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CRAAB 5 > Witrak- Starred Cardiopathology powerpoint items > Flashcards

Witrak- Starred Cardiopathology powerpoint items Flashcards

1
Q

What causes RIGHT SIDED hypertensive heart disease?

A

Chronically increased pulmonary artery pressure from:

Chronic pulmonary parenchymal disease (COPD, interstitial fibrosing disease)–> blood can’t pass through the diseased lung

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2
Q

What does a serum troponin test for?

A

(T or I)

Elevated in AMI (w/in 2-4 hrs, peaking at 48 and lasting 7-10 days)

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3
Q

What are two of the primary causes of valvular stenosis?

A
  1. Valvulitis (RF, SLE, RA)
  2. Congenital Deformity
  3. Calcific degenerative change, carcinoid syndrome, radiation
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4
Q

What causes of primary valve disease?

A
  1. Bacterial endocarditis

2. Myxomatous degeneration

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5
Q

What happens in a pt with bicuspid valves?

A
  1. Premature/accelerated aortic stenosis d/t flow abnormalities (sxs often present in pt’s 60s)
  2. Aortopaty (aortic root dilation/dissection)
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6
Q

What is a systolic click murmur syndrome?

A

Mitral valve prolapse (3% of adults have it)

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7
Q

How do infected vegetations in infectious endocarditis affect the valve function?

A

Infected vegetations cause leaflet distortion/destruction>

regurgitation and septic emboli

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8
Q

What is the best initial modality for diagnosing/assessing severity of cardiac valvular disease?

A

Echocardiography with Doppler (both TT and TE)

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9
Q

What are three of the main causes of acute mitral regurgitation?

A
  1. PAPILLARY MUSCLE/CHORDAL RUPTURE FOLLOWING AMI OR CHORDAE TENDINAE RUPTURE> FAILED MV
  2. acute bacterial endocarditis w/ leaflet destruction
  3. blunt chest trauma
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10
Q

What is the most common cause of myocarditis in the US?

A 
Viral disease?
Cox B/enterovirus
Adenovirus
Parvovirus B 19
Hep C
HHV-6
CMV
HIV
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11
Q

What source of myocarditis has a vector host?

A

Lyme disease- Borrelia

Can lead to a self-limited/transient conduction disorder

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12
Q

What are common causes of immune mediated myocarditis?

A
  1. Rheumatic carditis following group A strep pahryngitis

2. heart transplant jection

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13
Q

What is the best way to diagnose myocarditis and what is often seen on this test?

A

Echocardiogram

LV dysfunction

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14
Q

How is myocarditis often treated?

A

Many patients will improve gradually with or without Tx

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15
Q

What are the four types of pericardial diseases?

A
    1. Acute and recurrent pericarditis (benign)
      1. Pericardial effusion w/out tamponade
      2. Cardiac tamponade (req emergent pericardiocentesis)
      3. Constrictive pericarditis
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16
Q

What is the most common cause of classic/common “acute pericarditis?

A

Idiopathic–presumed VIRAL

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17
Q

What is the most common pathological cause of pericarditis?

A

Fibrinous/serofibrinous: serous fluid and fibrinous exudate

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18
Q

What is used to diagnose CHD during a routine pre-natal assessment?

A

Echocardiography

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19
Q

What test is used to confirm/clarify an echocardiographic assessment of CHD?

A

Cardiac angiography

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20
Q

What else causes shock/hypotension in CHD and what is the treatment for it?

A

Sepsis, hypoglycemia, dehydration, hypoadrenalism

Tx:

  1. Duct dependent CHD: PG E1 to keep DA open
  2. Repair
  3. Cardiac transplant if available
21
Q

What are common causes of sudden cardiac death?

A

Think fatal dysrhymia from congenital ION CHANNEL disorder:

  1. Long QT syndrome
  2. Brugada syndrome
  3. Catecholaminergic polymorphic ventricular tachycardia
22
Q

What are other causes of Sudden Cardiac Death?

A
  1. Coronary arterry spasm
  2. Metabolic disorder (hyperkalemia)
  3. WPW
  4. Commotio cordis- v. dysrhythmia d/t blunt chest trauma
  5. fright response- v. fib d/t overwhelming sympathetic discharge
23
Q

What is the most common cause of vasculitis in middle-aged/elderly adults?

