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Pathology > Lecture 9 Heart and Blood Vessels > Flashcards

Lecture 9 Heart and Blood Vessels Flashcards

1
Q

Define congenital cardiovascular disease

A

Heart disease present from birth

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2
Q

Define congenital cardiovascular disease

A

Heart disease present from birth

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3
Q

Define cardiac failure

A
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4
Q

How does heart compensate and what results?

A

Cardiac hypertrophy and/or dilation. Eventually inability to maintain normal.

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5
Q

Signs/symptoms of CV disease?

A

All-over excessive fluid filled veins -> systemic venous congestion and oedema. SOB, Fatigue, pulmonary oedema (fluid in lungs).

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6
Q

Define stenosis (valvular heart disease).

A

Failure to completely open.

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7
Q

What are the three ways for valvular heart disease?

A

Stenosis, incompetence/regurgitation and vegetations

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8
Q

What does incompetence/regurgitation mean for valvular heart disease?

A

Failure to close, allowing reversible flow

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9
Q

What does vegitation mean for valvular heart disease?

A

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

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10
Q

What is the most common valvular disease?

A

Stenosis of aortic and mitral valves. (2/3rd of

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11
Q

What is valvular stenosis mainly due to?

A

Primary valve cusp abnormality

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12
Q

Why do vegetations form?

A

From infective endocarditis & rheumatic fever

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13
Q

What is the clinical presentation of vegetations?

A

Sepsis, heart failure, new murmur.

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14
Q

As well as general reasons like hypertension and age degeneration, what are underlying causes of valvular disease?

A

Calcific aortic valve disease? Carcinoid syndrome, prosthetic heart valves and IV drug use

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15
Q

What is the pathological cause for mitral stenosis?

A

Rheumatic fever

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16
Q

What is the pathological cause for mitral incompetence?

A

Rheumatic fever, Dilation of mitral valve, papillary muscle fibrosis/dysfunction, degeneration of valve cusps

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17
Q

What is the pathological cause for aortic stenosis?

A

Rheumatic fever, calcific degerneration

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18
Q

What is the pathological cause for aortic incompetence?

A

Rheumatic fever, dilation of aortic root, rheumatological disorders.

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19
Q

Ehst is the pathological cause for endocarditis?

A

Rheumatic disease, bacteria, IV drug use, calcific valve disease, prosthetic heart valves

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20
Q

What are the clinical features of mitral stenosis?

A

Murmur. L atrial and R ventricle hypertrophy. Pulmonary hypertension.

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21
Q

What are the clinical features of mitral incompetence?

A

Murmur. Variable haemodynamic effect

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22
Q

What are the clinical features of aortic stenosis?

A

Murmur. L ventricle hypertrophy. Angina, syncope, L vent failure/ sudden death.

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23
Q

What are the clinical features of aortic incompetence?

A

Murmur. Collapsing pulse. Angina. L vent failure/ sudden death

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24
Q

What are the clinical features of endocarditis?

A

Murmurs. malaise, clubbing, arthralgia, pyrexia, skin lesions, spenomegaly, glomerulonephritis, haematuria,

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25
Q

Define endocardium?

A

inner lining of the heart and its valves

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26
Q

Where does infection occur in the endocardium?

A

Edge of heart valves

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27
Q

What does endocarditis on the R side mean?

A

IV drug use

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28
Q

What affects abnormal valves usually after dental extraction/ cleaning/ bronchoscopy or tonsillectomys?

A

Streptococci (a haemolytic). Cocci (cucu) because I never saw this after tonsillectomys

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29
Q

What affects previously normal valves?

A

IV drug abusers

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30
Q

When considering prophylaxis and endocarditis?

A

MUST give antibiotics to those at risk of developing endocarditis prior to any procedure that may produce a bacteraemia.

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31
Q

Define preicardium

A

Heart sac

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32
Q

What causes pericarditis and mycarditis?

