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Path Flashcards

1
Q

MC organism causing IE in IV drug users

A

S.aureus

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2
Q

MCC dev of AF

A

Initiated by aberrant electrical impulses that arise in regions of heightened excitability #MC Pulm Veins : causes multiple ectopic foci : inc risk & chronicity of subsequent AF

Aging or dilation of atria d/t HTN, MR

❗️ #MC catheter ablation of Pulm Veins

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3
Q

Hypovolemia

A

Inc Hct, Albumin (trapped in intravasc space), inc Uric acid abs in PCT > inc serum

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4
Q

1° disturbance in Cardiogenic shock

A

LVF > inc PCWP + dec CO > inc SVR > inc CVP

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5
Q

Hypovolemic shock

Pathophys

A

Dec BV > dec CVP > dec PCWP > dec CO > inc SVR

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6
Q

Septic shock pathophys

A

Periph vasodilation d/t inflamm mediators > dec SVR > inc CO > dec PCWP > dec CVP

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7
Q

Obstructive shock pathophys

A

Obstruction > inc CVP > inc SVR > dec PCWP > Dec CO

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8
Q

AFib characteristic

A

Absent P
I regularly irregular R-R
Narrow QRS
Low amp fibrillary waves : chaotic, cont atrial depol

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9
Q

HFrEF values

A

= LV systolic dys(f)

  • dec SV <60 mL
  • dec EF <35%
    X dec contractility
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10
Q

LV diastolic dys(f) values

A

= HFpEF

  • N contractility
  • dec compliance
  • dec SV
  • N EF
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11
Q

Effect of infusing isotonic saline

A

Isotonic saline - inc volume — inc cardiac vol c filling P — myocardial wall stretch (inc ED SARCOMERE LENGTH) — ANP, BNP release : 1) inc cGMP — inc GFR — inc fluid + water excretion 2) dec renin secretion — dec ATII, Alsosterone — inc water + Na excretion

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12
Q

Supine hypotension in 🤰🏻d/t?

A

Compression of IVC by gravid uterus
- Aortocaval syndrome

  • dec VR — dec PL — dec CO — dec BP
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13
Q

MC complication of AS?

A

AFib

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14
Q

BMPR2 mutation seen in?

A

Hereditary PAHTN

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15
Q

MCC IE in

  • dev nations:
  • developing nations:
A
  • dev nations: MVP+MR

- developing nations: RHD

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16
Q

Why does carcinoid tumor involve R heart?

A

Inc serotonin — inc fibroblast growth — fibrous deposits on the endocardium — TR

Endocardial fibrosis + thickening d/t vasoactive products I activated by Pulm circulation

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17
Q

Cystic medial degeneration w basket weave pattern seen in?

A

Marfan

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18
Q

Tracheal deviation + enlarged aortic knob + wide mediastinum on CXR seven in?

A

TAA

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19
Q

Atheroma formation

A

Endothelial injury - Monocytes + platelets into intima — lipid-laden macrophages (cannot phagocytose): foam cells — fatty streak — smooth muscle migration : fibrofatty atheroma

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20
Q

Mx changes + complications seen post-MI

0-12 hours:

1-3 days:

3-14 days:

2w - 2m:

A
  1. Wavy fibers : 4-12 hrs
  2. (Early coag. necrosis) Hyper eosinophilia + pyknotic nuclei + reperfuson injury : 12-24 hrs — Cardiogenic shock, ventricular arrhythmia, HF
  3. Extensive Coagulation necrosis + neutrophils : 1-3 days — Post infarction fibrinous pericarditis
  4. Macrophages : 3-7days
  5. Granulation tissue 7-10days
  6. Neovascularization : 10-14days
    — Free wall rupture, Tamponade, MR, LV pseudoaneurysm
  7. Collagen + scar formation : 2w - 2 months — Dressler syndrome, Mural thrombus
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21
Q

TTN gene mutation seen in?

A

DCM

  • AD, incomplete penetrance
  • Titin anchors beta-myosin heavy chain to Z-discs : myocardial tension
    Titin absence = myocard dys(f)
22
Q

NOTCH1 gene mutation seen in?

A

Familial bicuspid aortic valve disease

23
Q

Mutation in beta-myosin heavy chain or myosin-binding protein C seen in.

