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Cardio Step 1 > Pathology Part 1 > Flashcards

Pathology Part 1 Flashcards

1
Q

What are the 5 T’s of R to L shunts?

A 
Tetralogy 
Transposition
Truncus
Tricuspid
TAPVR
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2
Q

Right to left shunts are _____ cyanosis.

A

Early

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3
Q

What is the most common cause of early cyanosis?

A

Tetralogy of Fallot

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4
Q

Persistent Truncus Arteriosus is what?

A

Failure of truncus arteriosus to divide into pulmonary trunk and aorta

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5
Q

Those with persistent truncus arteriosus are most often accompanied with….

A

VSD

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6
Q

What is tricuspid atresia?

A
  • No tricuspid valve

- hypoplastic RV

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7
Q

Tricuspid atresia requires what other defects?

A

ASD and VSD

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8
Q

What is TAPVR?

A

Pulmonary veins drain into right heart circulation

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9
Q

What other defect is TAPVR associated with?

A

ASD and sometimes PDA to allow for R to L shunting to maintain CO

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10
Q

What are the L to R shunts in the frequency that they occur?

A

VSD>ASD>PDA

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11
Q

Left to right shunts are associated with ______ cyanosis.

A

Late

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12
Q

What drug closes a PDA?

A

Indomethacin

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13
Q

What heart sounds are characteristic of ASD?

A
  • S1: Loud

- S2: Wide, fixed split

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14
Q

What are the steps in Eisenmenger’s syndrome?

A
  1. Uncorrected VSD, ASD, PDA
  2. Compensatory pulmonary vascular hypertrophy
  3. Progressive pulmonary hyptertension
  4. Pulmonary resistance increases
  5. Shunt reverses to R to L
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15
Q

What are the ultimate effects of Eisenmenger’s syndrome?

A

Late Cyanosis
Clubbing
Polycythemia

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16
Q

Tetralogy of Fallot is caused by a _________ displacement of the _______ septum

A

Aterosuperior, infundibular

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17
Q

What are the characteristics of Tetralogy of Fallot?

A

PROVe:

  1. Pulmonary infundibular stenosis
  2. RV hypertrophy
  3. Overriding Aorta (over VSD)
  4. VSD
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18
Q

Why does squatting help with TOF?

A

Reduces blood flow to the legs and thus increases peripheral vascular resistance and decreases the cyanotic R to L shunt across the VSD.

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19
Q

Preferred treatment for TOF is what?

A

Early surgical correction

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20
Q

What is the cause of the early cyanosis tet spells in TOF?

A

The pulmonary stenosis forces R to L flow (instead of usual L to R) and RVH

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21
Q

In transposition of great vessels the ______ leaves the RV and the _______ leaves the LV

A

Aorta, Pulmonary trunk

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22
Q

Because in TGV, there is a _______ of systemic and pulmonary circulations, it is not compatible unless a ________ is present to ________

A

separation, shunt, allow adequate mixing of blood (VSD, PDA, or Patent foramen ovale)

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23
Q

TGV is due to what?

A

Failure of the aorticopulmonary septum to spiral

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24
Q

Without surgical correction, infants_______.

A

die within the first few months of life

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25
Q

Coarctation of the aorta can cause what?

A

Aortic Regurgitation

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26
Q

What is the infantile type of coarctation of the aorta?

A

INfantile is IN close to the heart

Aortic stenosis proximal to insertion of ductus arteriosus (preductal)

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27
Q

What is the adult type of coarctation of the aorta?

A

Stenosis is distal to ligamentum arteriosum (postductal)

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28
Q

For infantile coarctation of the aorta where do you check the pulses of Phyiscal Exam?

A

Femoral

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29
Q

Infantile Coarctation of the aorta is associated with what syndrome?

A

Turners syndrome

30
Q

Adult type coarctation of the aorta is associated with what other things?

A
  1. Notching of the ribs (due to collateral circulation)
  2. Hypertension in the UE
  3. Weak pulses in LE
31
Q

Adult type coarctation is associated with what other abnormality?

A

Bicuspid aortic valve

32
Q

In the fetal period, shunts are _____ to ______.

A

Right, Left

33
Q

In the neonatal period, lung resistance ________ and shunt becomes ______ to ______

A

Decreases, Left, Right

34
Q

PDA is associated with what kind of murmur?

A

Continuous, Machine-like

35
Q

PDA patency is maintained by what?

A

PGE and low oxygen tension

36
Q

Uncorrected PDA can eventually result in what?

A

Late cyanosis in the lower extremities

37
Q

What defect is associated with 22q11 syndrome?

A
  • Truncus Arteriosus

- TOF

38
Q

What defect is associated with Down Syndrome?

A
  • ASD
  • VSD
  • AVSD (endocardial cushion defect)
39
Q

What defect is associted with congenital rubella?

A
  • Septal Defects
  • PDA
  • Pulmonary artery stenosis
40
Q

What defect is associated with Turner Syndrome?

A

Coarctation of the aorta (preductal)

41
Q

What defect is associated with Marfan’s Syndrome?

A

Aortic Insufficiency and dissection (later)

42
Q

What defect is associated with infant of a diabetic mother?

A

TGV

43
Q

Hypertension is defined as a blood pressure of over ________

A

140/90 mmHg

44
Q

What are the risk factors for hypertension?

A
  • Older age
  • Diabetes
  • Smoking
  • Genetics
  • Black>White>Asian
45
Q

90% of hypertension is ________ and 10% is ______

A

Primary, secondary

46
Q

Primary hypertension is related to increase _____ and ________

A

Cardiac output, TPR

47
Q

Secondary hypertension is related to ________

A

Renal disease

48
Q

Malignant hypertension is severe and is a blood pressure of over _________

A

180/120

49
Q

Hypertension predisposes to what?

A
  • Atherosclerosis
  • LVHypertrophy
  • Stroke
  • CHF
  • Renal failure
  • Retinopathy
  • Aortic DIssection
50
Q

What are atheromas?

A

Plaques in blood vessel walls

51
Q

What are xanthomas?

A

Plaques or nodules composed of lipid-laden histiocytes in the skin (especially eyelids aka xanthelasma)

52
Q

What are Tendinous Xanthoma?

A

Lipid deposit in tendon, especially achilles

53
Q

What are corneal arcus?

A

Lipid deposit in cornea, nonspecific (arcus senilis)

54
Q

What is Monckeberg Arteriosclerosis?

A

Calcification in the media of the arteries, especially radial or ulnar

55
Q

Moncheberg artiosclerosis is usually _______ and occurs in ______ arteries. It _______ obstruct flow and the _______ is not involved.

A

benign, pipestem, does not, intima

56
Q

What are the two types of arteriolosclerosis?

A

Hyaline, hyperplastic

57
Q

What is hyalanie arteriolosclerosis?

A

Thickening of small arteries

  • essential hypertension
  • diabetes mellitus
58
Q

What is hyperplastic arteriolosclerosis?

A

Onion skinning

-Malignant hypertension

59
Q

What is atherosclerosis?

A

Fibrous plaques and atheromas form in intima of arteries

60
Q

Atherosclerosis is a disease of ______ arteries and ________ sized muscular arteries

A

elastic, large and medium

61
Q

What are the modifiable risk factors for atherosclerosis?

A
  • Smoking
  • Hypertension
  • Hyperlipidemia
  • Diabetes
62
Q

What are the non-modifiable risk factors for atherosclerosis?

A
  • Age
  • Gender (more in men and postmenopause women)
  • Family History
63
Q

__________ is important in the pathogenesis of atherosclerosis

A

Inflammation

64
Q

What are the first two steps of atherosclerosis progression?

A
  1. Endothelial cell dysfunction

2. Macrophage and LDL accumulation

65
Q

What are the third and fourth steps of atherosclerosis progression?

A
  1. Foam cell formation

4. Fatty streaks

66
Q

What is the fifth step of atherosclerosis progression?

A
  1. Smooth muscle cell migration (involves PDGF and FGF), proliferation, and extracellular matrix deposition.
67
Q

What are the sixth and seventh steps of atherosclerosis progression?

A
  1. Fibrous plaque

7. Complex atheromas

68
Q

What are the complications of atherosclerosis?

A
  • Aneurysms
  • Ischemia
  • Infarcts
  • Peripheral vascular disease
  • Thrombus
  • Emboli
69
Q

What are the locations of atherosclerosis in order of commonality?

A

Abdominal Aorta>Coronary artery>popliteal artery>carotid artery

70
Q

What are the symptoms of atherosclerosis?

A
  • Angina
  • Claudication
  • Can be asymptomatic

Cardio Step 1 (14 decks)

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