8/19- Course Review 2 Flashcards Preview

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Flashcards in 8/19- Course Review 2 Deck (20):
1

The layer of coronary artery most involved by the process of atherosclerosis is:

A. Endothelium

B. intima

C. Internal elastic lamina

D. Media

E. Adventitia

The layer of coronary artery most involved by the process of atherosclerosis is: 

A. Endothelium 

B. intima 

C. Internal elastic lamina

D. Media 

E. Adventitia

 - Endothelium = top part of intima; want answer for the whole layer! Mid layer of intima is involved by later parts of the atherosclerotic process

2

The key pathologic process in atherosclerosis is:

A. Monkeburg's medial calcific sclerosis

B. Cholesterol emobli in the bloodstream

C. Intimal thickening and lipid accumulation

D. Granulomatous inflammation

E. Fibrinoid necrosis of vessel wall

The key pathologic process in atherosclerosis is: 

A. Monkeburg's medial calcific sclerosis 

B. Cholesterol emobli in the bloodstream

C. Intimal thickening and lipid accumulation

D. Granulomatous inflammation 

E. Fibrinoid necrosis of vessel wall

3

Atherosclerotic plaques consist of the following basic components:

A. Peripheral blood elements and fibrin

B. Granulomata and lipid deposition

C. Amyloid deposits, muscle cells, and fibrinoid necrosis

D. Dysplastic endothelial cells and lipid deposits

E. Smooth muscle cells, inflammatory cells, ECM, and lipid

Atherosclerotic plaques consist of the following basic components:

A. Peripheral blood elements and fibrin

B. Granulomata and lipid deposition 

C. Amyloid deposits, muscle cells, and fibrinoid necrosis

D. Dysplastic endothelial cells and lipid deposits 

E. Smooth muscle cells, inflammatory cells, ECM, and lipid

4

Typical series of events in atherosclerosis?

1. Injury to endothelium

2. Smooth muscle migration into intima

3. Proliferation of smooth muscle in intima

4. Elaboration of ECM in intima

5. Lipid accumulartion in intima

6. Necrosis

7. Calcification

5

Which is the typical sequence of events in an acute myocardial infarction?

NOT just worsening atherosclerosis with progressive stenosis...that would not be acute MI

1. Plaque rupture

2. Exposure of subendothelium

3. Platelet adhesion and aggregation

4. Vasospasm

5. Thrombosis

6. Occlusion of artery

7. Loss of oxygen delivery to myocardium

8. Coagulative necrosis of myocytes

6

Typical microscopic changes seen 24-72 hrs after an MI are:

A. Edema and hemorrhage

B. Coagulative necrosis; loss of nuclei and striations; heavy neutrophilic infiltrate

C. Dark eosinophilic myofibers with stretching and waviness

D. Fibrovascular granulation tissue

E. Extensive phagocytosis of dead cells with collagen deposition

Typical microscopic changes seen 24-72 hrs after an MI are: 

A. Edema and hemorrhage 

B. Coagulative necrosis; loss of nuclei and striations; heavy neutrophilic infiltrate 

C. Dark eosinophilic myofibers with stretching and waviness 

D. Fibrovascular granulation tissue

E. Extensive phagocytosis of dead cells with collagen deposition

7

Typical microscopic changes seen 4-24 hrs after an MI are:

A. Dark eosinophilic myofibers with stretching and waviness

B. Fibrovascular granulation tissue

C. Coagulation necrosis with loss o...

Typical microscopic changes seen 4-24 hrs after an MI are: 

A. Dark eosinophilic myofibers with stretching and waviness

B. Fibrovascular granulation tissue 

C. Coagulation necrosis with loss o...

8

Dilated cardiomyopathy is diagnosed pathologically by:

A. Four chamber hypertrophy and dilatation

B. Absence of primary valvular disease

C. Cardiomegaly

D. Thin, flabby walls

E. All of the above

Dilated cardiomyopathy is diagnosed pathologically by: 

