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CardioPulm > 12.5 A > Flashcards

12.5 A Flashcards

1
Q

What is valvular stenosis?

A

the failure of a valve to open completely

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2
Q

What is valvular insufficiency?

A

failure of a valve to close completely, thereby allowing reversed flow

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3
Q

What is functional regurgitation?

A

the incompetence of a valve stemming from an abnormality in one of its support structures

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4
Q

Functional regurgitation could be thought of as a ____ valve defect.

A

secondary

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5
Q

What is mixed valvular stenosis?

A

stenosis with regurgitation

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6
Q

What is combined valvular stenosis?

A

involvement of more than one valve

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7
Q

The most frequent cause of aortic stenosis is what?

A

dystrophic calcification of an anatomically normal or congenitally bicuspid aortic valve

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8
Q

The most frequent cause of aortic insufficiency is what?

A

dilation of the ascending aorta related to hypertension, atherosclerosis, or aging

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9
Q

The most common cause of mitral stenosis is what?

A

rheumatic heart disease

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10
Q

The most common cause of mitral insufficiency is what?

A

myxomatous degeneration (prolapse)

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11
Q

Infective endocarditis can cause what valvular heart disease?

A

mitral or aortic regurgitation

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12
Q

What is the most common of all valvular abnormalities?

A

calcific aortic stenosis

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13
Q

The typical age of onset for aortic valvular stenosis of an anatomically normal valve is what?

A

60-80

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14
Q

The typical age of onset for aortic valvular stenosis of a bicuspid aortic valve is what?

A

40-60

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15
Q

Bicuspid aortic valves likely experience stenosis early because…

A

they incur more mechanical stress than normal tricuspid valves

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16
Q

Rheumatic aortic differs from calcific aortic stenosis with regards to what morphological feature?

A

rheumatic aortic stenosis often has a commissural fusion

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17
Q

Aortic stenosis leads to what other complication related to the pressure build up it incites?

A

left ventricular hypertrophy

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18
Q

Myxomatous degeneration is associated with what valvular heart disease?

A

mitral valve prolapse

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19
Q

How is mitral valve prolapse typically treated?

A
  • it is usually asymptomatic

- anti-microbial prophylaxis is recommended during dental procedures to prevent endocarditis

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20
Q

Mitral valve prolapse has what symptoms and complications?

A

usually asymptomatic although there is a slightly increased risk of sudden death due to arrhythmia

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21
Q

Mitral valve prolapse puts one at greater risk for endocarditis because of what?

A

because flow is abnormal, creating eddies that lead to fibrin deposition and that fibrin is capable of catching bacteria in the blood stream

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22
Q

Rheumatic fever can follow what sort of infection?

A

group A streptococci

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23
Q

Describe the pathogenesis of rheumatic fever?

A
  • group A streptococci infection
  • molecular mimicry results in cross reaction to myocardial tissue
  • chronic inflammatory response to myocardial tissue
  • deformity and damage
24
Q

Sydenham’s chorea is a diagnostic feature of what disease?

A

rheumatic fever

25
Q

What are aschoff bodies?

A

distinctive lesions in the heart of those suffering from rheumatic fever

26
Q

What are anitschkow cells?

A

large histiocytes with abundant basophilic cytoplasm that are part of aschoff bodies

27
Q

Describe aschoff bodies

A

distinct foci of fibrinoid necorsis surrounded by lymphocytes and macrophages

28
Q

Describe the joint involvement of rheumatic fever.

A

acute, non-specific, migratory arthritis, especially in the knees

29
Q

Describe the skin involvement of rheumatic fever.

A

subcutaneous nodules or erythema marginatum

30
Q

What are erythema marginatum?

A

giant aschoff bodies presenting as a rash in rheumatic fever patients

31
Q

Rheumatic fever affects what systems?

A
  • heart
  • joints
  • skin
  • arteries
32
Q

How does rheumatic fever affect the arteries?

A

hypersensitivity angitis

33
Q

What are the cardinal anatomic changes of the mitral valve in rheumatic heart disease?

A
  • leaflet thickening
  • commissural fusion and shortening
  • thickening and fusion of the tendinous cords
34
Q

What are the features of rheumatic heart disease?

A
  • pulmonary congestion andedema
  • hemorrhage and infarction
  • hyperplasia of pulmonary arteries
  • hemosiderosis
  • fibrosis of alveolar septa
  • right-sided heart failure
35
Q

What are the two categories of infective endocarditis?

A

acute and sub-acute

36
Q

What are some major risk factors for infective endocarditis?

A
  • drug use
  • artificial valves
  • valvular dysfunction
  • rheumatic heart disease
37
Q

What is acute versus sub-acute endocarditis?

A
  • acute is typically caused by infection of a previously normal heart valve by a highly virulent organism
  • sub-acute is caused by less virulent organisms and cause infections of deformed valves that are less destructive
38
Q

What are the clinical criteria for infective endocarditis?

A
  • positive blood cultures
  • EKG findings
  • new valvular regurgitation or murmur
39
Q

Which organism is most commonly implicated in acute infective endocarditis?

A

staph aureus

40
Q

What is the HACEK group?

A

a group of bacteria known to cause endocarditis

41
Q

What is a ring abscess?

A

the abscess created by endocarditis vegetations eroding the underlying myocardium

42
Q

What are Osler nodes?

A

subcutaneous nodules in the pulp of the digits seen in endocarditis

43
Q

What are Janeway lesions?

A

erythematous or hemorrhagic non-tender lesions on the palms or soles seen in endocarditis

44
Q

What are Roth spots?

A

retinal hemorrhages seen in endocarditis

45
Q

The most common contaminant of blood cultures is what organism?

A

coag-neg Staph

46
Q

The most common reason for blood culture contamination is what?

A

failure to adequately decontaminate the skin

47
Q

Describe the vegetations seen in endocarditis.

A

fibrin, inflammatory cells, and bacteria

48
Q

Endocarditis most commonly affects what valves?

A

aortic and mitral

49
Q

Septic emboli result from what heart disease?

A

endocarditis

50
Q

What is the viridans group?

A

a group of low virulence strep that are known to cause aub-acute endocarditis

51
Q

What are the cardiac complications of infectious endocarditis?

A
  • valvular insufficiency or stenosis
  • myocardial abscess with possible wall perforation
  • suppurative pericarditis
  • dehiscence of an artificial valve
52
Q

Left sided endocarditis lesions are more likely to cause what embolic complications?

A

systemic embolism in the brain, spleen kidney, etc.

53
Q

Right sided endocarditis lesions are more likely to cause what embolic complications?

A
  • osler’ nodes
  • janeway lesions
  • roth spots
  • lung involvement
54
Q

What is non-bacterial thrombotic endocarditis?

A
  • involves the precipitation of small amounts of fibrin and other blood components on the valve leaflets
  • vegetations are sterile
55
Q

Non-bacterial thrombotic endocarditis is most common in what sorts of individuals?

A

debilitated ones with cancer or sepsis; those with hypercoagulable states

56
Q

When you see endocarditis vegetations on the underside of a valve, your first thought should be what?

A

lupus

CardioPulm (31 decks)

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