Heart Pathology

Question 1

Three mechanism that initially maintain CO in HF

Answer 1

1. Frank-starling mechanism
2. Hypertrophy and/or dilation
3. Neurohormonal

Question 2

Parallel formation of new sarcomeres leading hypertrophy is triggered by ____ overload

Answer 2

pressure

parameter: wall thickness

Question 3

Series formation of new sarcomeres leading to dilation is triggered by ____ overload

Answer 3

volume

parameter: weight

Question 4

[diagnosis/type of HF]

liver congestion, spleen congestion, kidneys and brain congestion,

ascites, third spacing, edema
pronounced azotemia

Answer 4

RSHF

Question 5

[type of HF]

DOB, orthopnea, PND, prerenal azotemia, hypoxic encephalopathy

Answer 5

LSHF

Question 6

this marks the irreversibility of CHD lesions

Answer 6

pulmonary hypertension

Question 7

most common type of ASD

Answer 7

Ostium Seccundum (90%)

Question 8

[diagnosis]

fixed, widely split S2, pulmonary-stenosis like murmur, normal aortic knob

Answer 8

ASD

Question 9

most common CHD

Answer 9

VSD

Question 10

most common type of VSD

Answer 10

perimembranous

Question 11

[diagnosis]

continous machinery-like murmur, decreased PVR, decreased PGE2, increased oxygen tension

prominent aortic knob

Answer 11

PDA

Question 12

administration of this maintains patency of PDA

Answer 12

PGE2

Question 13

___ shunt

paradoxical embolism, clubbing, polycythemia

Answer 13

right to left shunt

Question 14

[diagnose this R-L shunt]

increased pBF, RVH

Answer 14

TGA or TAPVR

Question 15

[diagnose this R-L shunt]

increased pBF, LVH

Answer 15

TGA+VSD or PTA without hypoplastic PA

Question 16

[diagnose this R-L shunt]

decreased pBF, LVH

Answer 16

TA, Pulmonic atresia

Question 17

[diagnose this R-L shunt]

decreased pBF, RVH

Answer 17

TOF

Question 18

most common cyanotic CHD

Answer 18

TOF

Question 19

components of TOF

Answer 19

VSD, pulmonary stenosis, overriding aorta, RVH

Question 20

cour en sabot

Answer 20

TOF

boot shaped heart

Question 21

[cyanotic heard disease]

This is associated with PFO, ASD, PDA

apple on a stem appearance

Answer 21

TGA

Question 22

aortic stenosis can lead to ___ hypertrophy

Answer 22

LVH

Question 23

pulmonic stenosis can lead to ___ hypertrophy

Answer 23

RVH

Question 24

[diagnosis]

rib notching on CXR, UE HPN, LVH

location of CoA

Answer 24

Opposite the ligamentum arteriosus, distal to the arch

adult type = post ductal

Question 25

loss of contractility happens in ___ minutes of ischemia

Answer 25

less than 2 minutes

Question 26

irreversible injury happens in ____ minutes of ischemia

Answer 26

20 to 40 minutes

Question 27

___ marker for myocardial reinfarction

Answer 27

CKMB

Question 28

Transmural infarction results to permanent occlusion which reflects as ____ type of MI in ECG

Answer 28

STEMI

Question 29

Subendocardial infarction results to transient occlusion which reflects as ____ type of MI in ECG

Answer 29

NSTEMI

Question 30

most common main vessels involved in MI

Answer 30

LAD > RCA > LCX

Question 31

___ helps distinguish viable and infarcted tissues after MI (pale zone)

Answer 31

Triphenyltetrazolium chloride

Question 32

most sensitive and specific cardiac biomarker

Answer 32

cardiac troponin (Trop I and T)

Question 33

___ syndrome fibrinous pericarditis post MI

Answer 33

Dressler Syndrome

Question 34

most common mechanism of sudden cardiac death

Answer 34

lethal arrythmia

Question 35

most common cause of arrythmia

Answer 35

ischemic injury

Question 36

earliest change in Left sided HF

Answer 36

increase transverse diameter of myocytes

Question 37

most common known cause of mitral valve prolapse

Answer 37

fibrillin 1 gene defect

Question 38

[diagnosis] plump activated macrophages (abundant cytoplasm with round to ovoid nuclei and condensed chromatin pattern)

Answer 38

Rheumatic fever

Question 39

[diagnosis] condensed chromatin pattern, slender wavy ribbon "caterpillar cells"

Answer 39

anitschkow cells = Rheumatic fever

Question 40

Most commonly involved heart valve in RHD

Answer 40

mitral

Question 41

hallmark if IE

Answer 41

vegetation

Question 42

most common cause of acute IE in IV drug users

Answer 42

S. aureus

Question 43

most common cause of subacute IE

Answer 43

HACEK ``` Haemophilus Aggregatibacter Cardiobacterium Eikenella corrodens Kingella ```

Question 44

[diagnosis] vegetations small, bland vegetations attached to the closure line, loosely attached to the underlying valve associated with systemic hypercoaguable states

Answer 44

NBTE/Marantic endocarditis

Question 45

[diagnosis] vegetations small or medium sized vegetation on either or both side of the leaflet

Answer 45

Libman-Sacks Endocarditis

Question 46

[diagnosis] vegetations friable, bulky, destructive, contains ffibrin, may embolize

Answer 46

IE

Question 47

[diagnosis] vegetations calcification and fibrous bridging, along lines of closure, overlying foci of fibrinoid necrosis

Answer 47

RHD

Question 48

Causes hypertrophic CM

Answer 48

1. genetic 2. Friedrich ataxia 3. storage diseases 4. Infants of diabetic mothers

Question 49

Amyloidosis is a ___ pattern of cardiomyopathy

Answer 49

restrictive

Question 50

cardiomyopathy that mimics IHD, VHD, HHD, CHD

Answer 50

dilated

Question 51

cardiomyopathy that mimics HHD and AS

Answer 51

hypertophic

Question 52

Most common helminth that cause myocarditis

Answer 52

Trichnella spiralis

Question 53

Most common viral cause of myocarditis

Answer 53

Coxsackie A, B Enterovirus

Question 54

most common primary cardiac tumor in adults

Answer 54

Myxoma

Question 55

[diagnosis] ball-valve obstruction, embolization, commonly seen in atria usually solitary, sessile or pedunculated masses mottled with hemorrhage

Answer 55

myxoma

Question 56

most common primary cardiac tumor in children

Answer 56

rhabdomyoma

Question 57

[diagnosis] thin strands of cytoplasm that stretch from the nucleus to the surface membrane "spider cells" multiple, gray-white masses

Answer 57

rhabdomyoma

Question 58

[diagnosis] 1. Increased JVP 2. Arterial hypotension 3. Muffled heart sounds

Answer 58

cardiac tamponade

Question 59

water-bottle appearance

Answer 59

cardiac tamponade

Question 60

[diagnosis] chest pain relieved when leaning forwards pericardial friction rub

Answer 60

acute pericarditis