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NYCC Visceral Pathology > Rheumatic Heart Disease & Complications > Flashcards

Rheumatic Heart Disease & Complications Flashcards

1
Q

What is a pancarditis?

A

Inflammation of all three layers of the heart

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2
Q

What pathology is an example of a pancarditis?

A

Acute rheumatic heart disease

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3
Q

What is the etiologic agent of rheumatic fever/heart disease?

A

Group A beta-hemolytic streptococcus pyogenes

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4
Q

What plays a pivotal role in the manifestation of rheumatic heart disease?

A

Molecular mimicry

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5
Q

How does rheumatic heart disease manifest?

A

Untreated systemic streptococcus pyogenes infection causes the body to make antibodies against streptococcus that also attack your own tissues

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6
Q

What cells are present in myocarditis caused by rheumatic heart disease?

A

Anitchkow cells, lymphocytes, and macrophages

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7
Q

What is an Aschoff body?

A

Focal granuloma of chronic inflammation seen in rheumatic heart disease

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8
Q

What pathology is an Aschoff body associated with?

A

Rheumatic heart disease

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9
Q

What are anitchkow cells?

A

Giant cells of rheumatic heart disease

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10
Q

What pathology are anitchkow cells seen in?

A

Rheumatic heart disease

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11
Q

What is characteristic of the nuclei of anitchkow cells?

A

Caterpillar shaped nuclei

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12
Q

Caterpillar shaped nuclei are associated with what cells and pathology?

A

Anitchkow cells and rheumatic heart disease

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13
Q

What type of exudate is present in pericarditis?

A

Fibrinous exudate

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14
Q

Valves are made of _________________?

A

Endocardium

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15
Q

What side valves are most often injured in endocarditis?

A

Left

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16
Q

What causes verrucae on the valves of the heart?

A

Endocarditis

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17
Q

What are verrucae?

A

Wart like masses present on valve commissure in infectious endocarditis

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18
Q

What exudate is present at the valves in endocarditis?

A

Fibrinous exudate

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19
Q

Where on the valve does infectious/verrucous endocarditis occur?

A

Valve commissure

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20
Q

What layer of heart inflammation persists from acute to chronic rheumatic heart disease?

A

Endocarditis

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21
Q

What criteria is used to diagnose rheumatic heart disease?

A

Jones criteria

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22
Q

What major criteria are signs of rheumatic heart disease involving the heart?

A

Pericardial friction rub
Cardiomegaly
pericarditis
Congestive heart failure

23
Q

What major criteria is a sign of rheumatic heart disease involving joints?

A

Polyarthritis

24
Q

What major criteria is a sign of rheumatic heart disease involving the nervous system?

A

Chorea

25
Q

What major criteria is a sign of rheumatic heart disease involving the skin?

A

Erythema marginatum and subcutaneous nodules

26
Q

What is erythema marginatum and what pathology is it a major criteria for?

A

Large pink rings on the torso and limbs for a rheumatic heart disease diagnosis

27
Q

What minor criteria may help lead to a rheumatic heart disease diagnosis?

A

Previous history of rheumatic fever
Arthralgia or fever
Increased erythrocyte sedimentation rate
Positive C-reactive protein

28
Q

What valve is most commonly and severely affected in chronic rheumatic heart disease?

A

Mitral valve

29
Q

What valve is second most commonly affected in chronic rheumatic heart disease?

A

Aortic valve

30
Q

Pectinate muscles are a characteristic of (Ventricles/Atria)?

A

Atria

31
Q

Where will an embolus from the mitral valve embolize to?

A

Systemic circulation

32
Q

What pathology presents with a diastolic murmur at the 5th ICS on the left?

A

Mitral stenosis

33
Q

Patient presents to your office with a raspy voice and a rosy red rash across the cheeks and nose. Auscultation shows a diastolic murmur at the 5th ICS on the left. An ANA panel is performed and the results are negative. What is the likely diagnosis?

A

Mitral stenosis

34
Q

What facial feature is indicative of mitral stenosis?

A

Mitral facies (pinkish-purple patches on the cheeks

35
Q

What two bacteria can cause infective bacterial endocarditis?

A

Staphylococcus and streptococcus

36
Q

What is the most common predisposing factor for bacterial endocarditis in children?

A

Congenital cardiac malformations

37
Q

What are the most common predisposing factors for bacterial endocarditis in adults?

A

Mitral valve prolapse and congenital heart disease

38
Q

If a patient has a streptococcus Viridans or mutans infection that has gone systemic, what may occur?

A

Subacute bacterial endocarditis

39
Q

IV drug users are at increased risk of developing endocarditis (TRUE/FALSE)?

A

TRUE

40
Q

Patient presents with a low grade fever. Ophthalmic exam shows small spotting in the retina and palpation reveals painful red spots on the patients palms. The patient reported having a bad pharyngitis infection about a year ago. What is the likely diagnosis?

A

Infective endocarditis

41
Q

Myocarditis is diagnosed if it is the only heart layer currently affected (TRUE/FALSE)?

A

TRUE

42
Q

What is the main etiologic agent of myocarditis?

A

Virus (Coxsackievirus)

43
Q

Male patient age 32 presents with a fever. The patient has a history of HIV. Lymphocytes are slightly increased and enzymes are normal. Pain is centered just around the left chest with no radiation. What is a likely diagnosis?

A

Myocarditis

44
Q

What can predispose an individual to a mitral valve prolapse?

A

Familial
Hereditary collagen diseases (Marfan’s, Ehler-Danlos, Osteogenesis Imperfecta)

45
Q

What heart pathology presents with both a systolic ejection murmur and a diastolic murmur?

A

Aortic stenosis

46
Q

What two murmurs are audible in a patient with aortic stenosis?

A

Systolic ejection murmur and diastolic murmur
(2nd ICS on the R)

47
Q

What is the characteristic appearance of valvular stenosis?

A

Fish-mouth valves

48
Q

How does mitral valve prolapse predispose valves to vegetation?

A

Increased turbulence at the valve commissure leads to endocarditis

49
Q

What are septic emboli?

A

Emboli with infective material such as bacteria

50
Q

Where can septic emboli from bacterial endocarditis spread to?

A

Retina
Nail beds
Skin of palms and soles of feet

51
Q

What pathology can cause septic emboli?

A

Bacterial endocarditis

52
Q

What is a septic emboli to the eye called?

A

Roth spot

53
Q

What is a janeway lesion?

A

Non-painful septic emboli to the palms of the hands or soles of the feet

54
Q

What is a Osler node?

A

Painful septic emboli to the palms of the hands or soles of the feet

NYCC Visceral Pathology (40 decks)

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