A

TB, uraemia, carcinoma, MI, post surgery, Drugs, connective tissue disease, radiation, viral, bacterial, parasitic,

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33
Q

Name some unusual cardiac diseases?

A

Cardiomyopathy, Sarcoidosis, amyloidosis, thyrotoxicosis, myxoedema, alcoholism, pregnancy, drug induced.

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34
Q

Name dilated cardiac diseases

A

Idiopathic, alcohol, peripartum, genetic, myocarditis and sarcoid

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35
Q

Name hypertrophic cardiac diseases

A

Idiopathic, genetic, storage disease

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36
Q

Name restrictive cardiac diseases?

A

Idiopathic, amyloidosis, radiation induced, chemo related

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37
Q

What can hypertrophic cardiomyopathy led to?

A

end stage dilation

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38
Q

a 1/3rd of hypertrophic cardiomyopathy have?

A

intermittent left ventricular outflow obstruction

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39
Q

Clinical features of HCM?

A

Black outs, SOB, chest pain, palpitations, atrial fib,

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40
Q

What causes HCM?

A

50% familial, autosomal dominant. Genetic defect 1 of 4 genes that encode cardiac contractile elements

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41
Q

What I didn’t know that could cause aneurysms?

A

Autoimmune diseases, bacteria, fungus, syphilis

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42
Q

Aneurysm treatments?

A

Stents, surgery, reducing arterial pressure

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43
Q

Where are atherosclerotic aneuryms found?

A

Lower abdominal aorta and iliac arteries

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44
Q

Where are aortic dissections found?

A

Aorta and major branches

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45
Q

Where are berry aneurysms found?

A

circle of willis

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46
Q

Where are micro aneurysms found?

A

intracerebral vapillaries

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47
Q

Where are syphilitic aneurysms found?

A

ascending & arch of aorta

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48
Q

Where are mycotic (infective) aneurysms found?

A

Root or aorta and and vessel

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49
Q

What are the clinical effects of atherosclerotic aneurysms

A

Lower limb ischaemia, pulsatile abdominal mass, rupture, massive haemorrhage

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50
Q

What are the clinical effects of aortic dissection?

A

Loss of peripheral pulses, haemopericardium, rupture, double barrelled aorta

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51
Q

What are the clinical effects of micro-aneurysms?

A

Intracerebral haemorrhage (hypertension)

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52
Q

What are the clinical effects of syphilitie aneurysms?

A

Aortic incompetence

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53
Q

What is the circle of willis?

A

Circle of vessels around the base of the brain

54
Q

What is the circle of willis?

A

Circle of vessels around the base of the brain

55
Q

Define cardiac failure

A

heart unable to pump blood at rate required for normal functioning

56
Q

How does heart compensate and what results?

A

Cardiac hypertrophy and/or dilation. Eventually inability to maintain normal.

57
Q

Signs/symptoms of CV disease?

A

All-over excessive fluid filled veins -> systemic venous congestion and oedema. SOB, Fatigue, pulmonary oedema (fluid in lungs).

58
Q

Define stenosis (valvular heart disease).

A

Failure to completely open.

59
Q

What are the three ways for valvular heart disease?

A

Stenosis, incompetence/regurgitation and vegetations

60
Q

What does incompetence/regurgitation mean for valvular heart disease?

A

Failure to close, allowing reversible flow

61
Q

What does vegitation mean for valvular heart disease?

A

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

62
Q

What is the most common valvular disease?

A

Stenosis of aortic and mitral valves. (2/3rd of

63
Q

What is valvular stenosis mainly due to?

A

Primary valve cusp abnormality

64
Q

Why do vegetations form?

A

From infective endocarditis & rheumatic fever

65
Q

What is the clinical presentation of vegetations?

A

Sepsis, heart failure, new murmur.

66
Q

As well as general reasons like hypertension and age degeneration, what are underlying causes of valvular disease?

