

A blood clot formed in situ (in the natural or original position or place) within the vascular system and impeding blood flow

A

Thrombus

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19
Q

The formation or presence of a blood clot within a blood vessel

A

Thrombosis

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20
Q

Thromboxane A2 (TXA2) is produced by ____

A

Platelets

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21
Q

TXA2 causes what two things?

A
  • vasoconstriction

- platelet aggregation

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22
Q

What are the 3 fates of fatty plaque that has started to build up in an artery?

A
  1. Aneurysm and rupture
  2. Occlusion by thrombus
  3. Critical stenosis
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23
Q

What is the most common proposed mechanism to initiate atherosclerosis?

A

Endothelial cell injury

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24
Q

Lipid-lowering drugs that interfere with cholesterol synthesis to help reverse atherosclerosis are called ____

A

Statins (HMG CoA Reductase Inhibitors)

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25
Q

Medical term for chest pain

A

Angina pectoris

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26
Q

Medical term for heart attack

A

Acute myocardial infarction

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27
Q

Most common type of angina pectoris? (Chest pain)

A

Exertional/stable - associated w/fixed atherosclerotic narrowing (>75%) of one or more coronary arteries

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28
Q

Coronary artery spasm resulting in chest pain AT REST is known as:

A

Prinzmetal’s Angina

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29
Q

The worst form of angina pectoris is ___

A

Unstable/crescendo

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30
Q

What is the gold standard for diagnosing unstable/crescendo angina pectoris?

A

Coronary arteriography

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31
Q

The most specific enzyme and cardiac biomarker for an acute myocardial infarction (heart attack) is:

A

Troponin (comes from cardiac myocytes)

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32
Q

Dilated Cardiomyopathy (dilated ventricles) causes a ____ (systolic/diastolic) dysfunction

A

Systolic

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33
Q

Hypertrophic cardiomyopathy (enlarged walls) occurs in response to ___

A

Stress (coronary artery disease (CAD) or chronic hypertension)

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34
Q

Chaotic ventricular depolarization

A

Ventricular Fibrillation

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35
Q

Ventricular fibrillation is the most common cause of ____

A

Sudden Cardiac Death syndrome (SCD)

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36
Q

Irregular heartbeat is known as ___

A

Arrythmia

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37
Q

The sudden blocking of an artery

A

Embolism

38
Q

Inflammation of vessel walls is known as ____

A

Vasculitis

39
Q

The two causes of vasculitis:

A
  1. Immune mediated

2. Infectious

40
Q

Drug hypersensitivity is an example of ____ vasculitis

A

Immune mediated

41
Q

Wegener granulomatosis and Churg-Strauss syndrome are examples of ____ immune mediated vasculitis

A

Anti-neutrophil cytoplasmic antibodies

42
Q

Kawasaki disease is an example of ____ immune mediated vasculitis

A

Anti-endothelial cell antibodies

43
Q

A T-cell mediated immune response to an unknown vessel wall antigen causing thickened, nodular, tender temporal artery. Usually affects patients >70yo

A

Temporal arteritis

44
Q

Transmural fibrous aorta thickening (arch) which causes eye disturbances and weakening of the pulses of the upper extremity (pulseless disease) is known as ___

A

Takayasu arteritis

45
Q

Takayasu arteritis has genetic predisposition and is associated with what age and gender?

A

Females <40yo

46
Q

This CVS disease has a strong association w/cigarette smoking. Patient may have superficial phlebitis (vein inflammation), cold sensitivity, and chronic ulceration of toes or fingers followed by gangrene

A

Thromboangiitis Obliterans (Buerger Disease)

47
Q

This CVS disease is an inflammatory process that weakens arterial walls and leads to aneurysms and rupture. Associated w/rapidly developing hypertension, abdominal pain and melena (bloody stool). Kidneys are most affected (renal arteries) and it is a major cause of death. Also associated w/hepatitis B

A

Polyarteritis Nodosa

48
Q

A patient w/____ may present with gangrene or purpura (bleeding beneath the skin in lower extremity)

A

Polyarteritis Nodosa

49
Q

This CVS disease is a delayed type hypersensitivity response of T-cells to an unknown vascular antigen. Seen in children who may present w/eye or mouth rednesss, edema of hands and feet, rash, and lymph node enlargement. Coronary artery involvement is common.

A

Kawasaki disease

50
Q

The most frequent cause of myocardial infarction in children

A

Kawasaki disease

51
Q

This CVS disease in an antibody response to antigens in the vessel wall. The patient may present w/vomiting of blood (hemoptysis), bloody urine (hematuria), proteinuria, and palpable cutaneous purpura.

