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1 STEP Cardio pathology > MI complications 12/04 > Flashcards

MI complications 12/04 Flashcards

1
Q

0-4h gross change?

A

None

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2
Q

0-4h microscopic changes?

A

none

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3
Q

4-24 h gross change?

A

dark discoloration

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4
Q

4-24 h microscopic change?

A

COAGULATION NECROSIS.
Edema, hemorrage, WAWY fibers,
hypereosinophilic myocytes, shrunken nuclei.
Start to migrate neutrophils

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5
Q

None changes?

A

0-4h

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6
Q

dark discoloration?

A

4-24 h

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7
Q

COAGULATION NECROSIS.
Edema, hemorrage, WAWY fibers,
hypereosinophilic myocytes, shrunken nuclei.
Start to migrate neutrophils

A

4-24 h

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8
Q

0-4h/4-24 complications?

A

Cardiogenic shock (in massive MI>50proc sienos), Arrhytmia, CHF

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9
Q

Cardiogenic shock (in massive MI>50proc sienos), Arrhytmia, CHF

A

0-4h/4-24 complications

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10
Q

1-3 days gross?

A

yellow pallor/hyperemia

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11
Q

yellow pallor/hyperemia

A

1-3 days gross

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12
Q

1-3 days microscopy?

A

Extensive coagulation necrosis.
NEUTROPHIILS AROUND THE MI ZONE (infiltrate at the border zone). Occurs due to proinflammatory cytokines. Eventually migrate to center of MI.
Neurophils release lysosomal enzymes, ROS, cytokines.

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13
Q

Extensive coagulation necrosis.
NEUTROPHIILS AROUND THE MI ZONE (infiltrate at the border zone). Occurs due to proinflammatory cytokines. Eventually migrate to center of MI.
Neurophils release lysosomal enzymes, ROS, cytokines.

A

1-3 days microscopy

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14
Q

1-3 days complications

A

Fibrinous pericarditis (chest pain and friction rub)

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15
Q

Fibrinous pericarditis?

A

1-3 days complications

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16
Q

3-10 days gross?

A

Hyperemic border, central yellow/brown softening

17
Q

Hyperemic border, central yellow/brown softening

A

3-10 days gross

18
Q

3-10 days microscopy?

A

MARCOPHAGES INFILTRATE:
- phagocyte dead myocytes and neutrophils

on 7th day START GRANULATION TISSUE WITH NEOVASCULARIZATION by IL10 and TGF-beta

19
Q

MARCOPHAGES INFILTRATE:
- phagocyte dead myocytes and neutrophils

on 7th day START GRANULATION TISSUE WITH NEOVASCULARIZATION by IL10 and TGF-beta

A

3-10 days microscopy

20
Q

3-10 days complications

A

Rupture of free ventricular wall -> tamponade
Rupture of interventricular septal wall -> shunt
Rupture of papillar muscle -> mitral insufficiency
LV pseudoaneurysm -> risk of rupture

21
Q

Rupture of free ventricular wall -> tamponade
Rupture of interventricular septal wall -> shunt
Rupture of papillar muscle -> mitral insufficiency
LV pseudoaneurysm -> risk of rupture

A

3-10 days complications

22
Q

Rupture of free ventricular wall -> tamponade

A

3-10 days

23
Q

Rupture of interventricular septal wall -> shunt

A

3-10 days

24
Q

Rupture of papillar muscle -> mitral insufficiency

A

3-10 days

25
Q

LV pseudoaneurysm -> risk of rupture

A

3-10 days

26
Q

What predisposes interventricular rupture? what process?

A

Macrophage-mediated structural degradation

27
Q

10-14 days microscopic?

A

VESSELS:Neovascularization of granulation tissue (most prominent on 10-14 days),
FIBROBLASTS proliferation,
COLLAGEN (type III).

28
Q

Neovascularization of granulation tissue (most prominent on 10-14 days),, fibroblast proliferation, collagen (type III).

A

10-14 days microscopic

29
Q

10-14 days gross?

A

red border emerges as granulation tissue enters from the edge of infarct.

30
Q

red border emerges as granulation tissue enters from the edge of infarct.

A

10-14 days gross

31
Q

2 weeks to 2 months microscopy?

A

(AKA FIBROSIS) Collagen remodeling and fibroblast differentiation into myofibroblasts drive the formation of scar tissue.

32
Q

Collagen remodeling and fibroblast differentiation into myofibroblasts drive the formation of scar tissue.

A

2 weeks to 2 months microscopy

33
Q

2 months post MI and more

A

(AKA FIBROSIS) remodeling continues to a slower rate as scar matures and contracts. (contracted scar is mature)

collagen type III and I –> then only I in final stage

34
Q

(AKA FIBROSIS) remodeling continues to a slower rate as scar matures and contracts.(contracted scar is mature)

A

2 months post MI and more

35
Q

Gross when fibrosis starts (from 2 weeks to months)

A

white scar
In final - type I collagen

36
Q

2 weeks to 2 months complications

A

Dresslen syndrome -> results in fibrinous pericarditis
True ventricular aneurysm -> risk of mural thrombus
HF
Arrhythmias

37
Q

Dresslen syndrome -> results in fibrinous pericarditis
True ventricular aneurysm -> risk of mural thrombus
HF
Arrhythmias

A

2 weeks to 2 months complications

1 STEP Cardio pathology (8 decks)

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