REVIEW 2 (cardiac) Flashcards

1
Q

Are cardiac tumors usually benign or malignant?

A

They are usually benign and are pedunculated, (they have a stalk for easy remova)

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2
Q

What are the 3 types of cardiac tumors?

A
  1. Cardiac Myxomas (Adults)
  2. Rhabdomyomas (Kids)
  3. Metastatic Tumors
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3
Q

What is the most common primary cardiac tumor (35-50%)?

A

Cardiac Myxomas

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4
Q

Which primary cardiac tumor?

Most arise from the left atrium (75%), although they can occur in any chamber of the heart or on a valve.

A

Cardiac Myxomas

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5
Q

Which primary cardiac tumor?

  • glistening, gelatinous, polypoid mass, usually 5-6 cms, with a short stalk
  • Sometimes the tumor is sufficiently mobile as to obstruct the mitral valve orifice.
A

Cardiac myxoma

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6
Q

> 1/2 of the patients with cardiac myxomas of the left atrium have clinical evidence of __________

A

mitral valve dysfunction

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7
Q

1/3 of these pts with a cardiac myxoma of the left atrium or left ventricle die of what?

A

embolization of the tumor to the brain

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8
Q

Is surgical removal of cardiac myxomas usually successful?

A

Yes. surgical removal is successful in most cases

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9
Q

What is the most common primary cardiac tumor in infants and children and forms nodular masses in the myocardium.

A

Rhabdomyomas

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10
Q

Which primary cardiac tumor?

  • Almost all are multiple
  • involve both the left and right ventricles, and in 1/3 of cases, the atria as well.
  • In 1/2 of cases, the tumor mass projects into the cardiac chamber.
A

Rhabdomyoma

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11
Q

Which primary cardiac tumor?

Grossly they are pale gray masses, up to several centimeters

A

Rhabdomyomas

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12
Q

What is the most feared complication of an aneurysm no matter the location?

A

-Rupture and death by exsanguination

-the jet of blood may also dissect through the wall of the aorta and form a periarterial second lumen called a Dissecting Aneurysm (this may also be from the root of the aorta)

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13
Q

What comes first in the pathogenesis of atherosclerosis:

Fatty streak

Atheroma

Plaque

Malignant plaque

A

1st- Fatty Streaks

2nd- Atheromas

3rd- Plaques

4th- Malignant plaques

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14
Q

The following is major or minor criteria for “Jones Criteria”? What is this used to dx?

  1. Pancarditis
  2. Polyarthritis
  3. Sydenhams Chorea
  4. Subcutaneous Nodules
  5. Erythema Marginatum
A

Major Criteria

Used to dx RHD

Clinical dx made when 2 major OR 1 major + 2 minor criteria are fulfilled

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15
Q

Major or minor “Jones Criteria? Used to dx what?

  1. h/o Rheumatic Fever
  2. Fever
  3. Arthragias
  4. EKG signs of heart damage
  5. Evidence of prior Strept infection (ASO titers, C-reactive protein, increased sed. rate)
A

Minor criteria

Used to dx RHD

*Clinical dx made when 2 major OR 1 major + 2 minor criteria are fulfilled

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16
Q

When is a clinical diagnosis of RHD made?

(how many major or minor criteria)

A

clinical dx made when:

2 major criteria

OR

1 major + 2 minor criteria are fulfilled

17
Q

The following describes what histologic finding:

  • Aggregates of lymphocytes and macrophages around a central zone of fibrinoid necrosis
  • w/ time it assumes a granulomatous appearance and eventually is replaced by a scar
A

Aschoff Bodies

Seen in the myocardium of acute rheumatic myocarditis

18
Q
A
19
Q

What condition are Aschoff bodies seen in?

A

Acute Rheumatic Myocarditis

20
Q

90% of the time, ______ (L or R) sided heart valves are involved in both RHD and Infective Endocarditis

A

Left sided heart valves

21
Q

What is the only way you get right sided heart vegitation

A

??

22
Q

What is Acute Bacterial Endocarditis (ABE) usually due to?

A

highly vurulent organisms like Staph auereus or the Gram negatives

23
Q

What is Subacute Bacterial Endocarditis (SBE) usually due to?

A

Organisms of less virulence

Streptococcus viridans

24
Q

Which organism is responsible for the most cases of Prosthetic Valve Endocarditis?

A

Staph epidermidis (majority)

other groups- Enterococci, Gram neg bacteria and fungi

25
Q

What is the main organism associated with Endocarditis in IVDA’s?

A

St. aureus (50-60% of cases)

followed by Strept. species and candida (or any skin commensal)

26
Q

RHD- what is responsible for the majority of deaths in the acute phase due to conduction system fibrosis?

A

Myocarditis

27
Q

RHD:

The _______ is responsible for the most deaths after the acute phase

A

Endocarditis