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Pathology > Heart And Blood Vessels > Flashcards

Heart And Blood Vessels Flashcards

0
Q

What 4 things cause heart failure?

A

Ischaemic heart disease, hypertension, diseased heart valves, congenital heart disease.

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1
Q

What is heart failure?

A

Heart unable to pump, blood at rate required for normal functioning.

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2
Q

What happens during heart failure?

A

The heart compensates leading to cardiac hypertrophy and/or dilation. Eventually inability to maintain normal.

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3
Q

Give 4 symptoms of heart failure

A

Shortness of breath
Fatigue
Fluid in lungs
Fluid all over

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4
Q

What are the different types of heart failure?

A

Acute vs chronic

One sided vs both sides

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5
Q

What is valvular stenosis?

A

Failure to open completely, impeding flow

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6
Q

What is valvular incompetence/regurgitation?

A

Failure to close allowing reverse flow

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7
Q

What are valvular vegetations?

A

Abnormal tissue growth on valve (fibrin, platelets, bacteria)

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8
Q

Which is the most common valve disease?

A

Aortic and mitral stenosis.

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9
Q

What is valvular stenosis usually due to?

A

Primary valve cusp abnormality, chronic process.

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10
Q

What is valvular regurgitation usually due to?

A

Disease of cusps and damage to supporting structure eg tendinous cords, papillary muscles.

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11
Q

What can vegetations result from?

A

Infective endocarditis and rheumatic fever.

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12
Q

List 11 underlying causes of valvular heart disease

A 
Infection - endocarditis/rheumatic disease
Calcific aortic valve disease
Age related degeneration
Carcinoid syndrome
Fibrosis and muscle rupture after MI
Heart failure
Hypertension
Congenital
Prosthetic heart valves
Connective tissue disorders
IV Drug use
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13
Q

What is the pathological cause of mitral stenosis?

A

Rheumatic fever

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14
Q

What are the clinical features of mitral stenosis?

A

Pulmonary hypertension, L atrial and R ventricular hypertrophy, murmur.

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15
Q

What are the 4 causes of mitral incompetence?

A

Rheumatic fever, dilation of mitral valve, papillary muscle fibrosis and dysfunction, degeneration of valve cusps.

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16
Q

What are the clinical features of mitral incompetence?

A

Variable haemodynamic effect

Murmur

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17
Q

What are the 2 pathological causes of aortic stenosis.

A

Rheumatic fever and calcific degeneration.

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18
Q

What are the clinical features of aortic stenosis?

A

Murmur, left ventricular hypertrophy, angina, syncope, left ventricular failure or sudden death

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19
Q

What are the pathological causes of aortic incompetence?

A

Rheumatic fever, dilation of aortic root, rheumatological disorders.

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20
Q

What are the clinical features of aortic incompetence?

A

Murmur, collapsing pulse, angina, left ventricular failure.

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21
Q

What are the pathological causes of endocarditis?

A

Rheumatic disease, bacteria, prosthetic heart valves, cardiac valve disease, IV drug use.

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22
Q

What are the clinical features of endocarditis?

A

Malaise, clubbing, cardiac murmurs and failure, arthralgia, pyrexia, skin lesions, splenomegaly, haematuria, glomerulonephritis.

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23
Q

What are 7 symptoms/consequences of valvular disease?

A

Stroke, arrhythmias, syncope (fainting), ventricular hypertrophy, angina, heart failure, infarcts to kidney and spleen.

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24
Q

What is infective endocarditis?

A

Infection on the edge of heart valve - vegetation is a mass of bacteria, fibrin and platelets. Puts stress on the valve and tissue can fly off and get stuck elsewhere.

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25
Q

IV drug users get infective endocarditis on which side of the heart?

A

The right side

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26
Q

Which bacteria causes infective endocarditis?

A

Streptococci - dental extraction, tonsillectomy

Staph aureus - IV drug users

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27
Q

Who is at high risk of developing endocarditis prior to any procedure that may produce bacteraemia and what should they be given?

A

Those at risk - heart surgery, previous infective endocarditis, immunosuppressed. Give antibiotics.

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28
Q

How do we treat vegetations?

A

High strength antibiotics and hospital admission

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29
Q

What is pericarditis?

A

Inflammation of the heart sac

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30
Q

What is myocarditis?

A

Inflammation of the heart muscle

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31
Q

Give 11 causes of pericarditis and myocarditis

A 
Viral
Bacterial
Parasitic
Uraemia
Carcinoma
MI
post surgery
Drugs
Connective tissue disease
Unknown 
Radiation
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32
Q

What are the two types of pericarditis and myocarditis?

A

Acute and chronic

33
Q

What are the symptoms and signs of pericarditis and myocarditis?

A

Chest pain

Cardiac failure

34
Q

How can you treat pericarditis and myocarditis?

A

Anti-inflammatory drugs

Surgical excision of the pericardium

35
Q

Give 7 unusual cardiac diseases

A 
Cardiomyopathy
Multi-system diseases - sarcoidosis, amyloidosis
Thyrotoxicosis
Myxoedema
Alcoholism
Pregnancy
Iatrogenic disease
36
Q

What are the three types of cardiomyopathy

A

Dilated, hypertrophic, restrictive

37
Q

What can cause dilated cardiomyopathy?

A

Idiopathic, alcohol, peripartum, genetic, myocarditis, sarcoid.

38
Q

What causes hypertrophic cardiomyopathy

A

Genetic, idiopathic, storage disease.

