Patho quiz 1 Flashcards
1
Q
___Fibrillation is responsible for 25% of strokes
A
Atrial
2
Q
Aphasia effects __% of stroke patients, half is self-limiting
A
40%
3
Q
Difficulty with hand-eye coordination is from what lobe stroke?
A
Parietal
4
Q
What is the most common heart disease?
A
Coronary heart disease
5
Q
Intimia injury, insudation, oxidation, foam cell (results in fatty streak, ____), fibrous plaque formation
A
atheroma/plaque
6
Q
What is the target bp for treating HTN?
A
Less than 140/90
7
Q
Which cardiomyopathy: degeneration leading to heart failure, either ischemic or non-ischemic.
A
Dilated cardiomyopathy
8
Q
Valve cannot close completely
A
Regurgitation
9
Q
Which cardiomyopathy: most common cause of sudden cardiac death in young adults, reduced filling capacity
A
hypertrophic Cardiomyopathy
10
Q
What are the most common causes of stroke in younger adults?
A
Trauma, oral contraceptives, pregnancy/postpartum
11
Q
Acute pericarditis
A
Less than 6 weeks. Causes can be neoplasm, autoimmune, viral
12
Q
What is akinetopsia?
A
The inability to make fluid motion from images seen. Associated with parietal lobe damage
13
Q
Which stroke type is more common?
A
ischemic
14
Q
Cardiac Dysrhythmia
A
most important cause of death from MI, 85% of cases, often reversible
15
Q
What are the USUAL symptoms of hypertension?
A
HTN Is usually asymptomatic!
16
Q
Valve cannot open completely
A
Stenosis
17
Q
What extra-axial hemorrhagic stroke is common in elderly and alcoholics?
A
Subdural
18
Q
What percent obstruction is needed for critical stenosis? What percent obstruction makes blood flow bad even at rest?
A
70 to 75% obstruction. 90%
19
Q
What valve problem can have ocular associations?
A
Mitral valve regurgitation
20
Q
Issues with problem solving is from what lobe stroke?
A
Fontal
21
Q
___% of HTN is secondary HTN
A
5-10%
22
Q
Pericardial tamponade
A
Blood compresses heart outside of ruptured heart (myocardial rupture is rare, 1% of MI)
23
Q
What can cause secondary hyperlipidemia?
A
Diabetes, thyroid/renal/liver dysfunction, Cushing’s syndrome….. ….Obesity, alcohol consumption, diet, and estrogen therapy
24
Q
What is responsible for 80% of CVD?
A
Atherosclerosis
25
What is an atheroma formation? (aka plaque)
Accumulation lipids, degenerating foam cells, and collagen in the tunica intima
26
What are the DDX of TIA (transient ischemic attack)?
Migraines, seizures, similar episodes
27
____ fibrillation will quickly kill you
Ventricular
28
What are some systemic diseases that can cause pericardial inflammation?
Uremia, rheumatic fever, SLE, metastatic malignancies
29
What is the most important cause of death from MI?
Cardiac Dysrhythmia
30
Hearing problems is from what lobe stroke?
Temporal
31
Myocardial contractility and size of vascular compartment influences…
Strove v
32
Memory defects is from what lobe stroke?
Temporal
33
What stroke has a crescent shape?
Subdural stroke
34
Atherosclerosis can lead to
Ischemia , Thrombosis,
| Embolism , Aneurysm
35
How common and fatal are hemorrhagic strokes?
20% common, 80% fatal
36
What are the different degenerative myocardial disorders?
Dilated Cardiomyopathy, restrictive Cardiomyopathy, hypertrophic Cardiomyopathy
37
Which artery is the most common stroke site?
Middle cerebral artery
38
Organ damage from hypertension (7, 3 for heart)
Retinopathy, Left ventricular hypertrophy, Coronary heart disease, congestive heart failure, chronic kidney disease, peripheral arterial disease, strokes
39
What are the causes of hemorrhagic stroke?
HTN!!!! Aneurysm, arteriovenous malformation (skipping capillaries), and trauma
40
What are elevated blood indicators for MI?
Total creatine kinase and cardiac creatine kinase, cardiac troponin
41
Subendocardial MI
Not full thickness, non-overlapping arteries are at risk
42
Insudation
lipids enter the wall of the damaged vessel, LDL filters into the intima
43
140/90 to 159/99 is
Stage 1 hypertension. 140/90 is the goal for HTN treatment
44
Dysarthria is from left or right hemisphere stroke?
Left
45
160/100 to 179/109
Stage 2 hypertension
46
Vertigo is from what lobe stroke?
Occipital
47
What are the 3 intrinsic factors of blood pressure?
