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SP15 Pathology > Exam 2; Cardiovascular III > Flashcards

Exam 2; Cardiovascular III Flashcards

1
Q

This is failure of a valve to open completely, obstructing forward flow and sometimes is caused by rheumatic fever and typically is always stenotic

A

mitral valve stenosis

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2
Q

Acute rheumatic fever is a systemic disease usually in children which follows which bacteria

A

Group A beta hemolytic; streptococcal pharyngitis

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3
Q

What are the clinical features of rheumatic fever

A 
myocarditis
pericarditis
arthritis
erythema marginatum
subcutaenous nodules
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4
Q

What is characteristic of the pericarditis caused by rheumatic fever

A

fibrosis

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5
Q

What is characteristic of the endocarditis caused by rheumatic fever

A

sterile vegetations

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6
Q

What is characteristic of the myocarditis caused by rheumatic fever

A

Aschoff bodies; collections of mononuclear inflammatory cells and fibroblasts (granulomatous infection)

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7
Q

What is the longer term complication after recurrent bouts of acute rheumatic fever

A

chronic valvular disease with mitral valve stenosis (severe fibrosis and calcification)

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8
Q

How does rheumatic fever cause mitral valve stenosis

A

due to the production of antibodies against the streptococcal bacteria which cross react with various antigens in the heart, joints, and other sites

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9
Q

This is the insufficiency of a valve that fails to close completely, allowing back flow of blood

A

regurgitation

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10
Q

This is a condition in which the leaflets ballon into the left atrium during left ventricular contraction (systole)

A

mitral valve prolapse

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11
Q

What occurs regarding floppy mitral valve (severe prolapse)

A

the valve cuss are large and microscopically show fragmentation, separation, and loss of collagen (myxomatous); may be isolated or part of Marfan’s Syndrome

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12
Q

What are three complications of mitral valve regurgitation; develops in about 3% of affected patients

A 
endocarditis
thromboemboli
sudden death (rare)
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13
Q

What are three causes of aortic valve stenosis

A

chronic rheumatic valvular disease
degenerative
congenital bicuspid valve

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14
Q

What is the onset of degenerative aortic valve stenosis compared to congenital bicuspid valve

A

degenerative is associated with advanced age (70s or 80s)

congenital bicuspid valvue is a much younger initial onset (40-50 years)

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15
Q

What three things can cause aortic valve regurgitation

A

valve cusp destruction (endocarditis)
weakened cusp valves (Marfans/myxomatous)
dilation of the aortic root

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16
Q

What usually causes infective endocarditis

A

bacterial infection in a heart valve, although it can also be caused by fungi or other infections

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17
Q

What are six predisposing factors of IE

A 
intracardiac shunts
valvular disease
prosthetic valves (10-20% of all cases)
IV drug abuse
immune suppression
diabetes
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18
Q

What are the three factors that have been identified as having importance in the pathogenesis of IE

A

endocardial or endothelial injury dur to abnormalities in blood flow
fibrin thrombi
organisms in the blood

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19
Q

What are the clinical manifestations of infective endocarditis

A 
fever
fatigue
anemia
myalgia/arthralgia
roth spots (retinal hemorrhages) and splinter hemorrhages (nail bed)**
heart murmur
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20
Q

What is the difference in duration between acute endocarditis and subacute endocarditis

A

acute - short

subacute - longer

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21
Q

What is the difference in the organism between acute endocarditis and subacute endocarditis**

A

acute - virulent organism (Staph. aureus)

subacute - low virulence organism (Strep. viridians)

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22
Q

What is the difference in the vegetations between acute endocarditis and subacute endocarditis

A

acute - large

subacute - small

23
Q

What is the difference in tissue destruction between acute endocarditis and subacute endocarditis

A

acute - prominent tissue destruction

subacute - less tissue destruction

24
Q

What is the difference in valve between acute endocarditis and subacute endocarditis