A 
GIANT CELL (temporal) arteritis
(If affecting distribution of the external carotid artery)
- risk of vision loss
24
Q

How do you diagnose and tx Giant cell arteritis?

A

Dx: temporal artery biopsy

Tx: corticosteroids

25
What are two sources of life threatening/aggressive vasculitis in adults?
1. ANCA (anti-neutrophil cytoplasmic antibody | 2. CT disease (SLE)
26
What is ANCA? What are two types?
Small vessel vasculitis 1. Wegners- antiPR3 Abs (c-ANCA) 2. Microscopic polyangiitis: anti-myeloperoxiase Ab (MPO=pANCA)
27
What is the primary way to diagnose vasculitis?
Tissue biopsy (skin or deeper) Especially ANCA
28
What are the common mechanisms of vascular disease?
1. Lumen stenosis (gradual)- atherosclerosis, chronic HTN, diabetes 2. Sudden lumen occlusion - thrombosis, embolism
29
What are common causes of vascular disease seen in large to medium arteries?
1. ATHEROSCLEROSIS> aneurysms, dissection 2. Thrombosis- secondary to ruptured atherosclerotic plaque 3. Embolism- from cardiac source
30
What are two of the most common causes of vascular disease seen in small muscular arteries?
1. HTN | 2. Diabetes
31
Vascular disease in occurs in what type of small vessels predominantly?
Arterioles
32
What pathology is most commonly seen in large to medium sized VEINS?
Thrombosis- especially of the iliofemoral veins
33
What is the source of the most clinically significant/fatal pulmonary emboli?
Thrombosis of the iliofemoral veins
34
What is the most common cause of secondary hypertension?
Renal disease
35
What causes renovascular hypertension?
Atherosclerosis> renal artery stenosis Fibromuscular dysplasia--> HTN in young and middle aged white women
36
When should you consider fibromuscular dysplasia as a diagnosis?
In any young adult with refractory or malignant HTN or stroke
37
What is primary aldosteronism?
A cause of secondary HTN An increased mineralcorticoid state caused by: 1. Aldosterone secreting cortical adenoma 2. bilateral adrenal cortical hyperplasia 3. inherited enzymatic defects in aldosterone metabolism/sensitivity
38
What are the three structural types of aortic disease?
* *1. Dilation/aneurysm (fusiform, saccular, false) 2. Dissection 3. Traumatic disruption
39
What is a common complication association with aortic aneurysms?
RUPTURE with increased diamter thoracic aorta- 7% rupture risk if >6 cm abdominal aorta: 5 yr risk of rupture 20-40% if >5 cm
40
What causes the majority of ABDOMINAL, aortic arch and descending thoracic aneurysms?
Atherosclerosis> | weakening of aortic wall/degeneration of media by atheromatous plaque
41
What is the most frequent and emergent type of Aortic dissection?
Classic propagated type
42
Giant cell arteritis (temporal) is usually seen in what population?
1. Most common in elderly | 2. Scandanavians (rarely blacks)
43
What vessels does giant cell arteritis affect?
Medium to large arteries (esp extra cranial carotid system)
44
What is the feared complication associated with giant cell arteritis?
Vision loss from ischemic optic neuropathy
45
What is the diagnostic criteria for giant cell arteritis?
>50 localized HA w/ new onset tenderness/decreased pulse over temporal artery ESR> 50
46
What are esophageal varices?
Potentially fatal venous engorgement from portal hypertension d/t: CIRRHOSIS portal vein thrombosis hepatic vein thrombosis
47
What causes esophago-gastric varices?
Increased portal venous pressure> opens porto systemic shutns> esophago gastric varices> fatal GI bleed
48
90% of DVT (deep venous thrombosis) is seen in what veins?
Deep leg veins (iliofemoral)
49
What are the clinical symptoms of DVT?
1. Can be a fatal pulmonary embolus 2. may or may not be associated with unilaterally swollen/tender leg 3. Slow/impeded venous circulation (obesity, pregnancy, post op state)

CRAAB 5 (9 decks)

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