A

Calcific aortic valve disease? Carcinoid syndrome, prosthetic heart valves and IV drug use

67
Q

What is the pathological cause for mitral stenosis?

A

Rheumatic fever

68
Q

What is the pathological cause for mitral incompetence?

A

Rheumatic fever, Dilation of mitral valve, papillary muscle fibrosis/dysfunction, degeneration of valve cusps

69
Q

What is the pathological cause for aortic stenosis?

A

Rheumatic fever, calcific degerneration

70
Q

What is the pathological cause for aortic incompetence?

A

Rheumatic fever, dilation of aortic root, rheumatological disorders.

71
Q

Ehst is the pathological cause for endocarditis?

A

Rheumatic disease, bacteria, IV drug use, calcific valve disease, prosthetic heart valves

72
Q

What are the clinical features of mitral stenosis?

A

Murmur. L atrial and R ventricle hypertrophy. Pulmonary hypertension.

73
Q

What are the clinical features of mitral incompetence?

A

Murmur. Variable haemodynamic effect

74
Q

What are the clinical features of aortic stenosis?

A

Murmur. L ventricle hypertrophy. Angina, syncope, L vent failure/ sudden death.

75
Q

What are the clinical features of aortic incompetence?

A

Murmur. Collapsing pulse. Angina. L vent failure/ sudden death

76
Q

What are the clinical features of endocarditis?

A

Murmurs. malaise, clubbing, arthralgia, pyrexia, skin lesions, spenomegaly, glomerulonephritis, haematuria,

77
Q

Define endocardium?

A

inner lining of the heart and its valves

78
Q

Where does infection occur in the endocardium?

A

Edge of heart valves

79
Q

What does endocarditis on the R side mean?

A

IV drug use

80
Q

What affects abnormal valves usually after dental extraction/ cleaning/ bronchoscopy or tonsillectomys?

A

Streptococci (a haemolytic). Cocci (cucu) because I never saw this after tonsillectomys

81
Q

What affects previously normal valves?

A

IV drug abusers

82
Q

When considering prophylaxis and endocarditis?

A

MUST give antibiotics to those at risk of developing endocarditis prior to any procedure that may produce a bacteraemia.

83
Q

Define preicardium

A

Heart sac

84
Q

What causes pericarditis and mycarditis?

A

TB, uraemia, carcinoma, MI, post surgery, Drugs, connective tissue disease, radiation, viral, bacterial, parasitic,

85
Q

Name some unusual cardiac diseases?

A

Cardiomyopathy, Sarcoidosis, amyloidosis, thyrotoxicosis, myxoedema, alcoholism, pregnancy, drug induced.

86
Q

Name dilated cardiac diseases

A

Idiopathic, alcohol, peripartum, genetic, myocarditis and sarcoid

87
Q

Name hypertrophic cardiac diseases

A

Idiopathic, genetic, storage disease

88
Q

Name restrictive cardiac diseases?

A

Idiopathic, amyloidosis, radiation induced, chemo related

89
Q

What can hypertrophic cardiomyopathy led to?

A

end stage dilation

90
Q

a 1/3rd of hypertrophic cardiomyopathy have?

A

intermittent left ventricular outflow obstruction

91
Q

Clinical features of HCM?

A

Black outs, SOB, chest pain, palpitations, atrial fib,

92
Q

What causes HCM?

A

50% familial, autosomal dominant. Genetic defect 1 of 4 genes that encode cardiac contractile elements

93
Q

What I didn’t know that could cause aneurysms?

A

Autoimmune diseases, bacteria, fungus, syphilis

94
Q

Aneurysm treatments?

A

Stents, surgery, reducing arterial pressure

95
Q

Where are atherosclerotic aneuryms found?

A

Lower abdominal aorta and iliac arteries

96
Q

Where are aortic dissections found?

A

Aorta and major branches

97
Q

Where are berry aneurysms found?

A

circle of willis

98
Q

Where are micro aneurysms found?

