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CPR II Week 1 > Robbins Ch 12 Cardiac Pathology Part 1 > Flashcards

Robbins Ch 12 Cardiac Pathology Part 1 Flashcards

1
Q

Mitral valve prolapse is caused by damage to?

A

Collagen that weakens the leaftlets

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2
Q

Calcific aortic stenosis is caused by?

What mutation is it associated with?

A

1) Nodular calcification beginning in interstitial cells

2) NOTCH1

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3
Q

What is the key pathologic feature associated with rheumatic heart disease?

A

Fibrotic thickening

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4
Q

What is the role of the SA node?

The AV node?

A

1) Pacemaker of the heart

2) Ensures atrial contraction precedes ventricular systole

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5
Q

When is the heart perfused?

A

During diastole

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6
Q

What changes are seen in the heart as it ages?

A

1) Epicardial fat

2) Intracellular lipofuscin accumulations

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7
Q

What changes are seen in the valves as it ages probably as the result of organization of small thrombi?

A

Lambl excrescences

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8
Q

Pump failure which is a mode of cardiovascular dysfunction has what effect on the myocardium?

What does this ultimately lead to?

A

1) Contracts weakly during systole and relaxes incompletely

2) Inadequate cardiac output

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9
Q

What is the mechanism where increased filling volumes dilate the heart and thereby increase preload and subsequent actin-myosin cross-bridge formation, enhancing contractility and stroke volume?

A

Frank-Starling Mechanism

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10
Q

Systolic dysfunction is a progressive deterioration of?

It is reflected as a decrease in?

A

1) Myocardial contractile function

2) Ejection fraction

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11
Q

Diastolic dysfunction is the inability of?

A

The heart chamber to expand and fill sufficiently during diastole

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12
Q

What causes pressure-overload hypertrophy?

A

HTN or aortic stenosis

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13
Q

What leads to volume-overload hypertrophy?

What is the best measure of this hypertrophy?

A

1) Ventricular dilation

2) Heart weight in dilated hearts

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14
Q

What causes physiologic hypertrophy of the heart?

A

Aerobic exercise

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15
Q

In terms of congestive heart failure, what causes forward failure?

What causes backward failure?

A

1) Decreased cardiac output and tissue perfusion

2) Pooling of blood in the venous capacitance system

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16
Q

What is a common cause of left sided heart failure?

A

HTN

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17
Q

What effect does left sided heart failure have on the lungs?

How is this visualized on CXR?

What is pathognomonic for this condition?

A

1) Pulmonary edema
2) Kerley B and C lines
3) Hemosiderin-laden macrophages

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18
Q

What effect does left sided heart failure have on the kidneys?

A

Prerenal azotemia

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19
Q

What effect does left sided heart failure have on the brain in severe cases?

A

Hypoxic Encephalopathy

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20
Q

Insufficient ejection fraction is seen in what stage of the heartbeat due to left sided heart failure?

Stiff left ventricle that cannot relax is seen during?

Cardiac function is relatively preserved at rest during?

A

1) Systolic
2) Diastolic
3) Diastolic

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21
Q

What population is left sided heart failure most common in?

A

Women over 65

22
Q

What is the most common cause of right sided heart failure?

A

Left sided heart failure

23
Q

What is the term for isolated right-sided heart failure that typically occurs in patients with a disorder that affects the lungs?

What lung disorder is most common?

A

1) Cor Pulmonale

2) Pulmonary HTN

24
Q

Which sided heart failure is much more associated with systemic edema?

A

Right sided

25
Q

What effect does right sided heart failure have on the liver?

A

Nutmeg liver

26
Q

What is the hallmark sign of right sided heart failure?

A

Ankle (pedal) and pretibial edema

27
Q

How does DiGeorge syndrome present?

A

CATCH-22:

1) Cardiac abnormality
2) Abnormal facies
3) Thymic aplasia
4) Cleft palate
5) Hypocalcemia
6) All found on chromosome 22

28
Q

What gene found on chromosome 22 is involved with DiGeorge syndrome?

What does it regulate?

A

1) TBX1

2) NCC migration

29
Q

A right to left shunt is a type of congenital heart disease that can lead to?

A

1) Paradoxical embolism
2) Tetralogy of Fallot
3) Transposition of the great arteries (TGA)
4) Persistent truncus arteriosus
5) Tricuspid atresia
6) Total anomalous pulmonary venous connection

All but paradoxical embolism have a T in them

30
Q

A left to right shunt can lead to?

A

1) ASD
2) VSD
3) PDA

All have D’s in the acronym

31
Q

What term is defined as when pulmonary vascular resistance approaches systemic levels, the original left-to-right shunt becomes a right-to-left shunt and introduces poorly oxygenated blood into the systemic circulation?

A

Eisenmenger syndrome

32
Q

What is the difference between hypoplasia and atrophy?

A

Hypoplasia happens before birth and atrophy happens after

33
Q

Which sided shunts are the more common congenital heart disease?

A

Left to right shunts

34
Q

Left to right shunts are characterized by?

A

Insufficient cardiac output

35
Q

90% of atrial septal defect cases are due to defect of the?

A

Septum secundum

36
Q

What is present in all cases of ASD?

A

Murmur is present from excessive fluid

37
Q

What is the most common congenital cardiac abnormality?

A

Ventricular septal defect (VSD)

38
Q

Majority of VSD cases occur with?

A

Tetralogy of Fallot

39
Q

90% of VSD cases are termed?

The other 10%?

A

1) Membranous VSD

2) Infundibular VSD

40
Q

Where does membranous VSD occur?

Infundibular VSD?

A

1) Membranous intermuscular septum

2) Below the pulmonary artery or in the area of the muscular septum

41
Q

In the neonate, the ductus arteriosus closes due to?

A

Declining local levels of prostaglandin E2

42
Q

Preservation of ductal patency by giving PGE2 can be life-saving for infants with various congenital malformations that?

A

Obstruct the pulmonary or systemic outflow tracts

43
Q

How is patent ductus arteriosus detected?

What is it described as?

A

1) Continuous harsh murmur

2) Machine like

44
Q

What do right to left shunts cause early in postnatal life?

A

Cyanosis

45
Q

Tetralogy of fallot is defined as?

A

1) Ventral Septal Defect
2) Obstruction of Right Ventricular Outflow
3) Overriding aorta
4) Right Ventricular Hypertrophy

46
Q

What does ToF look like on CXR due to right ventricular hypertrophy?

A

Boot shaped

47
Q

What is ToF caused by?

A

Anterior superior displacement of infundibular septum

48
Q

Clinical consequences of ToF depend primarily on the severity of?

Why?

A

1) The subpulmonary stenosis

2) B/c this determines the direction of the blood flow

49
Q

How do the infants present from birth or soon thereafter with ToF?

A

Cyanotic

50
Q

With transposition of great arteries, the blood circulating to system is purely?

A

Deoxygenated

51
Q

Without any other defect, what is the likelihood of survival with transposition of great arteries?

A

Low, it is incompatible with life

52
Q

How does tricuspid atresia present at birth?

A

Cyanosis is present and there is a great chance of early mortality

CPR II Week 1 (7 decks)

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