A

HCM

  • AD
24
Q

Genetic disorders w associated CVD-

Down:

DiGeorge:

Friedreich ataxia:

Kartagener syndrome:

Marfan:

TS:

Turner:

A

Down: ASD, VSD

DiGeorge: TOF

Friedreich ataxia: HCM

Kartagener syndrome: Situs inversus

Marfan: MVP, aortic coarctation/ dissection, aneurysms

TS: rhabdomyoma

Turner: aortic coarctation, bicuspid aortic valve

25
Q

Egg on a string app on CXR?

A

Transposition of GV : failure of AP septum to spiral

26
Q

Bicuspid aortic valve seen in?

A
  1. Turner

2. Coarctation of aorta

27
Q

Congenital cardiac defect associations-

  1. ASD, VSD, PDA, TOF:
  2. PDA, PS, septal defects:
  3. ASD, VSD, septal defects:
  4. TGV, VSD:
  5. Ebstein anomaly:
  6. Supravalvular aortic stenosis:
A
  1. ASD, VSD, PDA, TOF: Fetal alcohol syndrome
  2. PDA, PS, septal defects: Rubella
  3. ASD, VSD, septal defects: Down
  4. TGV, VSD: infant of diabetic mother
  5. Ebstein anomaly: Li exp in utero
  6. Supravalvular aortic stenosis: Williams syndrome
28
Q

String of beads app of renal artery

A

Fibromuscular dysplasia d/t HTN

29
Q

Hyaline CS hyperplastic arteriolosclerosis

A

Hyaline: thick wall d/t protein leak — DM, HTN

Hyperplastic: onion skinning d/t prolif of smooth muscle cells

30
Q

Pipe stem app on X-ray

A

Vascular stiffening w/out obstruction - Möckeberg sclerosis/ Medial calcifications sclerosis

31
Q

Partial crescent shaped opacification of aorta on Abd X-ray?

A

Abd aortic aneurysm

D/t flap/ clot

32
Q

Unequal BP in arms + mediastinal widening on CXR?

A

Aortic dissection

Wide mediastinum also seen in traumatic aortic rupture (#MC @ aortic isthmus)

33
Q

Systolic dys(f)

A
  • dec EF

1. DCM

34
Q

Eccentric hypertrophy

A
  1. DCM
35
Q

Diastolic dys(f)

A
  1. HCM
36
Q

Concentric hypertrophy

A
  1. HCM
37
Q

Multiple renal micro aneurysms + diff stages of transmural infarction w fibrinoid necrosis seen in?

A

Polyarteritis nodosa

Hx HBV

38
Q

Recurrent although + genital ulcers seen in?

A

Beçhet syndrome

HLAB51

Turkish + mid eastern

39
Q
  1. Palpable purpurea + arthralgia + GI distress seen in?

2. Palpable purpura + weakness c arthralgia seen in.

A
  1. Henoch-Schönlein purpura / IgA vasculitis
  2. Mixed cryoglobulinemia
    Hx HCV,
40
Q

Cryptogenic stroke

A
  • R-L shunt
  • bubble study: agitated N saline
  • associated w PFO, ASD
41
Q

ASD vs PFO

A

ASD: aplasia of atrial septum secundum

PFO: incomplete fusion of atrial septum primum w secundum

42
Q

MR in MI seen d/t?

A

Papillary muscle ischemia

  • NEW HOLOSYSTOLIC MURMUR seen w/in 3-5days
43
Q

Dec in contractility + dec EF w Dobutamine d/t?

A

Transient wall motion defect w fixed atherosclerotic lesion limiting blood flow : Stable angina :: mismatch of O2 demand-supply

44
Q

Athlete’s heart changes

A
  1. Eccentric hypertrophy - inc LV cavity size + muscle mass - inc EDV - inc SV - no change in EF
  2. Inc max CO d/t inc SV
  3. Inc RBC mass + plasma volume to inc O2 carrying capacity
  4. Inc arteriolar + cap density to improve O2 uptake : dec SVR
45
Q

HCM murmur d/t?

A

Obstruction of LVOT d/t IVS hypertrophy

46
Q

MC complication of Left-MI

A

LHF + Pulm edema

47
Q

Thick ventricular walls + dec ventricular cavity size seen in

A

Concentric hypertrophy

P overload, parallel

48
Q

MCC aortic dissection

A

HTN

  • tearing chest pain radiating to back
49
Q

MCC coronary sinus dilation

A

any path causing RA dilation, #MC PHTN.

others:

  • persistent L SVC
  • TAPVR
50
Q

Pulsatilla mass w a thrill/ constant bruit on auscultation seen in?

A

AV fistula

Cardio (8 decks)

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