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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
Q

what are the causes of fibrinous pericarditis?

A
  1. post-MI = Dressler syndrome
  2. uremia
  3. RF
26
Q

what is the clinical presentation of fibrinous pericarditis?

A
  1. sharp chest pain
  2. fever
  3. friction rub
27
Q

what is the morphology of fibrinous pericarditis?

A
  1. yellow cloudy fluid
  2. rough epicardial surfaces = bread and butter appearance
  3. fibrin, WBC and RBCs
28
Q

what are the causes of purulent pericarditis?

A

infectious bacteria

29
Q

what are the causes of hemorrhagic pericarditis?

A
  1. malignancy
  2. bacterial infections
  3. following cardiac surgery
30
Q

what is chronic pericarditis?

A

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
Q

what are the causes of chronic pericarditis?

A
  1. bacterial

2. TB

32
Q

what are the causes of constrictive pericarditis?

A

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
Q

what is Crest syndrome?

A
  1. calcinosis cutis
  2. raynauds
  3. esophageal dysmotility
  4. sclerodactylyl
  5. telangiestasia
34
Q

what is the definition of telangiectasia?

A

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
Q

what is nevus flamemeus?

A

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
Q

what are spider telangiectasia?

A

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
Q

what is a capillary-type hemangioma?

A

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
Q

what is a cavernous hemangioma?

A

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
Q

what are gloms tumors?

A

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
Q

which vascular tumors are benign?

A
  1. capillary-type hemangioma
  2. cavernous hemangioma
  3. glomus tumors

4.

41
Q

which vascular tumors are malignant?

A
  1. hemangiosarcoma

2. Kaposi’s sarcoma

42
Q

what is a hemangiosarcoma?

A

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
Q

what are the two types of Kaposi’s sarcoma?

A
  1. classic or european = older people in their leg vessels and it was chronic
  2. HIV-negative endemic = infectious
44
Q

what is the pathogenesis of HIV Kaposi’s sarcoma?

A

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
Q

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:

A

Carney syndrome

heart, skin and endocrine problems

46
Q

what is a myxoma?

A

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
Q

what is the clinical presentation of someone with Carney syndrome?

A

it’s a type of benign myxoma effecting the atria

AD inheritance

  1. skin myxomas and hyperpigmentation
  2. cardiac myxomas
  3. endocrinopathies
48
Q

how do you diagnose myxomas

A
  1. echo
  2. MRI
  3. CXR
49
Q

what is a rhabdomyoma?

A

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
Q

what are the 2 benign tumors of the heart?

A
  1. rhabdomyoma

2. myxoma

51
Q

what are the malignant tumors of the heart?

A

angiosarcoma

52
Q

from what location is the heart most likely to get mets?

A

usually from the breast or lungs

53
Q

what are the direct cardiovascular effects of non cardiac neoplasms?

A
  1. pericardial and myocardial metastases lead to HF
  2. large vessel obstruction by tumor
  3. pulmonary tumor emboli
54
Q

what are the indirect cardiovascular effects of non cardiac neoplasms?

A
  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
Q

what are the effects tumor therapy?

A
  1. chemotherapy

doxorubicin toxicity will cause swelling and vacuoles

  1. radiation therapy will cause scaring
56
Q

what are the indications for cardiac transplantation?

A

heart failure

57
Q

what are the complications of heart transplant?

A
  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
Q

constrictive pericarditis characteristics?

A
  1. calcifications

2. caused by TB

59
Q

hemangiosarcoma of the liver industrial exposure?

A

polyvinyl chloride

60
Q

Carney syndrome?

A
  1. myxomas

2. involvement with heart, endocrine and skin hyperpigmentation

61
Q

tuberous sclerosis

A
  1. rhabdomyoma
  2. hematoma

ash lead spot lesion

Cardio Week 5 (5 decks)

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