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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
Medical term for chest pain
Angina pectoris
26
Medical term for heart attack
Acute myocardial infarction
27
Most common type of angina pectoris? (Chest pain)
Exertional/stable - associated w/fixed atherosclerotic narrowing (>75%) of one or more coronary arteries
28
Coronary artery spasm resulting in chest pain AT REST is known as:
Prinzmetal's Angina
29
The worst form of angina pectoris is ___
Unstable/crescendo
30
What is the gold standard for diagnosing unstable/crescendo angina pectoris?
Coronary arteriography
31
The most specific enzyme and cardiac biomarker for an acute myocardial infarction (heart attack) is:
Troponin (comes from cardiac myocytes)
32
Dilated Cardiomyopathy (dilated ventricles) causes a ____ (systolic/diastolic) dysfunction
Systolic
33
Hypertrophic cardiomyopathy (enlarged walls) occurs in response to ___
Stress (coronary artery disease (CAD) or chronic hypertension)
34
Chaotic ventricular depolarization
Ventricular Fibrillation
35
Ventricular fibrillation is the most common cause of ____
Sudden Cardiac Death syndrome (SCD)
36
Irregular heartbeat is known as ___
Arrythmia
37
The sudden blocking of an artery
Embolism
38
Inflammation of vessel walls is known as ____
Vasculitis
39
The two causes of vasculitis:
1. Immune mediated | 2. Infectious
40
Drug hypersensitivity is an example of ____ vasculitis
Immune mediated
41
Wegener granulomatosis and Churg-Strauss syndrome are examples of ____ immune mediated vasculitis
Anti-neutrophil cytoplasmic antibodies
42
Kawasaki disease is an example of ____ immune mediated vasculitis
Anti-endothelial cell antibodies
43
A T-cell mediated immune response to an unknown vessel wall antigen causing thickened, nodular, tender temporal artery. Usually affects patients >70yo
Temporal arteritis
44
Transmural fibrous aorta thickening (arch) which causes eye disturbances and weakening of the pulses of the upper extremity (pulseless disease) is known as ___
Takayasu arteritis
45
Takayasu arteritis has genetic predisposition and is associated with what age and gender?
Females <40yo
46
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
Thromboangiitis Obliterans (Buerger Disease)
47
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
Polyarteritis Nodosa
48
A patient w/____ may present with gangrene or purpura (bleeding beneath the skin in lower extremity)
Polyarteritis Nodosa
49
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.
Kawasaki disease
50
The most frequent cause of myocardial infarction in children
Kawasaki disease
51
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.
Microscopic Polyangitis
52
Microscopic angitis, Kawasaki disease, and polyarteritis Nodosa are all ____ type of necrosis (cell death)
Fibrinoid (the area of cell death is replaced by fibrous tissue)
53
Primary (essential) hypertension is idiopathic (cause unknown) and accounts for __% of all cases
95%
54
Name a genetic factor that would increase cardiac output causing hypertensive heart disease
Defects in renal sodium balance (Renal Angiotensin Aldosterone System (RAAS) which regulates blood volume)
55
An environmental factor that could cause hypertensive heart disease?
Increased salt intake
56
____ is characterized by a rapid elevation of BP above the previous level which produces acute damage to arterioles
Malignant Hypertension
57
The BP in malignant hypertension is ____
>180/120
58
A ballooning and weakened area of an artery is known as ____
Aneurysm
59
Involvement of all layers (intima, media, adventitia) is called a ___ aneurysm
True
60
____ is when blood enters the wall of the artery
Dissection
61
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)
Dissecting Aortic Aneurysm
62
The inability of the heart to pump blood into the arterial circulation at a sufficient rate to meet the physiologic needs of the body
Heart failure (forward)
63
The ability to pump blood at a sufficient rate only if the ventricular filling pressures are abnormally high
Heart failure (backward congestive failure)
64
The usual cause of heart failure?
Congestive heart disease
65
Blood volume is ____ (increased/decreased) in congestive heart failure
Increased
66
The % of end diastolic volume that the left ventricle ejects during systole
Ejection Fraction (EF)
67
The normal ejection fraction?
50-75%
68
Ejection fraction to diagnose heart failure?
<40%
69
The most prominent symptom of congestive heart failure?
Dyspnea (difficulty breathing)
70
Dyspnea is associated with ___ heart failure, while leg edema is associated with ___ heart failure
Left, right
71
The left ventricular wall thickens, but the heart does not dilate
Concentric hypertrophy
72
The left ventricular wall thickens AND the heart dilates. The right sided cardiac chambers would also dilate in this situation
Eccentric hypertrophy
73
The most common cause of left ventricular heart failure?
Ischemic heart disease
74
The most common cause of right sided heart failure?
Pre-existent left sided heart failure (>95%)
75
When the valve fails to open properly resulting in narrowing of the orifice (opening)
Stenosis
76
When the valve fails to close properly with resulting regurgitation of blood back through the incompletely closed valve
Insufficiency
77
The most common valvular heart disease?
Calcific aortic valve stenosis
78
With tight ____ stenosis the left atrium progressively dilates
Mitral
79
The enlarged mitral valve leaflets balloon into the left atrium during systole
Mitral valve prolapse
80
Mitral valve prolapse is more common in what age and gender?
Women, 20-40yo
81
Mitral valve prolapse is seen in people with ____ syndrome (intrinsic defect of connective tissue)
Marfan's
82
_____ causes and increased risk of developing infective endocarditis
Mitral valve prolapse
83
____ 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)
Infective endocarditis
84
The valve lesions in infective endocarditis are termed ____, and are composed of fibrin, platelets, and bacteria
Vegetations
85
_____ occurs a few weeks after pharyngitis due to group A Strep, and is diagnosed using the JONES criteria
Rheumatic Heart Disease
86
Which valve is always involved in rheumatic heart disease?
Mitral (alone in 65-70% of cases)
87
Rheumatic heart disease occurs most often in what age group?
Children (5-15yo), (only 20% in adults)
88
The two causative organisms of infective endocarditis?
1. Strep veridans (50-60%) | 2. Staph aureus (10-20%)
89
The most common defect seen in congenital heart disease (Acyanotic)? (25-30%)
Ventricular Septal Defect (VSD)
90
The most common type of cyanotic congenital heart disease?
Tetralogy of Fallot

Pathology (9 decks)

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