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Cardiac PathoPhys > February 13th and 18th Lectures > Flashcards

February 13th and 18th Lectures Flashcards

1
Q

What disease are the following risk factors associated with? Acquired valvular heart disease, implantation of prosthetic heart valves, ventricular septal defects, male

A

Infective endocarditis

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2
Q

What are some casual agents of infective endocarditis?

A

Bacteria, viruses, fungi, rickettsiae, parasites

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3
Q

What are the 3 critical elements required for infective endocarditis?

A
  1. Endocardium must be prepared for colonization
  2. Blood-borne microorganisms must adhere
  3. Adherent organisms must proliferate and promote propagation of infective endocardial vegetation
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4
Q

What are some classic findings of Infective endocarditis?

A

Fever, cardiac murmur, petechial lesions of the skin, conjunctiva and oral mucosa

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5
Q

What are the two types of myocardial diseases (general)?

A

Myocarditis and Cardiomyopathy

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6
Q

Which type of myocardial disease is acute and stormy?

A

Myocarditis

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7
Q

What is the cause of myocarditis?

A

Inflammation, leukocyte infiltration and necrosis of cardiac muscle cells
Many causes- North America- viral

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8
Q

What condition can myocarditis progress to?

A

Dilated cardiomyopathy

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9
Q

What do most types of cardiomyopathy result from?

A

Underlying cardiovascular disorders or secondary to infections, toxins, etc.

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10
Q

What are the three types of cardiomyopathy?

A

Dilated, Hypertrophic, Restrictive

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11
Q

What type of cardiomyopathy fits these facts?

Ventricular dilation, diminished myocardial contractility, decrease ejection fraction, increased EDV

A

dilated cardiomyopathy

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12
Q

What are common symptoms of dilated cardiomyopathy?

A

Dyspnea, fatigue, pulmonary congestion

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13
Q

Is dilated cardiomyopathy inflammatory or non-inflammatory

A

Inflammatory

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14
Q

What are the two types of hypertrophic cardiomyopathy?

A
  1. Asymmetrical septal

2. Hypertensive or valvular hypertrophic

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15
Q

What type of cardiomyopathy is idiopathic, from an autosomal dominant inherited disorder

A

Asymmetrical septal hypertrophy cardiomyopathy

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16
Q

What is the cause of hypertensive cardiomyopathy?

A

Increased resistance to ventricular ejection

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17
Q

What happens with restrictive cardiomyopathy?

A

Myocardium becomes rigid and non-compliant

Ventricular filling is impeded- diastolic pressure is raised

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18
Q

What other heart problem does restrictive cardiomyopathy mimic clinically?

A

Constrictive pericarditis

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19
Q

What are the two types of pericardial diseases?

A

Pericardial effusion

Pericarditis

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20
Q

What is a pericardial effusion?

A

Any accumulation of fluid in pericardial cavity

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21
Q

What happens if pericardial effusion has enough fluid to compress the heart

A

Cardiac tamponade

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22
Q

What side the of the heart is affected first by cardiac tamponade?

A

Right side, decreased atrial fluid first

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23
Q

What is pulsus paradoxus?

A

Arterial BP during expiration is 10 mm Hg greater than inspiration (sign of cardiac tamponade)

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24
Q

What are the two types of pericarditis?

A

Acute and Chronic

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25
Q

What type of pericarditis is often idiopathic, has a sudden onset of severe chest pain, and has a friction rub?

A

Acute pericarditis

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26
Q

What happens with chronic pericarditis?

A

Fibrous scarring with some calcification of pericardium
Visceral and parietal layers adhere
Heart becomes encased in rigid shell

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27
Q

What is a general term that describes several types of cardiac dysfunction that result in inadequate tissue perfusion?

A

Heart failure

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28
Q

In systolic heart failure, what increases with decreased contractility or excess plasma volume?

A

Preload (LVEDV)

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29
Q

What is the increased afterload in systolic heart failure associated with?

A

Hypertension or aortic valvular disease

30
Q

What is the name for cardiac muscle weakness due to hypertension induced hypertrophy?

A

Hypertensive hypertrophic cardiomyopathy

31
Q

What does RAA do?

A

Increase PVR and plasma volume

increase afterload and preload further

32
Q

Why is RAA activated?

A

Because there is a fall in CO

33
Q

What is the only helpful hormone in response to systolic heart failure?

