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Cardiology > Pathology > Flashcards

Pathology Flashcards

1
Q

emryonic defect which results in tetralogy of fallot

A

anterosuperior displacement of the infundibular septum

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2
Q

exposure to what can cause ebstein anomaly

A

lithium exposure in utero

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3
Q

risk factors of persistent pulmonary hypertension in the newborn

A

aspiration of meconium-stained amniotic fluid
neonatal pnuemonia

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4
Q

neonate with diabetic mother may be at risk of what cardiac complications

A

transportation of great arteries
truncus arteriosus
tricuspid atresia
VSD

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5
Q

cardiac defect associated with williams syndromec

A

supravalvular aortic stenosis

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6
Q

cardiac defect associated with 22q11 deletion syndrome

A

truncus arteriosus, tetralogy of fallot

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7
Q

cardiac defects associated with downs syndrome

A

AVSD (endocardial cushion defect), ASD, VSD

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8
Q

cardiac defects associated with congenital rubella

A

PDA, pulmonary artery stenosis, septal defects

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9
Q

string of beads appearance of renal artery

A

fibromuscular displasia
most common cause of secondary HTN in females

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10
Q

2 main types of arteiolosclerosis

A

thickening of arteries and artioles
1. hyaline - vessel wall thickening due to leakage of protein into subendothelial due to diabetes and hypertension

  1. hyperplastic - ‘onion skinning’ in severe hypertension with proliferation of smooth muscle cells
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11
Q

stanford vs DeBakey classification of aortic dissection

A

stanford (2 syllables = 2 types)
type 1 - ascending +/- arch/descending
type 2 - descending only

DeBakey (3 syllables = 3 types)
type 1 - ascening + descening
type 2 - ascending only
type 3 - descending only

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12
Q

at what point does the asending become the descending aorta

A

becomes the descending aorta just below the left subclavian artery

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13
Q

subclavian steal syndrome pathophysiology

A

occlusion of the subclavian artery proximal to the vertebral artery = hypoperfusion distal to stenosis
causes reversed blood flow in the vertebral artery = reduced cerebral perfusion on exertion of affected arm

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14
Q

subclavian steal syndrome features

A

BP difference in L vs R arm
arm ischaemia, pain, paraesthesia
vertebrobasillar insufficiency = dizziness, vertigo

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15
Q

risk factors for coronary artery vasospams

A

tobacco (number 1 risk)
cocaine
amphetamines
alcohol
triptans

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16
Q

treatment for coronary artery vasospams

A

CCB
nitrates
smoking cessation

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17
Q

MI complication;
- acute mitral valve regurgitation –> cardiogenic shock, severe pulmonary oedema

A

papillary muscle rupture

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18
Q

MI complication;
- cardiac tamponade, sudden death

A

ventricular free wall rupture

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19
Q

pathophysiology of dresslers syndrome

A

autoimmune pericarditis which develops 2 weeks after MI
cardiac antigens released after injury -> deposition of immune complexes in pericardium -> inflammation

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20
Q

MI complication;
- chest pain, murmur, HF, embolus

A

pseudoaneurysm

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21
Q

what is more likely to rupture and why - ventricular pseudoaneurysm or true ventricular aneurysm

A

pseudoaneurysm as its not contained within endocardium or myocardium

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22
Q

most common gene in familial dilated cardiomyopathy

A

TTP gene encoding the sarcometric protein titin

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23
Q

type of hypertrophy found in dilated cardiomyopathy

A

eccentric hypertrophy (sarcomeres added in series)

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24
Q

mutations in genes encoding what are responsible for familial hypertrophic cardiomyopathy

A

mutations in genes encoding sarcometric proteins such as myosin binding protein C and beta-myosin heavy chain

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25
Q

what drugs are avoided in hypertrophic cardiomyopathy

A

nitrates
betablockers
diuretics

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26
Q

eosinophillic infiltrates in myocardium

A

loffler endocarditis (associated with eosinophillic syndrome)

