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Pathology > Path MD2 > Flashcards

Path MD2 Flashcards

1
Q

What is the most commonly affected coronary artery in MI?

A

LAD - Left anterior descending coronary artery (50%)

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2
Q

Blockage in LAD would cause an MI where?

A

Anterior wall of LV, anterior septum, & apex

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3
Q

What is the 2nd most commonly affected coronary artery in MI?

A

RCA - Right coronary artery (30-40%)

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4
Q

What does the RCA supply?

A

In 90% of people, it supplies the posterior-inferior LV wall and posterior 2/3 of interventricular septum, posterior-inf. RV

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5
Q

What is another less commonly affected coronary artery in MI?

A

Circumflex coronary artery (10-20%)Comes from the Left coronary artery

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6
Q

What does the circumflex artery supply?

A

Lateral LV (except apex)

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7
Q

When is the earliest you can identify an MI via pallor?

A

8-12 hours after infarct

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8
Q

Histology of MI

A
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9
Q

What is an atherosclerotic plaque composed of?

A

Cells (SMC, fibroblast, macrophages, leukocyte)Connective tissue: collagen, elastin, fibrin, proteoglycansLipid: intracellular/extracellular

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10
Q

What are complications of coronary atherosclerosis?

A

* Critical stenosis of lumen * Acute thrombosis * Hemorrhage into plaque * Aneurysm & rupture of wall

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11
Q

What are the 2 major types of acute MI?

A

Subendocardial (10%): Necrosis limited to inner 1/3 - 1/2 of myocardium (mau be due to global reduction in perfusion or single vessel occlusion) * Multifocal, patchy, circumferential, coronary thrombosis rare, often due to hypotension/shock, No epicarditis, Don’t form aneurysms or lead to ventricular rupture Transmural (90%): Necrosis involves basically entire myocardial wall thickness (usually single vessel occlusion) * Unifocal, solid, in distribution of specific coronary artery, coronary thrombosis common, often cause shock, Epicarditis common, May result in aneurysm/ventricular rupture

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12
Q

Describe a remote (healed) MI macroscopically

A

Characterized by scar tissue where normal myocardium replaced by fibrous CTNormally, scar tissue is firm, white, and ventricular wall thinned

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13
Q

Describe the evolution of morphologic changes in MI over time

A
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14
Q

What is ventricular rupture?When is it most common?3 types & consequences?

A

Due to weakening of myocardium (due to necrosis & progressive removal of necrotic tissue) following transmural infarctionMost common 3-5 days after MITypes: free wall rupture (hemopericardium, tamponade); septal rupture (L to R shunt); Papillary muscle rupture of mitral valve (acute valvular insufficiency)

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15
Q

What is a ventricular aneurysm?

A

Due to remote MI composed of fibrous tissue (non-contractile). Weakened ventricle lead to out pouching of thinned ventricle. May cause blood stasis –> mural thrombus within aneurysm

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16
Q

Which part of the aorta is most affected by atherosclerosis?

A

Infra-renal abdominal aorta

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17
Q

What is an aortic dissection?What is it associated with?How do you differentiate the types?

A

Dissection of blood within wall of aorta - causing blood-filled channel. Blood from dissection may cause 2nd distal tear in intima -> double lumen aortaAssoc. with HTN, disorders of CT (Marfan’s syndrome)Type A (occurs before aortic arch), type B (occurs after arch)

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18
Q

What is the most commonly affected coronary artery in MI?

A

LAD - Left anterior descending coronary artery (50%)

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19
Q

Blockage in LAD would cause an MI where?

A

Anterior wall of LV, anterior septum, & apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the 2nd most commonly affected coronary artery in MI?

A

RCA - Right coronary artery (30-40%)

How well did you know this?
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21
Q

What does the RCA supply?

A

In 90% of people, it supplies the posterior-inferior LV wall and posterior 2/3 of interventricular septum, posterior-inf. RV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is another less commonly affected coronary artery in MI?

A

Circumflex coronary artery (10-20%)Comes from the Left coronary artery

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23
Q

What does the circumflex artery supply?

A

Lateral LV (except apex)

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24
Q

When is the earliest you can identify an MI via pallor?

A

8-12 hours after infarct

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25
Q

Histology of MI

A
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26
Q

What is an atherosclerotic plaque composed of?