A

Natriuertic peptide, as it causes blood volume to decreases thereby decreasing afterload
helps to excrete salt

34
Q

What are the three main pathways that mediate heart failture

A

Baroreceptors –> SNS activation
RAA activation –> fluid retention
ventricular wall tension –> hypertrophy

35
Q

Are the following forward or backward effects of left ventricular heart failure?
DOE, orthopnea, cough, cyanosis

A

Backward effects

36
Q

What are some forward effects of left sided ventricular heart failure?

A

Fatigue, oliguria, increased HR, confusion

37
Q

What diseases can lead to right heart failure?

A

COPD, CF, ARDS (Acute respiratory distress syndrome)

38
Q

Are the following forward or backward effects of Right sided heart failure?
Hepatomegaly, ascites, splenomegaly, anorexia, subcutaneous edema, JVD

A

Backward syndromes

39
Q

Are the following forward or backwards effects of right sided heart failure? Fatigue, oliguira, increase HR, faint pulses, restlessness, confusion, anxiety

A

Forward effects

40
Q

What do flow reduction in the systemic circuit lead to?

A

Ischemia –> hypoxia

41
Q

What is a blood clot attached to a vessel?

A

Thrombus

42
Q

What is a detached thrombus called?

A

Thromboembolus

43
Q

What are threats of arterial thrombi?

A
  1. Occlusion of artery

2. Thromboembolus causing occlusion at distant site

44
Q

What is a bolus of matter circulating in the bloodstream?

A

Embolus

45
Q

What is an air embolism?

A

Undissolved air (caused from IVs a lot)

46
Q

What is a sudden involuntary constriction of arterial smooth muscle that obstructs flow?

A

Vasospasm

47
Q

What is phlebitis

A

Inflammation of the intima of a vein

48
Q

What is valvular incompetence?

A

When intimal fold of venous valves are damaged

49
Q

What can valvular incompetence cause?

A

Varicose veins and chronic venous insufficiency

50
Q

What is a localized dilation of arterial wall?

A

Aneurysms

51
Q

What is AVF (arteriovenous fistulas)?

A

Abnormal communication b/w arteries and veins

52
Q

What is Buerger Disease? (AKA Thromboangilitis obliterals)

A

Type of arteritis
Inflammatory disease of peripheral arteries
Inflammatory lesions accompanied by thrombi and vasospams
Can occlude and obliterate small and medium arteries in feet and hands

53
Q

In what disease do fingers look like the American flag?

A

Raynaud Syndrome

54
Q

What is the difference between Raynaud Syndrome and Raynaud phenomenon

A

Syndrome- attack of vasospasms in small arteries, idiopathic
Phenomenon- secondary to systemic disease

55
Q

What is a true aneurysm?

A

Where all three tunics are affected

Subdivided into saccular or fusiform

56
Q

What is a false aneurysm

A

At least one tunic is not affected

57
Q

What is a dissecting aneurysm?

A

Tear in arterial wall that creates blood flow channel

58
Q

What are symptoms of dissecting aortic aneurysms?

A

Sudden, severe, tearing pain in back and abdomen

59
Q

What is it called when an embolism lodges in a major artery?

A

Acute arterial occlusion

60
Q

What are the 6 Ps?

A

Describe symptoms of acute arterial occlusion

Pallor, parasthesia, paralysis, pain, polar, pulseless

61
Q

What is the difference between varicose veins and chronic venous insufficiency?

A

Varicose veins involve superficial veins while chronic venous insufficiency involves deep vein valvular incompetence

62
Q

What conditions promote DVT (deep vein thrombosis) ?

A

Venous stasis
Venous endothelial damage
Hypercoagulable states

63
Q

What is the difference between primary and secondary lymphedema?

A

Primary- due to congenital absence or decreased number of lymphatics
Secondary- surgical removal of lymph nodes or destruction of lymphatics

64
Q

What is secondary hypertension?

A

Caused by altered hemodynamics associated with a primary disease (ex- kidney failure)

65
Q

Do parasymp or sympathetic nervous systems cause vasoconstriction?

A

Sympathetic nervous system

66
Q

What does angiotensin II do?

A

Causes remodeling of blood vessels and hypertrophy of myocardium.

67
Q

What do mutation in gene for adducin lead to?

A

An increased risk of hypertension

68
Q

How does inflammation play a role in primary hypertension?

A

Endothelial damage and tissue ischemia cause release of inflammatory cytokines- chronically there is vasoconstriction and vessel remodeling

69
Q

What is the majority of the pathology of primary hypertension caused by?

A

Influence renal sodium excretions and shift pressure-natriuresis relationship

70
Q

What is secondary chronic orthostatic hypotension caused by?

A

Endocrine disorders- metabolic disorders, diseases of CNS and PNS

Cardiac PathoPhys (4 decks)

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