Heart rate, stroke volume, and peripheral resistance
48
What supplies the anterior 3/5 of brain?
Internal carotids
49
Difficulty recognizing drawn objects is from what lobe stroke?
Occipital
50
Chronic pericarditis
More than 6 months. Causes from TB, idiopathic.
51
Effects of infective endocarditis?
Valve destruction (murmurs) or perforation, Bacteremia, Septic emboli, Immune complexes
52
Cardiovascular disease is the leading for ___ and ___
Morbidity and mortality
53
Women get HTN (earlier/later) in life
Later
54
Intimia injury, insudation, oxidation, foam cell (results in fatty streak, atheroma/plaque),______
fibrous plaque formation
55
Causes and manifestations of coronary heart disease?
Caused by atherosclerosis, results in angina pectoris and MI
56
What can cause oxidative stress in the brain?
Excess glutamate, intracellular Ca, and reperfusion injury (mitochondrial dysfunction)
57
Having a foramen ovale puts people at increased risk for what?
Stroke
58
What can hypertensive retinopathy lead to?
Increased stroke, decreased vision, deduction of retinal blood flow. "there are characteristic changes with chronic htn retinopathy"
59
What is more common, primary or secondary hyperlipidemia?
Secondary
60
What is artery dissection?
Tear causes blood to run through wrong layer creating a "valve"
61
Women can suddenly develop HTN during ___
3rd trimester of pregnancy
62
What extra-axial hemorrhagic stroke is common in trauma and can cause papilledema in the eye and headaches?
Subarachnoid
63
What are the two most common valve problems?
Mitral valve prolapse, aortic valve stenosis
64
From most common to least common, list ischemic stroke causes:
Thrombotic (35%), embolic, lacunar, dissection (5%)
65
Which cardiomyopathy: reduced filling capacity, heart becomes less elastic
Restrictive Cardiomyopathy
66
Symptoms (variable): Chest pain*, Shortness of breath*, Back pain, Numbness/weakness, Change in vision, Difficulty speaking*
hypertensive emergency
67
_____, insudation, oxidation, foam cell (results in fatty streak, atheroma/plaque), fibrous plaque formation
Intimia injury
68
What hemorrhagic stroke type is associated with Berry aneurysms?
Intra-axial (inside brain tissue)
69
What part of the pathogenesis of atherosclerosis first involves macrophages?
Oxidation
70
Numbers are hypertensive crisis?
>180 / >110
71
What can cause primary hyperlipidemia?
All familial: high LDL, high TG, or both
72
Cholesterol is Necessary for production of (4)
Cell membranes, Steroid hormones, Vitamin D, Bile acids
73
What stroke has a lenticular shape?
Epidural stroke
74
Inability to plan or sequence is from what lobe stroke?
Frontal
75
Difficulty reading/writing/calculating is from left or right hemisphere stroke?
Left
76
What is the #4 cause of death in the US?
Stroke
77
___-side failure typically causes ___-side failure
Left-side failure typically causes right-side failure
78
Intimia injury, _____, oxidation, foam cell (results in fatty streak, atheroma/plaque), fibrous plaque formation
insudation
79
Difficulty reading is from what lobe stroke?
Parietal
80
Intimia injury, insudation, ______, foam cell (results in fatty streak, atheroma/plaque), fibrous plaque formation
oxidation
81
Altered sexual drive is from what lobe stroke?
Temporal
82
What is the pathogenesis of atherosclerosis?
Intimia injury, insudation, oxidation, foam cell (results in fatty streak, atheroma/plaque), fibrous plaque formation
83
120/80 to 139/89 is
Prehypertension. 140/90 is the goal for HTN treatment
84
Prosopagnosia is from what lobe stroke?
Temporal
85
CO =
Stroke v * HR
86
Note: Increased pressure damages endothelium, angiotensin II contraction allow plasma to leak into interendothelial spaces = necrosis
1234
87
Sensory defects is from what lobe stroke?
Parietal
88
____ fibrillation more common than _____
Atrial fibrillation more common than ventricular
89
How can stress and caffeine affect essential HT?
It can cause homeostatic recalibration, causing too much sympathetic activity
90
What's a fatty streak?
A lesion from foam cell aggregates-- a precursor to a plaque/atheroma
91
Core is less than __% blood flow
15
92
What is the rule of thirds?
A third of stroke patients: recover with no/minimal disability, recover with residual disability, and die
93
Akinetopsia is from what lobe stroke?
Parietal
94
What numbers are desired BP?
90/60 to 120/80
95
CO * Peripheral resistance =
Arterial pressure
96
What supplies posterior 2/5th of brain, cerebellum, and brainstem?
Vertebral arteries
97
What is a watershed area?