A

Cells (SMC, fibroblast, macrophages, leukocyte)Connective tissue: collagen, elastin, fibrin, proteoglycansLipid: intracellular/extracellular

How well did you know this?
1
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2
3
4
5
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27
Q

What are complications of coronary atherosclerosis?

A

* Critical stenosis of lumen * Acute thrombosis * Hemorrhage into plaque * Aneurysm & rupture of wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the 2 major types of acute MI?

A

Subendocardial (10%): Necrosis limited to inner 1/3 - 1/2 of myocardium (mau be due to global reduction in perfusion or single vessel occlusion) * Multifocal, patchy, circumferential, coronary thrombosis rare, often due to hypotension/shock, No epicarditis, Don’t form aneurysms or lead to ventricular rupture Transmural (90%): Necrosis involves basically entire myocardial wall thickness (usually single vessel occlusion) * Unifocal, solid, in distribution of specific coronary artery, coronary thrombosis common, often cause shock, Epicarditis common, May result in aneurysm/ventricular rupture

29
Q

Describe a remote (healed) MI macroscopically

A

Characterized by scar tissue where normal myocardium replaced by fibrous CTNormally, scar tissue is firm, white, and ventricular wall thinned

30
Q

Describe the evolution of morphologic changes in MI over time

A
31
Q

What is ventricular rupture?When is it most common?3 types & consequences?

A

Due to weakening of myocardium (due to necrosis & progressive removal of necrotic tissue) following transmural infarctionMost common 3-5 days after MITypes: free wall rupture (hemopericardium, tamponade); septal rupture (L to R shunt); Papillary muscle rupture of mitral valve (acute valvular insufficiency)

32
Q

What is a ventricular aneurysm?

A

Due to remote MI composed of fibrous tissue (non-contractile). Weakened ventricle lead to out pouching of thinned ventricle. May cause blood stasis –> mural thrombus within aneurysm

33
Q

Which part of the aorta is most affected by atherosclerosis?

A

Infra-renal abdominal aorta

34
Q

What is an aortic dissection?What is it associated with?How do you differentiate the types?

A

Dissection of blood within wall of aorta - causing blood-filled channel. Blood from dissection may cause 2nd distal tear in intima -> double lumen aortaAssoc. with HTN, disorders of CT (Marfan’s syndrome)Type A (occurs before aortic arch), type B (occurs after arch)

35
Q

What is the most commonly affected coronary artery in MI?

A

LAD - Left anterior descending coronary artery (50%)

36
Q

Blockage in LAD would cause an MI where?

A

Anterior wall of LV, anterior septum, & apex

37
Q

What is the 2nd most commonly affected coronary artery in MI?

A

RCA - Right coronary artery (30-40%)

38
Q

What does the RCA supply?

A

In 90% of people, it supplies the posterior-inferior LV wall and posterior 2/3 of interventricular septum, posterior-inf. RV

39
Q

What is another less commonly affected coronary artery in MI?

A

Circumflex coronary artery (10-20%)Comes from the Left coronary artery

40
Q

What does the circumflex artery supply?

A

Lateral LV (except apex)

41
Q

When is the earliest you can identify an MI via pallor?

A

8-12 hours after infarct

42
Q

Histology of MI

A
43
Q

What is an atherosclerotic plaque composed of?

A

Cells (SMC, fibroblast, macrophages, leukocyte)Connective tissue: collagen, elastin, fibrin, proteoglycansLipid: intracellular/extracellular

44
Q

What are complications of coronary atherosclerosis?

A

* Critical stenosis of lumen * Acute thrombosis * Hemorrhage into plaque * Aneurysm & rupture of wall

45
Q

What are the 2 major types of acute MI?

A

Subendocardial (10%): Necrosis limited to inner 1/3 - 1/2 of myocardium (mau be due to global reduction in perfusion or single vessel occlusion) * Multifocal, patchy, circumferential, coronary thrombosis rare, often due to hypotension/shock, No epicarditis, Don’t form aneurysms or lead to ventricular rupture Transmural (90%): Necrosis involves basically entire myocardial wall thickness (usually single vessel occlusion) * Unifocal, solid, in distribution of specific coronary artery, coronary thrombosis common, often cause shock, Epicarditis common, May result in aneurysm/ventricular rupture

46
Q

Describe a remote (healed) MI macroscopically

A

Characterized by scar tissue where normal myocardium replaced by fibrous CTNormally, scar tissue is firm, white, and ventricular wall thinned

47
Q

Describe the evolution of morphologic changes in MI over time

A
48
Q

What is ventricular rupture?When is it most common?3 types & consequences?

