Histopathology 7: Vascular and cardiac pathology

Question 1

Describe dressler’s syndrome ?

Answer 1

Pericarditis weeks-months after an M.I

Question 2

What histological findings are seen < 6 hours post MI ?

Answer 2

normal histology

Question 3

What histological findings are seen 6- 24 hours post MI ?

Answer 3

• loss of nuclei
• Homogenous cytoplasm
• necrotic cell death

Question 4

What histological findings are seen 1-4 days post MI ?

Answer 4

-infiltration of polymorphs and macrophages to clear debris

Question 5

What histological findings are seen 5-10 days post MI ?

Answer 5

-debris cleared

Question 6

What histological findings are seen 1-2 weeks post MI ?

Answer 6

• granulation tissue
• myelofibroblasts depositing collagen
• revascularistation

Question 7

What histological findings are seen weeks - months post MI ?

Answer 7

-scar tissue

Question 8

What does Nutmeg liver indicate ?

Answer 8

hepatic cirrhosis most likely due to right sided heart failure

Question 9

List 5 causes of dilated cardiomyopathy ?

Answer 9

• Alcohol
• post partum
• sarcoidosis
• Haemochromatosis
• genetic: Duchenne’s muscular dystrophy

Question 10

List 2 causes of Hypertrophic cardiomyopathy ?

Answer 10

• Genetic

- storage diseases

Question 11

List 3 causes of restrictive Cardiomyopathy ?

Answer 11

• Sarcoidosis
• Amyloidosis
• Radiation

Question 12

Which type of cardiomyopathy shows myocyte disarray ?

Answer 12

• Hypertrophic

Question 13

Describe what is meant by HOCM ?

Answer 13

• Hypertrophic obstructive cardiomyopathy

- Septal hypertrophy leading to outflow tract obstruction

Question 14

Crescendo - decrescendo murmur heard over the left lower sternal edge and bifid pulse.

Most likely diagnosis

Answer 14

HOCM

Question 15

List 5 features of acute rheumatic fever ?

Answer 15

CASES

Carditis (pancarditis)
Arthritis 
Sydenham's chorea 
Erythema marginatum
Subcutaneous nodules

Question 16

Which valve is most commonly affected by rheumatic fever ?

Answer 16

Mitral valve

Question 17

What is the most common causative organism of rheumatic fever ?

Answer 17

Group A streptococcus (tonsillitis)

Question 18

Histology of the mitral valve and heart shows beady fibrous vegetations, Aschoff bodies and Anitschkov myocytes.

Most likely diagnosis ?

Answer 18

Rheumatic heart disease

Question 19

Which pathological mechanism leads to Rheumatic heart disease ?

A) Antigenic mimicry
B) Auto-immune
C) Inborn error of metabolism
D) Bacterial colonisation

Answer 19

A) antigenic mimicry

Question 20

Which type of endocarditis is associated with SLE ?

Answer 20

Libman-sacks endocarditis

caused by antigen-antibody complex deposition

Question 21

Which organism is the most common cause of acute infective endocarditis in IVDU ?

Answer 21

S.Aureus

Question 22

Which organism is the most common cause of subacute infective endocarditis ?

Answer 22

Strep. Viridans

Question 23

Which valve tends to be affected in IVDU with infective endocarditis ?

Answer 23

Right sided valves

Question 24

Which genetic syndrome is associated with bicuspid aortic valve ?

Answer 24

Turner’s syndrome

Question 25

Which valve disorder is associated with a mid systolic click and late systolic murmur ?

Answer 25

Mitral valve prolapse