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27
Q

causes of restrictive / infiltrative cardiomyopathy

A

PLEASe Help
postradiation fibrosis
loffler syndrome
endocardial fibroelastosis
amyloidosis
sarcoidosis
haemochromatosis

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28
Q

cardiomyopathy that causes diastolic dysfunction

A

hypertrophic cardiomyopathy
restrictive/infiltrative cardiomyopathy

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29
Q

cardiomyiipathy that causes systolic dysfunction

A

dilated cardiomyopathy

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30
Q

condition which causes ventricular concentric hypertrophy vs eccentric hypertrophy

A

concentric = hypertrophic CM
eccentric = dilated CM

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31
Q

primary disturbance driving each type of shock

A

hypovolaemic - decrease in PCWP
cardiogenic - decrease in CO
obstructive (PE, tamponade) - decrease in CO
distrubutive (sepsis, CNS) - decrease in SVR

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32
Q

pathophysiology of pulsus paradoxus

A

decrease in systolic bP > 10mmHg during inspiration
inspiration causes increase in venous return –> increase rv filling –> interventricular septum bows toward LV (due to decrease pericardial compliance ) –> reduced LV ejection = reduced BP

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33
Q

what conditions is pulsus paradoxus found in

A

constrictive Pericarditis
obstructive pulmonary disease (Croup, OSA, Asthma, copd)
cardiac Tamponade

(P COAT)

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34
Q

most common valve involved in endocarditis

A

mitral valve

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35
Q

most common valve involved in endocarditis in IVDU

A

tricuspid valve (dont tri drugs)

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36
Q

causative organism of endocarditis in prosthetic valves

A

staph epidermidis

37
Q

causative organism of endocarditis in IVDU

A

staph aureus, pseudomonas, candida

38
Q

causative organism of endocarditis colon cancer

A

s gallolyticus

39
Q

causative organism of endocarditis in GI/GU procedures

A

enterococcus

40
Q

causative gram negative organism of endocarditis

A

HACEK
haemophillus, aggregatibacter, cardiobacterium, eikenella, kingella

41
Q

causative culture negative organism of endocarditis

A

coxiella, bartonella

42
Q

causative organisms of endocarditis; acute and sub onset

A

acute - staph aureus
subacute - viridans strep

43
Q

libman sacks endocarditis

A

aseptic endocarditis found in SLE due to hypercoaguable state

44
Q

tree bark appearance of aorta

A

tertiary syphyillis - calcification of aorta

45
Q

consequences of syphillitic heart disease

A

aortic aneurysms
aortic insufficiency

46
Q

causative organisms of rheumatic fever

A

group A beta haemolytic streptococci

47
Q

heart valve most affected in rheumatic fever

A

mitral

48
Q

what typ eof hypersenstivity is rheumatic fever

A

type II

49
Q

diagnostic features of rheumatic fever

A

JONES (with a love heart for O)
Joint (migratory polyarthritis)
carditis
Nodules in skin
Erythema marginatum (evanscent rash with ring margin)
Sydenham chorea (involuntary irregular movements of limbs and face)

50
Q

pathology and immunologic features associated with rheumatic fever

A

aschoff bodies
anti streptolysin O
anti-DNase B titres

51
Q

what are aschoff bodies and what condition are they found in

A

rheumatic fever

granuloma with giant cells and anitschkow cells (enlarged oval wavy rodlike nucleus)

52
Q

what condition might rhabdomyomas be associated with

A

tuberous sclerosis

53
Q

where in the heart do myxomas typically occur

A

atria

54
Q

what type of interleukin does myxomas produce

A

IL-6

55
Q

histology - gelatinous material, cells immersed in glycosaminoglycans

A

myxoma

56
Q

ST elevation in leads V4-V6 would be due to thrombus in what vessel

A

distal left anterior descending

57
Q

ST elevation in lead V1-V4 would be due to thrombus in what vessel

A

proximal left anterior descending

58
Q

ST elevation in lead V1-V6 would be due to thrombus in what vessel

A

main left anterior descending

59
Q

what is the preferred medication to lower high triglyceride levels ? and their mechanism of action

