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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
Q

What are two sources of life threatening/aggressive vasculitis in adults?

A
  1. ANCA (anti-neutrophil cytoplasmic antibody

2. CT disease (SLE)

26
Q

What is ANCA? What are two types?

A

Small vessel vasculitis

  1. Wegners- antiPR3 Abs (c-ANCA)
  2. Microscopic polyangiitis: anti-myeloperoxiase Ab (MPO=pANCA)
27
Q

What is the primary way to diagnose vasculitis?

A

Tissue biopsy (skin or deeper)

Especially ANCA

28
Q

What are the common mechanisms of vascular disease?

A
  1. Lumen stenosis (gradual)- atherosclerosis, chronic HTN, diabetes
  2. Sudden lumen occlusion - thrombosis, embolism
29
Q

What are common causes of vascular disease seen in large to medium arteries?

A
  1. ATHEROSCLEROSIS> aneurysms, dissection
  2. Thrombosis- secondary to ruptured atherosclerotic plaque
  3. Embolism- from cardiac source
30
Q

What are two of the most common causes of vascular disease seen in small muscular arteries?

A
  1. HTN

2. Diabetes

31
Q

Vascular disease in occurs in what type of small vessels predominantly?

A

Arterioles

32
Q

What pathology is most commonly seen in large to medium sized VEINS?

A

Thrombosis- especially of the iliofemoral veins

33
Q

What is the source of the most clinically significant/fatal pulmonary emboli?

A

Thrombosis of the iliofemoral veins

34
Q

What is the most common cause of secondary hypertension?

A

Renal disease

35
Q

What causes renovascular hypertension?

A

Atherosclerosis>
renal artery stenosis

Fibromuscular dysplasia–> HTN in young and middle aged white women

36
Q

When should you consider fibromuscular dysplasia as a diagnosis?

A

In any young adult with refractory or malignant HTN or stroke

37
Q

What is primary aldosteronism?

A

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
Q

What are the three structural types of aortic disease?

A
  • *1. Dilation/aneurysm (fusiform, saccular, false)
    2. Dissection
    3. Traumatic disruption
39
Q

What is a common complication association with aortic aneurysms?

A

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
Q

What causes the majority of ABDOMINAL, aortic arch and descending thoracic aneurysms?

A

Atherosclerosis>

weakening of aortic wall/degeneration of media by atheromatous plaque

41
Q

What is the most frequent and emergent type of Aortic dissection?

A

Classic propagated type

42
Q

Giant cell arteritis (temporal) is usually seen in what population?

A
  1. Most common in elderly

2. Scandanavians (rarely blacks)

43
Q

What vessels does giant cell arteritis affect?

A

Medium to large arteries (esp extra cranial carotid system)

44
Q

What is the feared complication associated with giant cell arteritis?

A

Vision loss from ischemic optic neuropathy

45
Q

What is the diagnostic criteria for giant cell arteritis?

A

> 50
localized HA w/ new onset
tenderness/decreased pulse over temporal artery
ESR> 50

46
Q

What are esophageal varices?

A

Potentially fatal venous engorgement

from portal hypertension d/t:
CIRRHOSIS
portal vein thrombosis
hepatic vein thrombosis

47
Q

What causes esophago-gastric varices?

A

Increased portal venous pressure>
opens porto systemic shutns>
esophago gastric varices>
fatal GI bleed

48
Q

90% of DVT (deep venous thrombosis) is seen in what veins?

A

Deep leg veins (iliofemoral)

49
Q

What are the clinical symptoms of DVT?

A
  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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