Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Pathology > 30 - Cardiovascular Disease 3 > Flashcards

30 - Cardiovascular Disease 3 Flashcards

1
Q

Endocarditis is… + two types

A

inflammation of endocardium

prototypical lesion = vegetation on valves

infective and non-infective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of non=infective endocarditis

A

Nonbacterial thrombotic endocarditis

Endocarditis of SLE (Libman-Sacks disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Acute infective endocarditis

A

Highly virulent
Necrotising, ulcerative, destructive lesions
Difficult to cure and death occurs despite treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Sub-acute infective endocarditis

A

lower virulence
insidious infections of deformed valves
cured with antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Strep. bovis endocarditis indicates

A

Investigation into bowel cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Complications of infective endocarditis

A

immunologically mediated conditions e.g. glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Clinical presentation of IE

A

splinter/subungual haemorrhages
Janeway lesions
Osler’s nodes
Roth spots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Janeway lesions

A

erythematous or haemorrhagic non-tender lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Osler’s nodes

A

Subcutaneous nodules in the pulp of the digits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Roth spots

A

Retinal haemorrhages in the eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

FROM JANE

A

Fever
Roth spots
Oslers nodes
Murmurs

Janeway lesions
Anaemia
Nail - splinter haemorrhage
Emboli (septic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Non-infective endocarditis abbreviation

A

NBTE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

NBTE - who?

A

debilitated patients
those in hyper coagulable state
Trousseau syndrome
Endocardial trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Non-infective endocarditis libman-sacks endocarditis

A

associated with SLE usually asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Rheumatic fever - what is it

A

acute, immunologically mediated multi-system inflammatory disease follow group A strep pharyngitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Aschoff bodies

A

distinctive cardiac lesions

foci of T-cells, plasma cells and macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Rheumatic fever - pathological features

A

Features of vegetations called veruccae
Mitral valve changes are classical - virtually ONLY cause of mitral stenosis
Leaflet thickening
Fibrous bridging of valvular commissures & calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Rheumatic fever - pathogenesis

A

antibodes against M proteins of Strep A cross react with self-antigens in the heart. CD4 cells specific for strep peptide react with proteins on heart.

Produce cytokines that activate macrophages e..g Aschoff bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pericarditis - causes

A

inflammation of pericardial sac due to…

Coxsackie B, bacteria, TB, fungi, parasites

Rheumatic fever, SLE, scleroderma, post-cardiotomy
Late post-MI = dressler’s, drug hypersensitivity

Misc. conditions = post MI, uraemia, cardiac surgery, neoplasia, trauma, radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Acute pericarditis -

A 
serous 
serofibrinous
purulent
haemorrhagic 
caseous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Chronic pericarditis -

A

adhesive
adhesive mediastinopericarditis
constrictive pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Serous pericarditis -

A

inflammation causes clear serous fluid accumulation

caused, generally, by non-infectious aetiologies - most common, inflammation of adjacent structures. rarely by viral pericarditis (coxsackie B/ echovirus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Serous pericarditis - causes

A

Rheumatic fever, SLE, scleroderma

Uraemia, neoplasia, radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Dressler’s syndrome

A

2°pericarditis
aka - post-MI syndrome

Triad: fever, pleuritis chest pain, pericardial effusion

Autoimmune rxn to antigens released following myocardial infarction

Delay of weeks therefore not acute pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Pericarditis - clinical presentation

A

Exacerbated by: movement, respiration, laying flat
Relieved: sitting forward
Radiating: shoulders/neck
Differentials: angina, pleurisy

loudest pleural rub over diaphragm

fever, leucocytosis, pericardial effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Pericarditis - complications

A

pericardial effusion / cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Types of cardiomyopathy

A

Dilated
Hypertrophic
Restrictive
Arrythmogenic right ventricular cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Dilated cardiomyopathy - pathogenesis

A

progressive dilation -> contractile (systolic dysfunction)

heart enlarged heavy and flabby

29
Q

Dilated cardiomyopathy - causes

A

genetic - AD
alcohol or chemo
SLE, scleroderma, thiamine def. , acromegaly, thyrotoxicosis, diabetes

30
Q

Dilated cardiomyopathy - who?