A

fibrates
active PPAR alpha to decrease expression of 7-alpha-hydroxylase which is the rate limiting step of bile acid synthesis

60
Q

side effect of fibrates

A

cholesterol gallstones

61
Q

hereditary angioedema pathophsyiology

A

inherited disorder of dysfunctional or deficient C1 esterase inhibitor leading to increased levels of bradykinin or C1 complement pathway products which cause vasodilation and increased permeability

62
Q

hereditary angiodema presentation

A

episodic oedema of arms, face, genitals etc

63
Q

what medication should be avoided in patients with hereditary angiodema

A

ACE inhibitors

64
Q

underlying mechanism of AF

A

autonomous bursts of electrical activity within pulmonary veins

65
Q

underlying mechanism of sick sinus syndrome

A

age related degeneration of SA node

66
Q

mechanism of carotid massage in SVT

A

massaging carotid sinus stimulates carotid baroreceptors which decreases HR via activation of parasympathetic nervous system (via glossopharyngeal nerve)

67
Q

post MI - hypotension, tachycardia, respiratory distress

A

papillary muscle rupture
leads to mitral regurgitation and acute pulmonary oedema

68
Q

post MI - enlarged heart sillohette, hypotension, muffled heart sounds

A

left ventricular free wall rupture
causes tamponade and sudden death

69
Q

macophages with wavy nuclei

A

aschoff bodies found in rheumatic fever

70
Q

pathological features of cardiac tissue hours after MI

A

eosiophil infiltration
large influx of Ca which results in hypercontraction of sarcomeres

71
Q

JVC distention, bilateral upper limb swelling, facial swelling and skin blanching

A

SVC syndrome

72
Q

severe complications of SVC syndrome

A

increased risk of aneurysm or rupture of intracranial arteries

73
Q

pancoast tumour which causes horner syndrome is due to obstruction of what structure

A

stellate ganglion

74
Q

arrythmias, dilated cardiomyopathy, megacolon, megaoesophagus

A

chagas disease (trypanosoma cruzi)

75
Q

pathological features of HOCM

A

ventricular concentric hypertrophy (sarcomeres added parralel)
mitral regurgitation
asymmetric septal hypertrophy
systolic motion of anterior mitral valve
(ASK MR SAM)

76
Q

pathology of HOCM

A
77
Q

pathophysiology of rhuematic fever

A

cross-reactivity between bacterial antigen and host immune system at the mitral valve (molecular mimicry)
type II hypersensitivity reaction

78
Q

what type of virus causes rubella

A

positive single-stranded RNA virus of the gene rubivirus

79
Q

what type of bacterium is syphillis

A

a helically coiled spirochete

80
Q

what type of heart failure would be found in amyloidosis

A

restrictive cardiomyopathy

81
Q

causes of dilated cardiomyopathy

A

alcohol
beriberi
chagas disease
coxsachie B
cocaine
doxorubicin

82
Q

mumur found in rhematic heart disease

A

mid-diastolic rumble with opening snap at the apex

83
Q

mid-systolic murmur with wide, fixed S2

A

ASD

84
Q

most common cause of sudden death shortly after MI and its mechanism

A

arrythmias
re-entrant circuits

85
Q

what is the most common causative organism of infective endocarditis in a patient on haemodialysis

A

staph aureus

86
Q

what type of bacteria is staph aureus

A

gram psitive, catalase positive, coagulase positive, cocci

87
Q

pathophysiology of tertiary syphillis heart disease

A

endarteritis in the vasa vasorum which causes ischaemia of the aorta = aortic aneurysms and aortic insufficiency

88
Q

why is betablockers contraindicated in patients with MI + cocaine use

A

unopposed vascular smooth muscle contraction via alpha 1 receptors

Cardiology (20 decks)

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