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Pathology III > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

What is the most common type of non-ischemic

cardiomyopathy?

A

dilated

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2
Q

What are the three types of cardiomyopathy?

A

dilated, hypertrophic, restrictive

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3
Q

What is the ejection fraction of cardiomyopathy?

A

<40%

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4
Q

Most common cause of non-ischemic dilated cardiomyopathy?

A

chronic alcoholism

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5
Q

What are three characteristics of hypertrophic cardiomyopathy?

A

myocardial hypertrophy, abnormal diastolic filling, and intermittent ventricular outflow

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6
Q

Hypertrophic cardiomyopathy is classified as a __________disease.

A

genetic

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7
Q

What part of the ventricle enlarges with hypertrophic cardiomyopathy?

A

The walls < SEPTUM

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8
Q

What are the most common causes of restrictive cardiomyopathy?

A

amyloidosis, hemochromatosis

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9
Q

Which valves are most commonly infected in endocarditis?

A

Left side: mitral and aortic

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10
Q

Most common community acquired endocarditis is a result of what organism(s)?

A

1) S. aureus 2) AH Strep (S. viridans) 3) Culture negative

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11
Q

Most common nosocomial-acquired endocarditis is a result of what organism(s)?

A

1) S. aureas (mostly MRSA) 2) AH Strep. 3) Culture negative

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12
Q

Portals of entry for organisms that may cause endocarditis:

A

Poor dental health, dental procedures, genitourinary infections, procedures of the GU tract, skin infections, pulmonary infections, IV drug use

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13
Q

Sub-acute vs. Acute endocarditis

A

Acute: normal heart valve, highly virulent organism, 50% death in days-weeks.

Sub-acute: already damaged valve, less virulent, recovery

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14
Q

What is the most consistent sign of endocarditis?

A

Fever

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15
Q

Sub-acute endocarditis may result in what sequelae from embolized vegetations?

A

petechiae (mouth, tongue), splinter hemorrhages, Roth’s spots

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16
Q

What are the risk factors for endocarditis?

A

Artificial valves, immunocompromised, IV drug use, alcoholics, indwelling catheters, vascular grafts, AND rheumatic heart dz

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17
Q

What organism is associated with endocarditis of native valves which may be damaged?

A

S. viridans -main cause of sub-acute endocarditis

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18
Q

Which organism is associated with endocarditis involving prosthetic valves?

A

Staph epidermitis

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19
Q

Which organism is associated with endocarditis involving IV drug abuse?

A

Staph aureus

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20
Q

Which organism is associated with endocarditis involving alcoholism?

A

anaerobes and oral cavity bugs

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21
Q

Which organism is associated with endocarditis involving procedures or indwelling catheters?

A

Gm neg : E. coli

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22
Q

Which organism is associated with endocarditis involving patient with carcinoma of the colon?

A

Strep bovis

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23
Q

What is the endocarditis of SLE called?

A

Libman-Sacks endocarditis (collagen vascular inflammatory endocarditis)

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24
Q

What’s the gross appearance of Libman-Sacks lesions vs. infectious endocarditis?

A

Libman-Sacks: Flat and spreading

Infectious: Chunky and pedunculated

25
Q

Endocarditis resulting from hypercoagulable state (Trousseau’s syndrome)?

A

Marantic endocarditis -pancreatic and lung cancers

26
Q

Causes of myocarditis:

A

Infection (VIRAL-MOST COMMON), autoimmune, drugs, or transplant rejection

27
Q

Most common infectious agents causing myocarditis?

A

1) Coxsackie virus (group B), HIV, Meningococcus, R. typhi, Borrelia burgdorferi, toxoplasmosis

28
Q

What can be found microscopically in viral myocarditis?

A

Lymphocyte infiltrates

29
Q

Define stenosis

A

Failure of a valve to open completely

30
Q

Define insufficiency

A

Failure of valve to close completely

31
Q

Most common valve dz?

