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Parker- CV Path > Nichols- Hemodynamics 2 > Flashcards

Nichols- Hemodynamics 2 Flashcards

1
Q

Libman Sacks endocarditis is associated with what autoimmune disease?

A

Lupus.. think LSE is assc w/ SLE

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2
Q

Where are the vegetations in LSE?

A

Mitral & tricuspid valves (only on one side of the valve!

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3
Q

will the vegetations likely embolize in LSE?

A

Hell no!

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4
Q

Whats so special about marantic endocarditis?

A

It is not bacterial, but THROMBIC!!

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5
Q

Nichols made a red slide: What is marantic endocarditis a precursor for?

A

Infective endocarditis

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6
Q

Marantic endocarditis is assc with?

A

Malignant tumors, especially adenocarcinomas

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7
Q

On which side of the valve does marantic endocarditis form?

A

Atrial side

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8
Q

An infection on a blood clot on a heart valve is known as?

A

Infective endocarditis

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9
Q

what is the 4 step pathogenesis of IE?

A
  1. Valvular injury
  2. Platelet/fibrin deposition
  3. microbial seeding
  4. microbial multiplication
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10
Q

What bug is ACUTE IE usually caused by?

A

Acute= S. Aureus

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11
Q

What bug is Subacute IE usually caused by?

A

Subacute= viridans Strep

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12
Q

What bug usually gets on prosthetic heart valves?

A

Staph epi

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13
Q

What valve do drug users typically get IE on?

A

tricuspid

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14
Q

You have a patient with IE. You culture it. You tell the lab you are culturing an IE cuz some of the organisms are slow growing. You get results of Strep bovis. Whats your concern?

A

Colon cancer

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15
Q

What are the slow growing oral flora that can cause IE?

A

HACEK

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16
Q

What do 70% of IE pts have in common?

A

They had a pre-existing heart condition

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17
Q

How often will IE kill you if you dont treat it?

A

All the ducking time.. quack!

18
Q

2 big criteria for diagnosis of IE?

A
  1. Fever

2. Positive blood culture

19
Q

What is aortic stenosis?

A

Narrowing of aortic valve making it hard to pump blood out of LV

20
Q

3 main causes of aortic stenosis?

A
  1. Congenital bicuspid valve
  2. Senile degradation
  3. Chronic rheumatic disease
21
Q

describe the pathology of aortic stenosis

A

Thickened valve –> lipid deposition –>inflammation –> calcifications

22
Q

symptoms of aortic stenosis?

A

SAD: syncope, angina, dyspnea

23
Q

What is aortic stenosis gonna do to the left ventricle?

A

LVH

24
Q

What is mitral valve regurg?

A

regurg from LV to LA; usually due to MVP

25
Q

Contrast acute vs. chronic mitral regurg

A
  1. Acute you’re gonna get flash pulmonary edema due to increased LA pressure; this will lead to DYSPNEA
  2. Chronic you’re gonna get LA dilation to compensate for the increased volume. Eventually the compensation will not be able to keep up and you’ll get decompensation and HF
26
Q

What is MVP?

A

billowing of MV into LA; it is very common and can progress to mitral regurg

27
Q

Congenital causes of MVP?

A

Marfan, ehlers-danlos

28
Q

describe the micro path of MVP

A
  1. Degredation of outer zona fibrous

2. Expansion of inner zone spongiosa

29
Q

Specific sign for MVP.. u better know this!

A

Midsystolic click: S1… click!… S2 (lub.. click.. dub)

30
Q

Rheumatic heart disease is inflammation following infection by?

A

Group A beta hemolytic strep

31
Q

Your body’s immune system thinks antigens from your heart are the bacterial M-proteins from the group A strep.. this phenomenon is known as?

A

Molecular mimicry

32
Q

Diagnosis for Rheumatic heart disease is proof of infection by group A beta hemolytic strep (via ASO titer or anti-DNAse B titer) and…

A

2 major or 2 major/1minor Jones criteria. The major jones criteria are:

  1. J- joints- migratory polyarthritis
  2. O- heart- pancarditis
  3. N- nodules - subQ nodules
  4. E- erythema marginatum
  5. S- Sydenham’s chorea
33
Q

Gross path of Rheumatic heart disease?

A

Small vegetations on valve closure

34
Q

Micro path of Rheumatic heart disease?

A

Aschoff bodies and Anitschkow cells

35
Q

Complications of Rheumatic heart disease?

A

65% go onto mitral stenosis

25% go onto aortic regurg/stenosis

36
Q

What is aortic regurg?

A

Regurg of blood from aorta -> LV

37
Q

Causes of aortic regurg?

A
  1. Congenital bicuspid aortic valve
  2. Endocarditis
  3. Chronic rheumatic valve deformation
38
Q

Describe acute aortic regurg

A
  1. Decreased forward SV
  2. Increased EDV
  3. Backup into LA and pulmonary edema
39
Q

Describe chronic aortic regurg

A
  1. Compensation by dilation of LV
  2. Normal forward SV; increased overall SV
  3. Decreased diastolic BP
  4. Eventually decomensation with decreased SV, increased EDV, increased EDP leading to HF
40
Q

Bigtime!: Patient presents with bounding pulse so hard that their head is bobbing. Very wide pulse pressure. What do they have?

A

Aortic regurg

Parker- CV Path (9 decks)

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