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CPR II Week 1 > Robbins Ch 12 Cardiac Pathology Part 2 > Flashcards

Robbins Ch 12 Cardiac Pathology Part 2 Flashcards

1
Q

Coarctation of the Aorta is more common in?

A

1) Males

2) Females with Turner syndrome (XO)

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2
Q

How is Coarctation with Patent Ductus Arteriosus characterized?

A

1) Present in infants

2) Proximal to PDA

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3
Q

How is Coarctation without Patent Ductus Arteriosus characterized?

A

1) Present in adults

2) Distal to aortic arch

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4
Q

How does Coarctation without PDA present?

A

1) Weak Pulses in the LE
2) Hypotension in the LE
3) Intermittent pain (claudication) on excess movement of the legs

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5
Q

What commonality is seen between adult and infant coarctation of the aorta?

A

Systolic murmur that may be associated with a vibratory thrill

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6
Q

What does severe aortic congenital atresia lead to?

What additional condition allows this condition to be compatible with life?

A

1) Hypoplastic left heart syndrome

2) PDA

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7
Q

90% of Ischemic heart disease cases comes from?

A

Atheromas in the coronary arteries

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8
Q

What effect does tachycardia have on the heart?

A

1) Increases oxygen demand

2) Decreases functional supply by decreasing the relative time spent in diastole

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9
Q

With chronic ischemia, at 75% occlusion and 25% flow patients will experience?

At 90% occlusion and 10% flow?

A

1) Exercise induced ischemia

2) Ischemia at rest

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10
Q

Because anginas result in partial occlusion that lasts 15 seconds to 15 minutes, what results?

A

No myocardial death

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11
Q

What is the most common angina?

What is it caused by?

A

1) Stable Angina

2) Imbalance in coronary perfusion relative to metabolic demand

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12
Q

Variant (Prinzmetal) Angina are irregular attacks caused by?

What do they respond well to?

A

1) Coronary artery vasospasm

2) Nitrates

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13
Q

What type of Angina leads to severe stenosis, thrombus, or vasospasm not alleviated by nitrates?

A

Unstable (Crescendo) Angina

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14
Q

What myocardial response is seen to coronary artery obstruction?

A

There is loss of function before there is cell death

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15
Q

What coronary vessel supplies most of the apex, anterior wall of the LV, and the anterior 2/3 of the ventricular septum?

A

Left anterior descending artery

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16
Q

What is a transmural MI sometimes referred to as?

A

STEMI

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17
Q

Which area of the heart is the least well perfused and is the most vulnerable for MI?

A

Subendocardium

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18
Q

What are subendocardial MI sometimes referred to as?

A

NSTEMI

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19
Q

What artery is most commonly infarcted?

Most transmural MI involve at least part of the?

A

1) LAD

2) Left ventricle

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20
Q

What method is used for reperfusion of the heart by eliminated the thrombus but not the plaque?

What effect does late reperfusion (>6hrs) have?

A

1) Thrombolytics

2) Doesn’t help and may actually be hazardous

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21
Q

What are the eosinophilic intracellular strips composed of closely packed sarcomeres?

When are they seen?

A

1) Contraction bands

2) Irreversibly injured myocytes

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22
Q

What labs confirm the diagnosis of MI?

When do they begin to appear?

A

1) Troponin and CK-MB

2) 3-12 hours

23
Q

Why is CK-MB sensitive, but not specific?

A

It can be elevated after skeletal muscle injury

24
Q

What is the treatment plan for an MI?

A

MONA:

1) Morphine
2) Oxygen
3) Nitrates
4) Aspirin

25
Q

What is the most common type of myocardial rupture seen after having an acute MI?

A

Rupture of the ventricular free wall

26
Q

A fibrinous or fibrinohemorrhagic pericarditis that occurs 2-3 days after transmural MI due to underlying myocardial inflammation is known as?

A

Dressler syndrome

27
Q

With changes seen in the surrounding non-infarcted heart tissue, some of the deleterious effects of ventricular remodeling appear to be reduced by?

A

ACE inhibitors

28
Q

What accounts for 50% of all heart transplant recipients?

A

Chronic ischemic heart disease

29
Q

What is the most common cause of arrhythmias?

A

Ischemic injury

30
Q

What effect does atrial fibrillation have on heart rate?

A

Irregularly irregular rhythm

31
Q

What is the prototype of channelopathies?

A

Long QT syndrome

32
Q

What is the most common underlying etiology of sudden cardiac death?

The mechanism is most commonly from?

A

1) Coronary artery disease

2) Lethal arrhythmia (Asystole or ventricular fibrillation)

33
Q

Right sided hypertensive heart disease as a result of pulmonary hypertension is known as?

A

Cor pulmonale

34
Q

What is the earliest change of systemic hypertensive heart disease?

A

Myocytes show an increased transverse diameter

35
Q

What is stenosis?

A

Failure of a valve to open completely which impedes forward flow

36
Q

What is insufficiency (regurgitations, incompetence)?

A

Failure of a valve to close completely which allows reversed flow

37
Q

What is the most common of all valvular problems and involves age-related wear and tear?

A

Calcific Aortic Stenosis

38
Q

What is not present in Calcific Aortic Stenosis as seen in rheumatic and congenital aortic
stenosis?

A

Commissural fusion

39
Q

Calcific stenosis of congenitally bicuspid aortic valve involves what gene on chromosome 9?

A

NOTCH

40
Q

What is the gross morphology of Mitral Valve Prolapse?

A

Leaflets are enlarged, redundant, thick, and rubbery

41
Q

What is the histological morphology of Mitral Valve Prolapse?

A

Marked thickening of the spongiosa layer with deposition of mucous material (This is called myxomatous degeneration)

42
Q

When are clicks heard with mitral valve prolapse?

A

Mid-systolic clicks

43
Q

Which sex is mitral valve prolapse 7x more common in?

A

Women

44
Q

What is virtually the only cause of mitral valve stenosis?

A

Rheumatic fever from strep pyogenes A

45
Q

What are the inflammatory lesions seen with rheumatic heart disease?

A

Aschoff Bodies

46
Q

The inflammatory process of acute rheumatic heart disease is best characterized as chronic inflammation, with what cells?

A

T cells and macrophages

47
Q

In chronic Rheumatic heart disease, what are the vegetations that overly the necrotic foci and along the lines of closure?

A

Verrucae

48
Q

What clinical feature is seen on acute rheumatic heart disease?

A

Erythema marginatum

49
Q

How is rheumatic heart disease diagnosed?

A

J♥NES criteria:

1) Joints
2) Heart
3) Nodules, subcutaneous
4) Erythema marginatum
5) Sydenham chorea

50
Q

What is acute infectious endocarditis caused by?

A

Infection of a previously normal valve by staphylococcus aureus

51
Q

What is subacute infectious endocarditis caused by?

A

Infection of a previously deformed valve by viridans streptococci

52
Q

What does strep viridans commonly cause?

Staph aureus is common in what population?

Staph Epidermidis commonly infects?

A

1) Dental issues
2) IV drug users
3) Prosthetic valves

53
Q

What is the most consistent sign of Infectious Endocarditis?

A

Fever

CPR II Week 1 (7 decks)

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