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CV II Exam 2 > Pathology of the Heart IV > Flashcards

Pathology of the Heart IV Flashcards

1
Q

LVH

A

with systemic hypertension (>140/90)***

CHF or arrhythmias

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2
Q

cor pulmonale

A

pulmonary disorder causes pulmonary HTN

leads to right side hypertensive heart disease

COPD, interstitial lung disease, recurrent PE, kyphoscoliosis, obesity

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3
Q

stenosis

A

valve can’t open completely

  • cusp abnormality
  • almost always chronic
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4
Q

insufficiency

A

regurg or incompetence

-reverse flow

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5
Q

functional regurg

A

valve fine

-dilated annulus

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6
Q

most common cause of valve problems

A

rheumatic heart disease - mitral valve

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7
Q

aortic stenosis

A

calcified aortic valve

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8
Q

aortic insufficiency

A

dilation of ascending aorta - HTN and aging

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9
Q

mitral stenosis

A

rheumatic heart disease

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10
Q

mitral insufficiency

A

myxomatous degeneration - prolapse

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11
Q

calcific aortic stenosis

A

senile - in elderly 60-80yo

calcium mass in sinuses of valsalva

lead to LVH (concentric)

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12
Q

bicuspid aortic stenosis

A

in 2% population
-congeintal

more susceptible to calcification
-develps earlier

40-50yo

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13
Q

mitral annular calcification

A

women over 60yo

  • occasional associated with arrhythmias
  • not often affect valvular function
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14
Q

myxomatous degeneration of mitral valve

A

mitral valve prolapse

  • ballooning of leaflets
  • midsystolic click - leaflets hit inside vnetricle wall
  • regurg murmur

secondary dilation of annulus, fibrosis of leaflets, jet lesions, thrombi

  • marfan syndrome
  • young women
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15
Q

young women with midsystolic click, anxiety and depression

A

mitral valve prolapse

aka myxomatous dengeration of mitral valve

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16
Q

acute rheumatic fever

A

from strep pharyngitis - 10 days - 6 weeks after
-antibodies for group A strep attack heart

pancarditis - every layer affected
-myocardium, endocardium, pericardium

also get polyarthritis

immune problem, NOT infection

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17
Q

aschoff bodies

A

acute rheumatic fever

granuloma - macros, lymphos, other inflamm cells

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18
Q

mononuclear in aschoff bodies

A

anitschkow cells

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19
Q

multinucleated in aschoff bodies

A

achoff cells

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20
Q

linear chromatin in aschoff bodies

A

caterpillar cells

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21
Q

chronic rheumatic heart disease

A

rheumatic heart disease

  • long term after acute rheumatic fever
  • chronic valvular disease - mitral and aortic

often mitral stenosis**

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22
Q

jones criteria

A

for acute rheumatic fever

previous group A strep infection
AND 2 major finding, or 1 major and 2 minor findings

Major - polyarthritis, carditis, subQ nodules, erythema marginatum of skin, chorea
minor - fever, arthralgia, acute phase reactants

23
Q

acute vs. chronic rheumatic?

A

acute - vegetations on valve (majority mitral)
chronic - diffuse fibrous thickening

VEGF - with revascularization

24
Q

rheumatoid heart disease

A

NOT rheumatic

-no aschoff bodies

25
Q

infective endocarditis organisms

A

strep viridans
staph aureus
HACEK - haemophilus, actinobacillus, cardiobacterioum, eikenella, kingella

26
Q

artificial valves

A

often strep epidermidis causing infective endocarditis

27
Q

infective endocarditis

A

bulky vegetations of fibrin/platelet clot and organisms

  • erode away valves
  • possible for systemic emboli

usually left heart valves

unless IV drug user - right side

28
Q

acute bacterial endocarditis

A

worse
-very high fever, heart problems

staph aureus

IV drug users

29
Q

subacute bacterial endocarditis

A
  • intermittent fevers
  • strep viridans

more common

30
Q

diagnosis for infective endocarditis

A

3 cultures in 24 hours

use duke criteria
2 major, 1 major/3 minor, 5 minor

31
Q

janeway lesions

A

new bumps on palms and soles of feet

from infective endocarditis

32
Q

osler noes

A

nodes in pulp of digits

from infective endocarditis

33
Q

roth spots

A

oval retinal hemorrhage with pale centers

from infective endocarditis

34
Q

duke criteria

A

for diagnosis of infective endocarditis
2 major, 1 major/3 minor, 5 minor

MAJOR

  • positive blood culture
  • EKG findings diagnostic
  • new murmur

MINOR

  • IV drug use
  • fever
  • vascular lesions
  • immune - osler, roth, janesaw
  • EKG consistent
35
Q

nonbacterial thrombotic endocarditis

A

NBTE

  • along lines of closure of valve leaflets
  • sterile - no microorganisms
  • risk fx - hypercoag

aka - marantic endocarditis

thrombi can embolize

36
Q

libman sacks disease

A

non-infected vegetations

  • pt with SLE
  • malar rash
  • new murmur

any surface of mitral/tricuspid valves

37
Q

vegetation both sides of valve

A

libman sacks - SLE

38
Q

vegetations that extend to chordae tendinae

A

infective endocarditis

39
Q

small bland vegetation at line of closure

A

NBTE

40
Q

small, warty vegetations, on line of closure

A

rheumatic heart disease

41
Q

carcinoid syndrome

A

metastatic tumor - releases substances

  • serotonin, kallikrein, bradykinin, prostaglandins, histamine
  • diarrhea, flushing, skin rash, bronchoconstriction
  • and fibrous intimal thickening of endocardial surfaces

gut tumor - right heart
-tumor in lung - left heart

42
Q

fen/phen

A

old drug for weight loss - can lead to thickening of endocardial surfaces

43
Q

cardiomyopathy

A

heart disease from primary abnormality of myocardium

44
Q

dilated cardiomyopathy

A

majority

large flabby heart

45
Q

hypertrophic cardiomyopathy

A

thick left ventricle - banana shaped space

46
Q

restrictive cardiomyopathy

A

uncommon

-increase in mass without increased volume of left ventricle

47
Q

myocarditis

A

inflammation cause of myocardial injury

48
Q

coxsackie A and B

A

major cause of myocarditis

49
Q

major causes of myocarditis

A 
coxsackie A and B viruses
lyme disease - borrelia burgorferi
hypersensitivity - eosions
-trichinosis - helminths from undercooked meat
-chagas disease - trypsanoma cruzi
50
Q

trypsanoma cruzi

A

chagas disease

cause of myocarditis

51
Q

round nucleus myocarditis

A

lymphocyte
-mononuclear

viral infection

52
Q

bi-lobated nucleus myocarditis

A

eosinophils

hypersensitivity myocarditis

53
Q

giant cells in myocarditis

A

giant cell myocarditis

CV II Exam 2 (18 decks)

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