A

Microscopic Polyangitis

52
Q

Microscopic angitis, Kawasaki disease, and polyarteritis Nodosa are all ____ type of necrosis (cell death)

A

Fibrinoid (the area of cell death is replaced by fibrous tissue)

53
Q

Primary (essential) hypertension is idiopathic (cause unknown) and accounts for __% of all cases

A

95%

54
Q

Name a genetic factor that would increase cardiac output causing hypertensive heart disease

A

Defects in renal sodium balance (Renal Angiotensin Aldosterone System (RAAS) which regulates blood volume)

55
Q

An environmental factor that could cause hypertensive heart disease?

A

Increased salt intake

56
Q

____ is characterized by a rapid elevation of BP above the previous level which produces acute damage to arterioles

A

Malignant Hypertension

57
Q

The BP in malignant hypertension is ____

A

> 180/120

58
Q

A ballooning and weakened area of an artery is known as ____

A

Aneurysm

59
Q

Involvement of all layers (intima, media, adventitia) is called a ___ aneurysm

A

True

60
Q

____ is when blood enters the wall of the artery

A

Dissection

61
Q

A ______ will show widened mediastinum on a chest x-ray, and symptoms include extreme pain (chest radiating to back between scapula and moving downward as it progresses)

A

Dissecting Aortic Aneurysm

62
Q

The inability of the heart to pump blood into the arterial circulation at a sufficient rate to meet the physiologic needs of the body

A

Heart failure (forward)

63
Q

The ability to pump blood at a sufficient rate only if the ventricular filling pressures are abnormally high

A

Heart failure (backward congestive failure)

64
Q

The usual cause of heart failure?

A

Congestive heart disease

65
Q

Blood volume is ____ (increased/decreased) in congestive heart failure

A

Increased

66
Q

The % of end diastolic volume that the left ventricle ejects during systole

A

Ejection Fraction (EF)

67
Q

The normal ejection fraction?

A

50-75%

68
Q

Ejection fraction to diagnose heart failure?

A

<40%

69
Q

The most prominent symptom of congestive heart failure?

A

Dyspnea (difficulty breathing)

70
Q

Dyspnea is associated with ___ heart failure, while leg edema is associated with ___ heart failure

A

Left, right

71
Q

The left ventricular wall thickens, but the heart does not dilate

A

Concentric hypertrophy

72
Q

The left ventricular wall thickens AND the heart dilates. The right sided cardiac chambers would also dilate in this situation

A

Eccentric hypertrophy

73
Q

The most common cause of left ventricular heart failure?

A

Ischemic heart disease

74
Q

The most common cause of right sided heart failure?

A

Pre-existent left sided heart failure (>95%)

75
Q

When the valve fails to open properly resulting in narrowing of the orifice (opening)

A

Stenosis

76
Q

When the valve fails to close properly with resulting regurgitation of blood back through the incompletely closed valve

A

Insufficiency

77
Q

The most common valvular heart disease?

A

Calcific aortic valve stenosis

78
Q

With tight ____ stenosis the left atrium progressively dilates

A

Mitral

79
Q

The enlarged mitral valve leaflets balloon into the left atrium during systole

A

Mitral valve prolapse

80
Q

Mitral valve prolapse is more common in what age and gender?

A

Women, 20-40yo

81
Q

Mitral valve prolapse is seen in people with ____ syndrome (intrinsic defect of connective tissue)

A

Marfan’s

82
Q

_____ causes and increased risk of developing infective endocarditis

A

Mitral valve prolapse

83
Q

____ is characterized by microbial invasion of heart valves or mural endocardium (with destruction of cardiac tissues). This is most commonly seen in intra-venous drug users (IVDU)

A

Infective endocarditis

84
Q

The valve lesions in infective endocarditis are termed ____, and are composed of fibrin, platelets, and bacteria

A

Vegetations

85
Q

_____ occurs a few weeks after pharyngitis due to group A Strep, and is diagnosed using the JONES criteria

A

Rheumatic Heart Disease

86
Q

Which valve is always involved in rheumatic heart disease?

A

Mitral (alone in 65-70% of cases)

87
Q

Rheumatic heart disease occurs most often in what age group?

A

Children (5-15yo), (only 20% in adults)

88
Q

The two causative organisms of infective endocarditis?

A
  1. Strep veridans (50-60%)

2. Staph aureus (10-20%)

89
Q

The most common defect seen in congenital heart disease (Acyanotic)? (25-30%)

A

Ventricular Septal Defect (VSD)

90
Q

The most common type of cyanotic congenital heart disease?

A

Tetralogy of Fallot

Pathology (9 decks)

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