A

Due to weakening of myocardium (due to necrosis & progressive removal of necrotic tissue) following transmural infarctionMost common 3-5 days after MITypes: free wall rupture (hemopericardium, tamponade); septal rupture (L to R shunt); Papillary muscle rupture of mitral valve (acute valvular insufficiency)

49
Q

What is a ventricular aneurysm?

A

Due to remote MI composed of fibrous tissue (non-contractile). Weakened ventricle lead to out pouching of thinned ventricle. May cause blood stasis –> mural thrombus within aneurysm

50
Q

Which part of the aorta is most affected by atherosclerosis?

A

Infra-renal abdominal aorta

51
Q

What is an aortic dissection?What is it associated with?How do you differentiate the types?

A

Dissection of blood within wall of aorta - causing blood-filled channel. Blood from dissection may cause 2nd distal tear in intima -> double lumen aortaAssoc. with HTN, disorders of CT (Marfan’s syndrome)Type A (occurs before aortic arch), type B (occurs after arch)

52
Q

1

What is the most commonly affected coronary artery in MI?

A

LAD - Left anterior descending coronary artery (50%)

53
Q

1

Blockage in LAD would cause an MI where?

A

Anterior wall of LV, anterior septum, & apex

54
Q

1

What is the 2nd most commonly affected coronary artery in MI?

A

RCA - Right coronary artery (30-40%)

55
Q

1

What does the RCA supply?

A

In 90% of people, it supplies the posterior-inferior LV wall and posterior 2/3 of interventricular septum, posterior-inf. RV

56
Q

1

What is another less commonly affected coronary artery in MI?

A

Circumflex coronary artery (10-20%)Comes from the Left coronary artery

57
Q

1

What does the circumflex artery supply?

A

Lateral LV (except apex)

58
Q

1

When is the earliest you can identify an MI via pallor?

A

8-12 hours after infarct

59
Q

1

Histology of MI

A
60
Q

1

What is an atherosclerotic plaque composed of?

A

Cells (SMC, fibroblast, macrophages, leukocyte)Connective tissue: collagen, elastin, fibrin, proteoglycansLipid: intracellular/extracellular

61
Q

1

What are complications of coronary atherosclerosis?

A

* Critical stenosis of lumen * Acute thrombosis * Hemorrhage into plaque * Aneurysm & rupture of wall

62
Q

1

What are the 2 major types of acute MI?

A

Subendocardial (10%): Necrosis limited to inner 1/3 - 1/2 of myocardium (mau be due to global reduction in perfusion or single vessel occlusion) * Multifocal, patchy, circumferential, coronary thrombosis rare, often due to hypotension/shock, No epicarditis, Don’t form aneurysms or lead to ventricular rupture Transmural (90%): Necrosis involves basically entire myocardial wall thickness (usually single vessel occlusion) * Unifocal, solid, in distribution of specific coronary artery, coronary thrombosis common, often cause shock, Epicarditis common, May result in aneurysm/ventricular rupture

63
Q

1

Describe a remote (healed) MI macroscopically

A

Characterized by scar tissue where normal myocardium replaced by fibrous CTNormally, scar tissue is firm, white, and ventricular wall thinned

64
Q

1

Describe the evolution of morphologic changes in MI over time

A
65
Q

1

What is ventricular rupture?When is it most common?3 types & consequences?

A

Due to weakening of myocardium (due to necrosis & progressive removal of necrotic tissue) following transmural infarctionMost common 3-5 days after MITypes: free wall rupture (hemopericardium, tamponade); septal rupture (L to R shunt); Papillary muscle rupture of mitral valve (acute valvular insufficiency)

66
Q

1

What is a ventricular aneurysm?

A

Due to remote MI composed of fibrous tissue (non-contractile). Weakened ventricle lead to out pouching of thinned ventricle. May cause blood stasis –> mural thrombus within aneurysm

67
Q

1

Which part of the aorta is most affected by atherosclerosis?

A

Infra-renal abdominal aorta

68
Q

1

What is an aortic dissection?What is it associated with?How do you differentiate the types?

A

Dissection of blood within wall of aorta - causing blood-filled channel. Blood from dissection may cause 2nd distal tear in intima -> double lumen aortaAssoc. with HTN, disorders of CT (Marfan’s syndrome)Type A (occurs before aortic arch), type B (occurs after arch)

Pathology (5 decks)

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