12&13 - Cardiac Pathology II

Question 1

carnevale defines HTN

Answer 1

140/90 over three consevutive readings at least one week apart

Question 2

cause unknown HTN

Answer 2

essential HTN 90-95% cases

Question 3

malignant HTN

Answer 3

180/120

medical emergency!

Question 4

stage II HTN

Answer 4

160/100

Question 5

signs of retinopathy

Answer 5

hard exudate

flame hemorrhage

cotton wool spot

retinopathy due to HTN

Question 6

what can long term chronic HTN do to CNS? malignant HTN?

Answer 6

chronic –> cerebral infarction (stroke)

malignant HTN –> intracranial hemorrhage

Question 7

how will the left ventricular hypertrophy develop with HTN

Answer 7

concentrically

Question 8

failure of valve to open completely =

Answer 8

stenosis

–> pressure overload

Question 9

failure of valve to close completely =

Answer 9

insufficiency

–> volume overload

Question 10

calcification of anatomically normal and congenitally bicruspid aortic valves

Answer 10

aortic stenosis

Question 11

dilation of the ascending aorta, usually related to HTN and aging

Answer 11

aortic insufficiency

Question 12

rheumatic heart disease –>

Answer 12

mitral stenosis

Question 13

mitral valve prolapse aka

Answer 13

myxomaous degeneration

this is a mitral insufficiency

Question 14

most common valvular abnormality

Answer 14

calcific aortic stenosis

“wear and tear” in 90s or younger people with bicuspid aortic valves

Question 15

how is calcific aortic stenosis different than stenosis caused by rheumatic heart disease?

Answer 15

rheumatic would include fusion of the commissures

calcific: within sinuses of valsalve

Question 16

why do we need to treat arotic stenosis?

Answer 16

50% of those presenting with angina will die in 5 yr

50% with CHF will die in 2 yr

Question 17

sclerosis v. stenosis

Answer 17

sclerosis is fibrosis process, not calcification

can lead to stenosis

Question 18

what causes rheumatic heart disease

Answer 18

group A strep infection with anitgenic mimicry to mprtn epitopes in heart valves

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Question 19

what is pancarditis

Answer 19

inital infection of rheumatic heart disease which effects the whole heart

Question 20

pericarditis is

Answer 20

fibrinous

Question 21

myocarditis

Answer 21

aschoff bodies

Question 22

which valve is most involed with rheumatic heart disease

Answer 22

mitral

then aortic, tricuspid, pulmonic

Question 23

what do catepillar cells indicate

Answer 23

pancarditis

Question 24

what does fish mouth indicate

Answer 24

rheumatic heart disease

atrial view of mitral valve

Question 25

key histological change in tissue with mitral valve prolapse

Answer 25

myxomatous degeneration

Question 26

midsystolic click indicates

Answer 26

mitral valve prolapse

Question 27

would you rather have an endocardial infection with staph aureus or strep viridian

Answer 27

step viridians because associated with subacute IE and can be treated with antibiotics staph aureus is associated with acute IE and is destructive, often requiring surgery, high mortality

Question 28

major criteria for infectious endocarditis

Answer 28

- 2 positive blood cultures - echocardiogram identification - new vavlular regurgitation

Question 29

4 signs of IE

Answer 29

- splinter hemorrhages - Janeway lesions - Roth spots - Osler nodes

Question 30

infection of the heart muscle itself

Answer 30

myocarditis

Question 31

most common cause of myocarditis

Answer 31

coxsackieviruses A and B

Question 32

how can you tell if it is a a primary(myocarditis) or secondary inflammation?

Answer 32

MI- neutroplils, secondary inflammation myocarditis - virus cause- lymphocytic infection

Question 33

borrelia and myocarditis

Answer 33

lyme disease

Question 34

heart with chagas infection

Answer 34

dilated floppy heart **amastigotes (cause inflammation and destroy heart tissue)

Question 35

heart disease resulting from an abnormality in myocardium

Answer 35

cardiomyopathy

Question 36

assymetric thickening of ventricles

Answer 36

hypertrophic cardiomyopathy ptrns abnormal in muscle cells

Question 37

looks normal, but muscle rigid and does not expand

Answer 37

restrictive cardiomyopathy due to amyloid deposits, radiation

Question 38

very dilate and weak LV and LA

Answer 38

dialted cardiomyopathy large fibers that are weak and do not contract well

Question 39

how will muscular dystrophy affect the heart?

Answer 39

hypertrophic cardiomyopathy

Question 40

how would storage disorders affect the heart>

Answer 40

hypertrophic cardiomyopathy

Question 41

most common cause of sudden death in young athletes

Answer 41

hypertrophic cardiomyopathy

Question 42

type of heart failure for dilated cardiomyopathy

Answer 42

systolic dysfunction

Question 43

type of heart failure with hypertrophic and restrictive cardiomyopathy

Answer 43

diastolic dysfunction