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Cardio Week 5 > ICL 5.5: Pathology of Pericardial Diseases and Tumors > Flashcards

ICL 5.5: Pathology of Pericardial Diseases and Tumors Flashcards

1
Q

B myosin heavy chain

A

hypertrophic cardiomyopathy

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2
Q

lymphocytic infiltration of the myocardium

A

viral myocarditis

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3
Q

septic infarct

A

infectious endocarditis

septic infarct happens from vegetations breaking off to the brain and lungs

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4
Q

Dressler syndrome

A

post MI pericarditis

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5
Q

5-7 days post MI

A

cardiac tamponade due to heart rupture

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6
Q

pulsus paradoxicus

A

can’t feel a pulse but can see electrical signal s on EKG

seen with cardiac tamponade

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7
Q

doxorubicin

A

dilated cardiomyopathy

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8
Q

cor pulmonale

A

right sided heart failure caused by lung disease

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9
Q

transerythin

A

amyloidosis

restrictive cardiomyopathy

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10
Q

hemosidrin

A

heart failure cells

hemochromatosis

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11
Q

alcohol

A

beer heart = dilated cardiomyopathy

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12
Q

Chagas disease

A

dilated cardiomyopathy

colon and esophagus problems

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13
Q

splinter hemmorhages

A

infective endocarditis

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14
Q

verrucous endocarditis

A

rheumatic fever

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15
Q

hematoxylin bodies

A

libman sachs

SLE endocarditis

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16
Q

what are the two types of pericardial effusions?

A

they can either be a transudate or exudate

  1. serous (transudate) = low protein, no cells
  2. purulent (exudate) = infectious, high protein, many WBCs
  3. malignant
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17
Q

what is a serous pericardial effusion?

A

passive accumulate of fluid in the pericardial sac

so if you tap the fluid there are no cells and low protein

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18
Q

what is a purulent pericardial effusion?

A

active accumulation of pericardial fluid in the pericardial sac maybe due to infection, you’ll see lots of WBCs and high protein levels

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19
Q

what is a malignant pericardial effusion?

A

due to metastatic disease and it’s usually hemorrhagic

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20
Q

what is hemoperricardium?

A

blood in the pericardial cavity

can be caused by:

  1. ruptured myocardium – due to MI or trauma
  2. aortic dissection – due to HTN or marfan syndrome

if it’s severe hemoperricardium with 500+ mL of blood, it can cause tamponade and even sudden death

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21
Q

what are the causes of pericarditis?

A
  1. infectious agents = viruses, pyogenic bacteria, TB*, fungi, parasites
  2. immunologically mediated = rheumatic fever, SLE, scleroderma, postcardiotomy, post-MI (Dresslers), drug hypersensitivity reaction
  3. miscellaneous
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22
Q

what are the types of pericarditis?

A
  1. acute
  2. fibrinous
  3. purulent
  4. hemorrhagic
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23
Q

what are the causes of acute pericarditis?

A
  1. infectious (viral)

2. usually autoimmune diseases = SLE, RA, scleroderma

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24
Q

what is the morphology of acute pericarditis?

A

aka serous pericarditis

volume is 50-200 mL and there are scant inflammatory cells – rarely large enough to cause tamponade