39
Q

What causes restrictive cardiomyopathy

A

Idiopathic, amyloidosis, radiation induced, chemotherapy related.

40
Q

What is cardiac dilation?

A

Dilation of chambers, heart large and flabby

41
Q

What is hypertrophic cardiomyopathy?

A

Heavy muscular hypercontracting
Abnormal diastolic filling
1/3 have intermittent left ventricular outflow obstruction
End stage dilation can occur
Thickening of heart muscle causes young people to drop dead.

42
Q

What are the clinical features of HCM?

A

Sob, chest pain, palpitations, blackout, sudden death, AF.

43
Q

What is an aneurysm?

A

Localised, permanent, abnormal dilation of a blood vessel.

44
Q

Give 12 causes of aneurysms?

A

Age, atherosclerosis ischaemia, hypertension, inflammation, diabetes, autoimmune diseases, bacteria, bacterial endocarditis, fungus, Marfan’s syndrome, syphilis.

45
Q

How can you treat aneurysms?

A

Stents, surgery, reducing arterial pressure.

46
Q

What are the 6 types of aneurysms?

A

Atherosclerotic, aortic dissection, berry, micro aneurysm, syphilitic, mycotic (infective)

47
Q

What is the site and clinical effects of an atherosclerotic aneurysm?

A

Lower abdominal aorta and iliac arteries, pulsating abdominal mass, lower limb ischaemia, rupture, massive haemorrhage.

48
Q

Where would you find an aortic dissection and what are the clinical effects?

A

Aorta and major branches, loss of peripheral pulses, haemopericardium, external rupture, haemorrhage, double barrelled aorta.

49
Q

Where do you find berry aneurysms and what do they cause?

A

Circle of Willis, subarachnoid haemorrhage

50
Q

Where do you find micro aneurysms and what do they cause?

A

Intra cerebral capillaries, intra cerebral haemorrhage, associated hypertension.

51
Q

Where do you find syphilitic aneurysm and what do they cause?

A

Ascending and arch of aorta, cause aortic incompetence.

52
Q

Where would you find mycotic aneurysms and what do they cause?

A

Root and aorta of any vessel, thrombosis or rupture, causing cerebral infarction or haemorrhage.

53
Q

What is the systolic blood pressure?

A

Pressure as the heart beats

54
Q

What is the diastolic pressure?

A

Pressure as the heart relaxes

55
Q

What is BP measured in.?

A

Millimeters of mercury.

56
Q

When would you offer 24hr monitoring of BP

A

When it is continually over 140/90

57
Q

What are the categories of diastolic BP?

A

Mild - 95/104
Moderate - 105-114
Severe - >115

58
Q

Hypertension can be classified into…

A

Causes

Clinical

59
Q

What are the two causes classification of hypertension?

A

Primary and secondary

60
Q

How is hypertension classified clinically?

A

Benign and malignant

61
Q

What is a nine modifiable risk factor for essential hypertension?

A

Genetics - family history

62
Q

Give 4 modifiable risk factors of hypertension

A

Diet - high sodium
Lifestyle - stress and physical inactivity
Weight - obesity
Alcohol and smoking

63
Q

Give 4 secondary hypertension causes

A

Renal - polycystic kidney disease
Endocrine - thyrotoxicosis
Vascular - raised intra vascular volume
Neurogenic - acute stress (surgery)

64
Q

What is benign hypertension?

A

Normally remains stable, relatively normal life, until/unless complications arise

65
Q

What is malignant hypertension?

A

Rapidly rising BP, 90% die within first year

66
Q

What 5 organs does hypertension effect

A 
Blood vessels
Heart
Kidney
Eyes
Brain
67
Q

Give 4 complications of hypertension

A

Large blood vessel disease - atherosclerosis
Small blood vessel disease - arteriolesclerosis
Increased risk of rupture and dissection and MI

68
Q

Give three heart disease complications of hypertension?

A

Left ventricular hypertrophy
Cardiac failure
MI

69
Q

Give two complications of hypertension on the kidney

A

Benign nephrosclerosis

Renal failure

70
Q

Give an example of hypertension complications in the eye

A

Hypertensive retinopathy - damage to the wall of the eye

71
Q

What are the 4 grades of retinopathy

A

Grade 1 - thickening of arterioles
Grade 2 - arteriolar spasms
Grade 3 - haemorrhages
Grade 4 - papilloedema

72
Q

Give two complications of hypertension in the brain

A

Cerebral haemorrhage

Cerebral infarction

73
Q

Give 10 factors indicating adverse prognosis in hypertension

A 
Organ damage
Male
Young
Black ethnicity
Smoker
Alcohol
Obese 
Diabetes
Persistent diastolic >115
High cholesterol
74
Q

What four things does diabetic vascular disease damage.

A

Vessels, kidneys, nerves, retinas

75
Q

What are 3 complications of diabetic vascular disease?

A

Gangrene, blindness, renal failure

76
Q

Give six causes of DVT

A

Immobility, pregnancy and child birth, oestrogens, malignancy, clotting disorders, IV cannulas,

77
Q

Give 6 causes of varicose veins

A

Valve incompetence in legs, stasis, oedema, impaired venous return, fibrin deposits around veins.

78
Q

What can varicose veins cause

A

Ulceration

79
Q

Give 7 common types of congenital cardiovascular disease

A

Septal defects, patent ductus arteriosus, narrowed aorta, valvular abnormalities, vessels the wrong way around, coronary artery defects, multiple defects - fallows tetralogy.

Pathology (7 decks)

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