A

Aortic stenosis and mitral regurg and insufficiency (MVP?_

32
Q

Partial fusion of cusps

A

Raphe

33
Q

Mitral valve prolapse affects what population more readily?

A

Women, 20-40yo

34
Q

How is MVP often found?

A

Incidentally, during routine exam

35
Q

Complications of MVP

A

Infective endocarditis, mitral insufficiency, stroke/systemic infarct, arrhythmias

36
Q

Rheumatic fever follows infection by what organism?

A

Grp A beta-hemolytic strep (S. pyogenes)

37
Q

What marker in the blood can indicate the likelihood of developing rheumatic heart dz?

A

ASO titers remaining high

38
Q

Acute rheumatic fever is likely due to an immune response caused by what Ab which cross-react with cardiac myosin?

A

anti-streptococcal M protein

39
Q

What are aschoff bodies and what are they pathognomonic for?

A

Rheumatic fever/heart dz

Aschoff bodies are granulomatous structures consisting of fibrinous material, lymphocytes, occasional plasma cells and macrophages with surround necrotic centers

40
Q

What are fused macrophages called?

A

Caterpillar cells or Anitschkow cells, due to appearance of chromatin

41
Q

Most important cardiac consequence of rheumatic heart dz?

A

Mitral stenosis (#2 aortic stenosis)

42
Q

On physical exam, how is carditis most commonly detected?

A

Tachycardia (out of proportion with fever) and new murmur

43
Q

What is the gross appearance of mitral stenosis?

A

“fish mouth”

44
Q

What is the pathogenesis of chronic rheumatic heart dz?

A

Progressive deformity of the valve leading to stenosis combined with insufficiency.

45
Q

Most common complications of prosthetic heart valves?

A

Thrombosis, infection, structural failure (bioprosthesis), dehiscence (prosthetic)

46
Q

Non-cardiac manifestations of rheumatic heart dz?

A

polyarthritis (#1), Sydenham’s chorea, erythema marginatum, subcutaneous nodules

also: abdominal pain, arthralgias, fever, and development of pneumonia

47
Q

Most common causes of pericarditis?

A 
Idiopathic (viral?) -MOST COMMON
Infectious
Inflammatory
Autimmune
Drugs
Trauma
Misc -Tumors
48
Q

What dz would you be concerned for if you appreciated a hemorrhagic pericardial effusion?

A

TB, cancer, trauma

49
Q

What are the 5 types of pericarditis?

A

Serous, fibrinous, hemorrhagic, purulent, caseous

50
Q

Characteristics of serous pericarditis?

A

Usually non-infectious (possibly viral)
Uremia
Autoimmune - SLE, RA
Often complete resolution

51
Q

Characteristics of fibrinous pericarditis?

A 
Post-MI or Dressler's syndrome
Post-cardiac surgery
Trauma
Chronic uremia
Autoimmune -SLE, RA
Bread and butter appearance
Audible friction rub
52
Q

Characteristics of hemorrhagic pericarditis?

A

TB, Tumor, Trauma
Bacterial infection
Bleeding disorder

53
Q

Characteristics of purulent pericarditis?

A

Septic infection
Exudative
Resolution often involves scarring

54
Q

Most common heart tumor?

A

Atrial myxoma -benign

Most occur in the left atrium.

55
Q

Microscopic findings of myxoma?

A

Polygonal or elongated cell shapes
Mono or multi nucleated
Eosinophilic cytoplasms

56
Q

Most common primary pediatric tumor of the heart?

A

Rhabdomyoma -behavior benign, but positioning can lead to lethal arrhythmias and chamber obstruction

Spontaneous regression

57
Q

Neoplasm with the greatest propensity to metastasize to the heart?

A

Melanoma

58
Q

Most common malignancy found in the heart?

A

Lung cancer -proximity to heart, lymphatic invasion

Bronchogenic carcinoma

Pathology III (2 decks)

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