inflammation is minimal so no exudation of fibrin occurs

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25
what are the causes of fibrinous pericarditis?
1. post-MI = Dressler syndrome 2. uremia 3. RF
26
what is the clinical presentation of fibrinous pericarditis?
1. sharp chest pain 2. fever 3. friction rub
27
what is the morphology of fibrinous pericarditis?
1. yellow cloudy fluid 2. rough epicardial surfaces = bread and butter appearance 3. fibrin, WBC and RBCs
28
what are the causes of purulent pericarditis?
infectious bacteria
29
what are the causes of hemorrhagic pericarditis?
1. malignancy 2. bacterial infections 3. following cardiac surgery
30
what is chronic pericarditis?
it's disabilitating because there are adhesive mediastinal scars mediastinal means that it's not only around the heart; it has extended to the surrounding structures and this will cause problems the pericardial sac is obliterated and it adheres to the surrounding mediastinal structures = dysphagia and dyspnea this means the heart won't be able to pump so there will be increased strain and it will hypertrophy or even dilate
31
what are the causes of chronic pericarditis?
1. bacterial | 2. TB
32
what are the causes of constrictive pericarditis?
it results from suppurative or hemorrhagic pericarditis like from staph or TB* the pericardial space is obliterated by a scar and/or calcification* this leads to severe cardiac dysfunction, tamponade, and the heart is encased in dense fibrocalcific that limits diastolic expansion -- so during PE the heart sounds are distant and muffled since you're listening to them through a wall of calcium
33
what is Crest syndrome?
1. calcinosis cutis 2. raynauds 3. esophageal dysmotility 4. sclerodactylyl 5. telangiestasia
34
what is the definition of telangiectasia?
a group of abnormally prominent capillaries, venules and arterioles that create small focal red lesions usually in skin and mucous membranes of the body
35
what is nevus flamemeus?
a birthmark characterized by being deep purple and flat = port wine the "birthmark" is composed of dilated capillaries usually in the head and neck and they may grow proportionally with the child
36
what are spider telangiectasia?
tiny dilated capillaries usually on the tip of the nose they're associated with hyperestrogenism like in pregnancy and alcoholics with liver cirrhosis that can't metabolize estrogen
37
what is a capillary-type hemangioma?
benign tumor of the capillaries in the skin usually but can also effect the liver, spleen and kidney they usually appear early in lie and fade by 1-3 years old
38
what is a cavernous hemangioma?
benign tumor or large cavernous vascular channels if they rupture these large vascular channels and if it happens to be the brain that's bad news
39
what are gloms tumors?
benign, painful modified smooth muscle cell tumors in the distal digits like under the nails they arise from the glomus body which is in the distal digits and regulates temperature and pain
40
which vascular tumors are benign?
1. capillary-type hemangioma 2. cavernous hemangioma 3. glomus tumors 4.
41
which vascular tumors are malignant?
1. hemangiosarcoma | 2. Kaposi's sarcoma
42
what is a hemangiosarcoma?
atypical (anaplastic) endothelial cells occurs in young people with no gender predilection effects the skin, liver, spleen, lungs, bones andretroperitoneum in the liver, it's associated with known carcinogens, e.g. polyvinyl chloride
43
what are the two types of Kaposi's sarcoma?
1. classic or european = older people in their leg vessels and it was chronic 2. HIV-negative endemic = infectious
44
what is the pathogenesis of HIV Kaposi's sarcoma?
the virus causes proliferation of blood vessels and angiogenesis so it can cause Kaposi this way another way it can cause Kaposi is when the infected B cells can produce cytokines which stimulate mesenchymal cells which leads to proliferation of vessels infected CD4 cells also produce cytokines that can lead to mesenchymal cell proliferation can occur not only in the skin but also the heart, lungs and brain
45
A 35 year old female reports that she feels like she is going to pass out when she tries to sleep on her left side. She also has noticed that her legs have multiple dark spots. She also has a history of diabetes type one. DD: Tests:
Carney syndrome heart, skin and endocrine problems
46
what is a myxoma?
benign tumor of the atria usually occurs in the left atria so it can block the flow of the mitral valve due to mutation of tumor suppressor gene 10% have familial myxomas = Carney syndrome = AD 1. skin myxomas and hyperpigmentation 2. cardiac myxomas 3. endocrinopathies
47
what is the clinical presentation of someone with Carney syndrome?
it's a type of benign myxoma effecting the atria AD inheritance 1. skin myxomas and hyperpigmentation 2. cardiac myxomas 3. endocrinopathies
48
how do you diagnose myxomas
1. echo 2. MRI 3. CXR
49
what is a rhabdomyoma?
tumor of the myocardium itself it's associated with tuberous sclerosis = hemartomas in the CNS, heart, kidney and skin can present with seizures, nodules on the skin, Ashleaf lesions,
50
what are the 2 benign tumors of the heart?
1. rhabdomyoma | 2. myxoma
51
what are the malignant tumors of the heart?
angiosarcoma
52
from what location is the heart most likely to get mets?
usually from the breast or lungs
53
what are the direct cardiovascular effects of non cardiac neoplasms?
1. pericardial and myocardial metastases lead to HF 2. large vessel obstruction by tumor 3. pulmonary tumor emboli
54
what are the indirect cardiovascular effects of non cardiac neoplasms?
1. nonbacterial thrombotic endocarditis = marantic endocarditis = Troussou's 2. carcinoid heart disease = involves the tricuspid valve 3. pheochromocytoma = HTN from increased adrenergic stimulation = hypertrophy of the heart 4. myeloma-associated amyloidosis = restrictive cardiomyopathy
55
what are the effects tumor therapy?
1. chemotherapy doxorubicin toxicity will cause swelling and vacuoles 2. radiation therapy will cause scaring
56
what are the indications for cardiac transplantation?
heart failure
57
what are the complications of heart transplant?
1. rejection -- can be either cellular mediated by T cells or humoral via antibodies from the recipient against the donor 2. infections like CMV and toxoplasmosis because the patient is immunosuppressed 3. post-transplant lymphoproliferative disease
58
constrictive pericarditis characteristics?
1. calcifications | 2. caused by TB
59
hemangiosarcoma of the liver industrial exposure?
polyvinyl chloride
60
Carney syndrome?
1. myxomas | 2. involvement with heart, endocrine and skin hyperpigmentation
61
tuberous sclerosis
1. rhabdomyoma 2. hematoma ash lead spot lesion

Cardio Week 5 (5 decks)

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