The areas that are most at risk for stroke (no redundancy)
98
What are the most common bacteria in infective endocarditis?
Streptococcus, Staphylococcus
99
Visual field defects is from what lobe stroke?
Occipital
100
Atherosclerosis is responsible for __% of CVD
80
101
What is the criteria for hypertensive urgency?
Greater than 180/110 with no end organ damage
102
Wernicke's aphasia is from what lobe stroke?
Temporal
103
Aggressive behavior is from what lobe stroke?
Temporal (although I would think frontal also)
104
What extra-axial hemorrhagic stroke commonly affects the middle meningeal artery?
Epidural
105
What are cotton wool spots?
Swelling of axons in the nerve fiber layer
106
Mexican Americans have lower/higher rates of HTN
Lower
107
What are the ocular manifestation of hyperlipidemia?
Arcus, xanthelasma, lipemia retinalis
108
Trouble with frontal eye fields is from what lobe stroke?
Frontal
109
What's the number one way to prevent stroke?
Control hypertension
110
Atherosclerosis is injury to the ____
Intima (and endothelium)
111
95% of HTN cases are what type of HTN?
Essential (Primary) HTN
112
What numbers are hypotension?
lower than 90/60
113
Heart valve order?
Tri pul mi aorta
114
Total cholesterol (TC) of ___ mg/dl regresses atherosclerosis
70 mg/dl or lower
115
Diplopia is common in what strokes?
Brainstem and occipital
116
Difficulty drawing objects is from what lobe stroke?
Parietal
117
Difficulty reading/writing is from what lobe stroke?
Occipital
118
Stroke v * HR =
CO
119
Can have ___-side failure without ___-side failure
Can have right-side failure without left-side failure
120
Total cholesterol (TC) of ___ mg/dl increases risk for CVD
160 mg / dl or higher
121
Inability to name an object is from what lobe stroke?
Parietal
122
___ is the Most common reason for hospitalization for those over 65
Heart failure
123
What is pheochromocytoma?
It's an Adrenal tumor that secretes vasoconstrictive hormones
124
paralysis is from what lobe stroke?
Frontal
125
Which stroke type is more fatal?
Hemorrhagic
126
What is hemispatial neglect?
Not a vision problem; inability to attend to one side of world
127
which heart problem is an issue in developing countries?
Rheumatic heart disease
128
What are the percentages of normal blood flow experienced in an ischemic core vs penumbra?
Core is less than 15%, penumbra is 15-40%
129
Broca's aphasia is from what lobe stroke?
Frontal
130
What is the criteria for hypertensive emergency?
Greater than 180/110 WITH end organ damage
131
What's a foam cell?
swollen macrophages that eat fat
132
penumbra is ___% blood flow
15-40
133
What are the symptoms of artery dissections?
Headache or neck pain, Horner's syndrome, Transient vision loss, Ischemic stroke
134
How common and fatal are ischemic strokes?
80% common, 40% fatal
135
Intimia injury, insudation, oxidation, foam cell (results in _____, atheroma/plaque), fibrous plaque formation
fatty streak
136
What's the minimum HDL level you want?
40 mg /dl or higher. This is good cholesterol
137
Note CHD risk factors:
Smoking*, Hypertension*, Hyperlipidemia*, Diabetes*, Obesity, High alcohol consumption, Sedentary lifestyle, Family history of heart disease, Type A personality
138
90/60 to 120/80 is
Desired BP
139
Intimia injury, insudation, oxidation,_____ (results in fatty streak, atheroma/plaque), fibrous plaque formation
foam cell
140
Rheumatic heart disease
5-15 years old, type II hypersensitivity to group A strep
141
Symptoms: Severe headache*, Shortness of breath , Nosebleeds, Severe anxiety*
hypertensive urgency
142
Arterial pressure=
CO * Peripheral resistance
143
What complications result from Hypertensive heart disease? 5
Left ventricular hypertrophy, Myocardial ischemia, coronary artery disease, cardiac dysrhythmia, heart failure
144
What are the compensatory mechanisms for HF?
Increased sympathetic, vasoconstriction, myocardial hypertrophy, renin-angiotensin mech
145
Transmural MI
Occlusion of a major coronary artery and Affects complete thickness of heart wall
146
Among long-term stroke survivors….
71% are work-impaired, 31% require daily assistance, 20% need help walking, 16% live permanently in nursing homes
147
Spatial disorientation is from left or right hemisphere stroke?
Right
148
What is tissue plasminogen activator (tPA)?
It's a one time IV treatment for acute ischemic stroke used within 3 hours of stroke). Dissolves clot, but can cause hemorrhaging
149
Roles of pericardium:
Holds heart, helps regulate pressure and rate, first line defense. The fluid is cushion and lubricant