A

intracerebral vapillaries

99
Q

Where are syphilitic aneurysms found?

A

ascending & arch of aorta

100
Q

Where are mycotic (infective) aneurysms found?

A

Root or aorta and and vessel

101
Q

What are the clinical effects of atherosclerotic aneurysms

A

Lower limb ischaemia, pulsatile abdominal mass, rupture, massive haemorrhage

102
Q

What are the clinical effects of aortic dissection?

A

Loss of peripheral pulses, haemopericardium, rupture, double barrelled aorta

103
Q

What are the clinical effects of micro-aneurysms?

A

Intracerebral haemorrhage (hypertension)

104
Q

What are the clinical effects of syphilitie aneurysms?

A

Aortic incompetence

105
Q

What are the clinical effects of mycotic (infective) aneurysms?

A

Thrombosis or rupture. Cerebral infarction of haemorrage.

106
Q

What is the circle of willis?

A

Circle of vessels around the base of the brain

107
Q

When is someone offered 24hr ambulatory monitoring?

A

When they have BP 140/90

108
Q

What is mild diastolic bp between?

A

95-104mmHg

109
Q

What is moderate diastolic bp between?

A

105-114mmHg

110
Q

What is severe diastolic bp?

A

> 115mmHg

111
Q

Primary hypertension is also known as?

A

Essential hypertension (95%)

112
Q

Risk factors for essential hypertension?

A

(non-modifiable) Genes, family history. (Modifiable) diet, lifestyle weight, alcohol, smoking.

113
Q

Causes of secondary hypertension?

A

Renal (polycystic kidney disease), Endocrine (thyrotoxicosis), vascular (raise IV volume), neurogenic (acute stress)

114
Q

What is benign hypertension?

A

Remains stable, normal life until complications arise

115
Q

What is malignant hypertension?

A

Accelerated hypertensive disease, 5% of cases. Rapid ^ BP 90% die in first year.

116
Q

Hypertension can lead to what for blood vessels?

A

atherosclerosis, arteriosclerosis and ^risk of MI, rupture and dissection

117
Q

Define sclerosis

A

Thickening/hardening of body tissue

118
Q

Hypertension can lead to what for the heart?

A

Heart disease, left ventricular hypertrophy, cardiac failure and MI

119
Q

Hypertension can lead to what for the kidney?

A

Benign nephrosclerosis and renal failure

120
Q

Hypertension can lead to what for the eyes?

A

Hypertensive retinopathy,

121
Q

What are retinopathy grades?

A

Grade I: thicking of arterioles. II: arteriolar spasms. III haemorrages. IV Papilloedema (seen in malignant hypertension)

122
Q

Define adverse prognosis?

A

preventing success in outcomes

123
Q

Factors indicating adverse prognosis in hypertension?

A

Male, young, black ethnicity, smoker, persistent diastolic BP > 115, diabetes, hypercholesterolemia, obesity, organ damage.

124
Q

What can diabetic vascular disease cause?

A

Damage to vessels/ kidneys/ nerves/ retinas

125
Q

Complications of diabetic vascular disease?

A

Gangrene, renal failure and blindness

126
Q

Define gangrene

A

Localised death of tissue

127
Q

How can diabetic vascular disease be improved?

A

effective diabetes control

128
Q

What is deep vein thrombosis?

A

When normal venous return is impeded -> thrombosis.

129
Q

What causes DVT?

A

immobility, malignancy, pregnancy, child birth, oestrogens, haematological disorders, IV cannulas.

130
Q

What is varicosities?

A

Common problem. Torte and distended veins. Ulceration on ankles and lower legs.

131
Q

What causes varicosities?

A

incompetent valves in legs, imparied venous return, stasis, oedema, fibrin deposits around veins.

132
Q

Common congenital CV diseases?

A

Septal defects, patent ductus arteriosus, corarctation of aorta (narrowed), transposition of vessels, fallot’s tetralogy

Pathology (25 decks)

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