A

20-50

slow progressive signs

31
Q

Dilated cardiomyopathy - 5 yr survival

A

25%

death due to CCF, arrythmia / embolism

32
Q

Dilated cardiomyopathy - treatment

A

cardiac transplantation

long-term ventricular assist

33
Q

Hypertrophic cardiomyopathy -

A

stiff LV myocardium

diastolic dysfunction with preserved systolic function

34
Q

Hypertrophic cardiomyopathy - causes

A

100% genetic

35
Q

Hypertrophic cardiomyopathy - clinical features

A

low stroke volume due to impaired diastolic filling
obstruction to LV outflow in 25% of patients
exertional dyspnoea
systolic ejection murmur

36
Q

Hypertrophic cardiomyopathy - complication

A 
AF
mural thrombus formation
cardiac failure
ventricular arrythmias
sudden death in some familes and sudden death in athletes
37
Q

Hypertrophic cardiomyopathy - treatment

A

decreased heart rate and contractility - B-adrenergic blockers
reduction of the mass of the septum

38
Q

Restrictive cardiomyopathy -

A

1°decrease in ventricular compliance due to impaired vent filling during diastole

39
Q

Restrictive cardiomyopathy - idiopathic or 2°

A

fibrosis, amyloidosis, sarcoidosis, metastatic tumours or deposition of metabolites

40
Q

Restrictive cardiomyopathy - morphology

A

ventricles normal size but with slightly enlarged chambers.

myocardium is firm and non-compliant

41
Q

Arrythmogenic right ventricular cardiomyopathy -

A

aka arrhythmogenic RV dysplasia

AD - 1in5k

42
Q

Arrythmogenic right ventricular cardiomyopathy - morphology

A

RV dilation / myocardial thinning
Fibrofatty replacement of RV
Disorder of cell-cell desmosomes
Exercise causes cells to detach and die

43
Q

Arrythmogenic right ventricular cardiomyopathy - clinical presentation

A

silent, syncope, chest pain, palpitations, sudden cardiac death in the young during exercise

44
Q

Myocarditis - cause

A

infections (most) - Coxsackie A&B viruses; Chagas disease (Trypanosoma cruzi - protozoa)

45
Q

Myocarditis - clinical features

A

asymptomatic
heart failure, arrhythmias and sudden death
non-specific - fatigue, dyspnoea, palpitations, precordial discomfort and fever
can mimic acute MI
DCM can develop

46
Q

maybe steal slide 57 of 82

A

for causes of myocarditis

47
Q

Vasculitis -

A

inflammation of vessel walls

any organ and any vessel

48
Q

GCA stands for

A

giant cell arteritis

49
Q

GCA - who?

A

elderly in west

50
Q

GCA - pathology

A

chronic granulomatous inflammation
large -> med arteries
esp. head art. e.g. temporal also vertebral and ophthalmic arteries

aorta = giant cell aortitis

ophthalmic arterial involvement: permanent blindness

MEDICAL EMERGENCY

51
Q

GCA - morphology

A

intimal thickening

med. granulomatous inflammation -> elastic lamina fragmentation

multinucleated giant cells

52
Q

GCA - clinical presentation

A

Rare

53
Q

GCA - diagnosis

A

biopsy

54
Q

GCA - treatment

A

corticosteroids

anti-TNF therapy in refractory cases

55
Q

Aneurysms -

A

localised, permanent, abnormal dilatations of a blood vessel

56
Q

Aneurysms - aetiology

A 
atherosclerotic
dissecting
berry
microaneurysms
syphilitic
mycotic
false
57
Q

What is a dissecting aneurysm?

A

Tear in the wall

blood tracks between intimal and medial layers

58
Q

Dissecting symptoms

A

Tearing pain in chest radiating to upper left shoulder

59
Q

Most common dissecting aneurysm

A

thoracic aorta 2°to systemic hypertension.

progressive vascular occlusion and haemopericardium. High mortality w/o treatment

60
Q

Dissecting aneurysm

A

Aim to reduce arterial pressure / surgery

61
Q

Berry aneurysm -

A

small, saccular lesions that develop in the circle of willis

develop at sites of medial weakness at arterial bifurcations

62
Q

Berry aneurysm - who?

A

young hypertensive patients

63
Q

Berry aneurysm - what does rupture cause?

A

subarachnoid haemorrhage (SAH)

64
Q

Charcot-Bouchard aneurysms -

A

occur in intracerebral capillaries in hypertensive disease, causing intracerebral haemorrhage

retinal microaneurysms can develop in diabetes

65
Q

Mycotic aneurysms -

A

rare
weakening of arterial wall 2°to bacterial/fungal infection
organisms enter media from the vasa vasorum
SBE is the most common underlying infection
often in cerebral arteries
infections of AAAs -> risk rupture

66
Q

What is a false aneurysm?

A

Blood filled space around a vessel, usually following traumatic rupture or perforating injury

67
Q

False aneurysm morphology

A

adventitial fibrous tissue contains the haematoma

commonly seen following femoral artery puncture during angiography/plasty

68
Q

6 Ps

A 
Pale
Pulseless
Painful
Paralysed
Paraesthetic
Perishing cold

Clinical Pathology (65 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions