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Cardio Step 1 > Pathology Part 2 > Flashcards

Pathology Part 2 Flashcards

1
Q

What is an aortic aneurysm?

A

Localized pathological dilation of BV

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2
Q

Abdominal aortic aneurysm is associated with _________ and occurs more frequently in _______ over the age of __________.

A

atherosclerosis, hypertensive male smokers, 50

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3
Q

Thoracic aortic aneurysm is associated with what?

A
  • Hypertension
  • Cystic medial necrosis (marfan syndrome)
  • Tertiary syphilis
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4
Q

What is an aortic dissection?

A

Longitudinal intraluminal tear forming a false lumen

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5
Q

Aortic dissection is associated with what?

A
  • Hypertension
  • Bicuspid aortic valve
  • Cystic medial necrosis
  • Inherited connective tissue disorders
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6
Q

What does aortic dissection present with?

A

tearing chest pain radiating to the back

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7
Q

CXR in aortic dissection shoes what?

A

mediastinal widening

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8
Q

The false lumen can be….

A
  • limited to the ascending aorta
  • Propagate from the ascending aorta
  • Propagate from the descending aorta
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9
Q

Aortic dissection can result in

A
  • Pericardial tamponade
  • Aortic rupture
  • Death
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10
Q

What are the ischemic heart disease manifestations?

A
  • Angina
  • Coronary steal syndrome
  • Myocardial Infarction
  • Sudden Cardiac Death
  • Chronic ischemic heart disease
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11
Q

Angina is a CAD Narrowing of _______ with no _________

A

> 75%, myocyte necrosis

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12
Q

Stable angina is mostly secondary to _______

A

Atherosclerosis

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13
Q

What is seen on ECG of stable angina? And how does it present?

A

ST depression, chest pain with exertion

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14
Q

Prinzmetal’s variant angina occurs secondary to _______

A

coronary artery spasm

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15
Q

Prinzmetal’s variant angina presents on the ECG as what?

A

ST depression

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16
Q

Unstable/crescendo angina is what?

A

Thrombosis with incomplete coronary artery occlusion

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17
Q

What is sen on ECG of Unstable/crescendo angina? and how does it present?

A

ST depression, worsening chest pain at rest of with minimal exertion

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18
Q

With coronary steal syndrome a vasodilator may do what?

A

Aggravate ischemis by shunting blood from an area of critical stenosis to an area of higher perfusion

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19
Q

Myocardial infarction is most often ______ thrombosis due to ________ with complete ________ and ________.

A

acute, coronary artery atherosclerosis, occlusion of coronary artery, myocyte necrosis

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20
Q

MI on ECG initially shows ______ progressing to _____ with ________ and ___________

A

ST depression, ST elevation, continued ischemia, transmural necrosis

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21
Q

SCD is what?

A

Death from cardiac causes within 1 hour of onset of symptoms

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22
Q

SCD is most often due to a _________

A

lethal arrhythmia (VFib)

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23
Q

SCD is associated with what in 70% of cases?

A

CAD

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24
Q

Chronic ischemic heart disease leads to a progressive onset of ________ due to chronic ischemic myocardial damage.

A

CHF

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25
What are the most common coronary arteries to be occluded?
LAD>RCA>circumflex
26
What are the symptoms of MI
- Diaphoreisis - Nausea - Vomitting - Severe retrosternal pain - Pain in L arm and/or jaw - Shortness of breath - Fatigue
27
What gross and light microscope things are seen at 0-4 hours post MI?
None
28
What are the risks at 0-4 hours post MI?
- Arrythmia - CHF exacerbation - Cardiogenic Shock
29
What are the gross findings of 4-12 and 12-24 hours post MI?
Occluded artery with area of infarct and dark mottling | Tetrazolium stain reveals pale area
30
What is seen on the light microscope at 4-12 hours?
- Early coagulative necrosis - Edema - hemorrhage - Wavy fibers
31
What are the risks at 4-12 hours?
Arrhythmias
32
What is seen on the light microscope at 12-24 hours?
- Contraction bands from reperfusion injury - Release of necrotic cell content into blood - Beginning of neutrophil migration
33
What are the risks at 12-24 hours?
Arrhythmias
34
What are the gross findings at 1-3 days?
Hyperemia
35
What is the light microscope finding at 1-3 days?
- Coagulative necrosis - Tissue surrounding infarct shows acute inflammation - Neutrophil migration
36
What are the risks at 1-3 days?
Fibrinous pericarditis
37
What are the gross findings at 3-14 days?
- Hyperemic border | - Central yellow brown softening (maximum at 10 days)
38
What are the light microscope findings at 3-14 days?
Macrophage infiltration followed by granulation tissue at the margins
39
What are the risks at 3-14 days?
- Free wall rupture leading to tamponade - Papillary muscle rupture - Ventricular aneurysm - Interventricular septal rupture (because of macrophages that have degraded important structural components)
40
What are the gross findings at 2 weeks-months?
Gray-white area
41
What are the light microscope findings at 2 weeks-months?
Contracted scar complete
42
What are the risks at 2 weeks-months?
Dressler's syndrome
43
In the first 6 hours ______ is the gold standard for diagnosing MI
ECG
44
What arises after 4 hours and is elevated for 7-10 days?
Cardiac troponin
45
What is the most specific protein marker for MI?
Cardiac troponin
46
What is predominantly found in myocardium but can also be released from skeletal muscle?
CK-MB
47
CK-MB is useful in diagnosing reinfarction following acute MI because _________
its levels return to normal after 48 hours
48
ECG changes include...
- ST elevation (transmural infarct) - ST depression (subendocardial infarct) - Pathologic Q wave (transmural infarct)
49
What are the characteristics of transmural infarcts?
- Increased necrosis - Entire wall - ST Elevation on ECG with Q waves
50
What are the characteristics of subendocardial infarcts?
- Due to ischemic necrosis of <50% of ventricle wall - Especially vulnerable to ischemia - ST depression on ECG
51
Anterior wall (LAD) leads to Q waves where?
V1-V4
52
ANteroseptal (LAD) leads to Q waves where?
V1-V2
53
Anterolateral (LCX) leads to Q waves where?
V4-V6
54
Lateral Wall (LCX) leads to Q waves where?
I, avL
55
Inferior Wall (RCA) leads to Q waves where?
II, III, aVF
56
What are the complications of MI?
- Cardiac Arrhythmias - LV failure and pulmonary edema - Cardiogenic shock - Ventricular free wall rupture - Ventricular aneurysm formation - Postinfarction fibrinous pericarditis - Dressler's syndrome
57
What is an important cause of death before reaching the hospital and is common in the first few days?
Cardiac Arrhythmia
58
Cardiogenic shock uccurs when when there is a ________ and there is a _______
large infarct, high risk of mortality
59
Free wall rupture leads to what?
Cardiac tamponade and papillary muscle rupture
60
Tamponade and pap muscle rupture leads to what?
Severe mitral regurgitation and interventricular septum rupture (leads to VSD)
61
Ventricular aneurysm formation leads to what?
- Decreased CO - Risk of arrhythmia - Embolus from mural thrombus
62
When is the greatest risk for ventricular aneurysm formation?
1 week post MI
63
What is postinfarction fibrinous pericarditis? When does it occur?
Friction rub, 1-3 days post MI
64
What is Dressler's syndrome? When does it occur?
Autoimmune phenomenon resulting in fibrinous pericarditis, several weeks post-MI

Cardio Step 1 (14 decks)

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