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Path year 5 > Histopath - CVD > Flashcards

Histopath - CVD Flashcards

1
Q

Atherosclerosis

A

Atheromatous deposits in and fibrosis of the inner layer of the arteries

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2
Q

Atherosclerosis RFs

A
  • Age
  • Genetics
  • Hyperlipidaemia
  • HTN
  • Smoking
  • DM
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3
Q

Progression of atheroma

A

Raised lesion -> soft lipid core -> white fibrous cap

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4
Q

Ischaemic heart disease

A

Groupd of conditions which result from myocardial ischaemia

Oxygen supply < demand

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5
Q

Which conditions fall under ischaemic heart disease?

A
  • Stable/unstable angina
  • MI
  • Chronic ischaemic heart disease w heart failure
  • Sudden cardiac death
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6
Q

Ischaemic heart disease plaque sites

A
  • First few cm of LAD (left anterior descending artery) or LCX
  • Entire length of RCA
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7
Q

Angina

A

Critical stenosis (narrowing) when demand > supply

No muscle death -> no raised troponin/ECG changes generally

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8
Q

Stable v unstable angina

A

Stable: occlusion around 70%

Unstable: occlusion >90% + chest pain at rest

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9
Q

Prinzmetal angina

A

Uncommon, due to coronary artery spasm

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10
Q

Myocardial infarction

A

Death of cardiac muscle due to prolonged ischaemia

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11
Q

*Histopathology of MI at different times

  • <6h
  • 6-24h
  • 1-4 days
  • 5-10 days
  • 1-2 weeks
  • Weeks-months
A
  • <6h: normal histology
  • 6-24h: Flocculent densities form within mitochondria
  • 1-4 days: Neutrophils begin to arrive at the area of coagulative necrosis
  • 5-10 days: Macrophages begin to arrive at the area of coagulative necrosis
  • 1-2 weeks: Granulation tissue begins to form
  • Weeks-months: Collagen is deposited, forming a fibrous scar
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12
Q

MI Complications

A
  • Death
  • Arrhythmia
  • Rupture
  • Tamponade
  • Heart failure
  • Valve disease
  • Aaneurysm
  • Dressler syndrome
  • Embolism
  • Reperfusion injury
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13
Q

Right sided cardiac failure histopathology liver

A

Nutmeg liver

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14
Q

Histology of cardiac failure

A
  • Dilated heart
  • Scarring and thinning of walls
  • Fibrosis and replacement of ventricular myocardium
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15
Q

Cardiomyopathy

A

Disease of muscle tissue

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16
Q

3 types of cardiomyopathy

A
  • Dilated
  • Hypertrophic
  • Restrictive

too thin, too thick, too stiff

17
Q

Dilated cardiomyopathy

A

Loss of myocytes

18
Q

Dilated cardiomyopathy casuses

A
  • Idiopathic
  • Infective
  • Alcohol
  • Thyroid disease
19
Q

Hypertrophic cardiomyopathy

A

Defect in beta myosin heavy chain

20
Q

What is hypertrophic cardiomyopathy associated with?

A

Sudden cardiac death

21
Q

Restrictive cardiomyopathy

A

Impaired compliance

22
Q

What is restrictive cardiomyopathy associated with?

A

Amyloid and sarcoid

23
Q

*Patient has abdominal pain radiating to his back and collapses and dies

A

Abdominal aortic aneurysm

24
Q

*Man has an MI 3 years ago. Now he comes into hospital and very unwell. Blood is aspirated from the pericardium.

A

Ventricular rupture

25
Q

*Elderly man with atrial fibrillation with right flank pain

A

Renal infarct

26
Q

*50 year old lady with memory issues/progressive amnesia, hypertension

A

Multiple cerebral infarcts

27
Q

*Man, ex-smoker, with history of hypertension and MI, has sudden chest pain which radiates to the neck

A

Thrombus of the Left Anterior Descending artery

28
Q

*Lady with Multiple myeloma and restrictive cardiomyopathy. What will you see on heart biopsy?

A

Amyloid depositions

29
Q

*Man with uncontrolled hypertension and angina

A

?Left ventricular hypertrophy

30
Q

*An 18 year old student collapses and dies whilst playing football. A postmortem finds asymmetric hypertrophy of the interventricular septum. Microscopic examination shows thickened and disorganized muscle fibres with hyperchromatic nuclei. What is the most likely diagnosis?

A

Hypertrophic cardiomyopathy (causing sudden cardiac death)

Path year 5 (48 decks)

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