A

acute - previously normal

subacute - previously abnormal valve

25
What are five complications of infective endocarditis
``` valvular regurgitation/valvular dysfunction/CHF rupture of the chord tendineae contiguous spread of infection thromboembolism with infarction septic emboli with metastatic abscesses ```
26
What are the top two causes of vasculitis (inflammation of the BVs)
``` infection immunologic mechanism (usually associated with other problems) ```
27
What is the etiology of giant cell (temporal) arteritis
unknown, but may be T cell mediated
28
What are the clinical features of giant cell (temporal) arteritis
``` rare before the age of 50 fever weight loss headache visual disturbances pain and tenderness over the temporal artery caudication of the jaw (weakness when chewing due to decreased blood supply) polymyalgia rheumatica ```
29
What is the pathology of giant cell (temporal) arteritis
granulomatous inflammation | intimal proliferation/fibrosis - narrowing of the lumen decreasing blood flow
30
What is the etiology of Takayasu Arteritis
unknown
31
What are the clinical manifestations of Takayasu Arteritis
thickening of the wall reduces blood flow in the major branches - reducing pulse usually affects < 40 females neurologic manifestations
32
What is the pathology of Takayasu arteritis
granulomatous inflammation with fibrosis affecting the aortic arch and arch branches
33
What is the etiology of polyarteritis nodsa
unknown in most cases, thought there was a link to HepB
34
What are the clinical manifestations of polyarteritis nodsa
``` It's acute-relapsing chronic; confusing due to multiple organ systems involved RENAL FAILURE fever weight loss hematuria hypertension abdominal pain melena (blood in stool) ```
35
What is the pathology of polyarteritis nodsa
haphazard and segmental involvement of med/small muscular arteries fibrinoid necrosis, thrombosis, neutrophils, aneurysms with healing there is a lot of macrophages and PNMs
36
What are the usual sites of involvement involving polyarteritis nodsa
kidney (85) heart (75) liver (65) GI tract (50)
37
What is the etiology of Kawasaki disease
suspected that a viral infection causes hypersensitivity reaction; anti-endothelial antibodies "mucocutaneous lymph node syndrome" medium vessels
38
What are the clinical manifestations of Kawasaki disease
``` typical in infants in young children skin rash mucous membrane lesions servical lymphadenopathy usually self limiting but 1-2% due with coronary artery vasculitis ```
39
What is the etiology of microscopic polyangiitis
antigen-antibody complexes
40
What are the clinical manifestations of microscopic polyangiitis
``` skin rash joint swelling pleural efffusion pulmonary infiltrates myocarditis GI bleeding renal failure ```
41
What may microscopic polyangiitis be precipitated by
drugs microorganisms foreign proteins or tumor proteins
42
There is a presence of this regarding microscopic polyangiitis
circulating anti-neutrophilic cytoplasmic antibodies (MPO-ANCA)
43
What is the pathology of microscopic polyangiitis
involves arterioles, capillaries, venules (microvasculature) fibrinoid necrosis karyorrhexis of neutrophils (leukocytoclastic vascilitis)
44
What is the etiology of Wegener granulomatosis
abnormal expression of proteinase 3 on endothelial cell surface followed by ANCA (anti-neurtophilic cytoplasmic antibodies) binding and neutrophil activation resulting in damage to the endothelium and vessel
45
What are the clinical manifestations of Wegener granulomatosis
sinusitis pneumonitis renal failure glomerulonephritis
46
What is the pathology of Wegener granulomatosis
necrotizing granulomas with vasculitis
47
Which systems does Wegener granulomatosis affect
kidnes | upper and lower respiratory tract
48
What is the etiology of thromboangiitis obliterates (Buerger)
endothelial injury from substance in cigarette smoke
49
What are the clinical manifestations of thromboangiitis obliterates (Buerger)
pain of the extremities ischemic ulcers gangrene
50
What is the pathology of thromboangiitis obliterates (Buerger)
segmental acute and chronic vasculitis mainly in the extremities with thrombosis
51
This is a longitudinal tear of the aortic media which begins in the ascending aorta and extends variable distance proximal (toward the heart) and distal to the descending aorta
dissecting aortic hematoma
52
What are the complications of a dissecting aortic hematoma
severe hemorrhage from rupture | organ ischemia due to luminal compression by the expanding hematoma
53
What are the predisposing factors of a dissecting aortic hematoma
hypertension | inherited connective tissue disorders (Marfan's)

SP15 Pathology (17 decks)

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