A. Four chamber hypertrophy and dilatation

B. Absence of primary valvular disease

C. Cardiomegaly 

D. Thin, flabby walls 

E. All of the above

9

The best histologic description of idiopathic dilated CM is:

A. Nonspecific attenuation and hypertrophy of myocytes

B. Myocardial necrosis

C. Extensive mycoyte hypertrophy with mycocyte disarray

D. Intense neutrophilic infiltrate between myocytes

E. Intense lymphocytic infiltrate between myocytes

The best histologic description of idiopathic dilated CM is: 

A. Nonspecific attenuation and hypertrophy of myocytes

B. Myocardial necrosis

C. Extensive mycoyte hypertrophy with mycocyte disarray 

D. Intense neutrophilic infiltrate between myocytes

E. Intense lymphocytic infiltrate between myocytes

10

The best histologic description of hypertophic CM is:

A. An orderly arragnement of hypertrophic myocytes

B. Nonspecifi attenuation and hypertrophy of myocytes

C. Extensive mycoyte hypertrophy with mycocyte disarray

D. ...

The best histologic description of hypertophic CM is: 

A. An orderly arragnement of hypertrophic myocytes

B. Nonspecifi attenuation and hypertrophy of myocytes

C. Extensive mycoyte hypertrophy with mycocyte disarray 

D. ...

11

On exam of a heart at autopsy, you find large, irregular masses of the mitral valve leaflets that extend onto the valve cords. You tell the clinician that the most likely etiology of these vegetations is:

A. Infective endocarditis

B. Nonbacterial thrombotic (marantic) endocarditis

C. Acute rheumatic heart disease

D. Endocarditis of SLE (Libman-Sacks Disease)

E. Carcinoid heart disease

On exam of a heart at autopsy, you find large, irregular masses of the mitral valve leaflets that extend onto the valve cords. You tell the clinician that the most likely etiology of these vegetations is:

A. Infective endocarditis 

B. Nonbacterial thrombotic (marantic) endocarditis

C. Acute rheumatic heart disease 

D. Endocarditis of SLE (Libman-Sacks Disease) 

E. Carcinoid heart disease

12

On exam of a heart at autopsy, you find small vegetations on both sides of the mitral valve leaflets with no extension on the valve cords. Your immediate suspicion is?

LSE

13

Which of the following statements is true

A. Aschoff bodies are characteristic of chronic rheumatic heat disease

B. The aortic valve is the most commonly affected valve in rheumatic heart disease

C. Fusion of the cusp commissure is characteristic of calcific (senile) aortic stenosis

D Fusion of the cusp commissure sis characteristic of rheumatic heart disase

Which of the following statements is true

A. Aschoff bodies are characteristic of chronic rheumatic heat disease 

B. The aortic valve is the most commonly affected valve in rheumatic heart disease 

C. Fusion of the cusp commissure is characteristic of calcific (senile) aortic stenosis 

D. Fusion of the cusp commissures is characteristic of rheumatic heart disase

- Aschoff bodies are characteristics of acute rheumatic heart disease (?)

- Mitral valve is the most commonly affect in rheumatic heart disease

14

Causes of left-sided heart failure include all of the following, except?

A. Ischemic heart disease

B. Calcific (senile) aortic valve stenosis

C. Intrinsic disease of the lungs or pulmonary vasculature

D. Hypertension

E. All of these cause left-sided heart failure

Causes of left-sided heart failure include all of the following, except? 

A. Ischemic heart disease

B. Calcific (senile) aortic valve stenosis

C. Intrinsic disease of the lungs or pulmonary vasculature 

D. Hypertension 

E. All of these cause left-sided heart failure

15

Features of right-sided heart failure include of the following except:

A. Chronic passive congestion of the liver

B. Congestion of the kidneys with pronounced azotemia

C. Hypoxic encephalopathy

D. Severe pulmonary congestion and edema

E. Pitting edema of the extremities

Features of right-sided heart failure include of the following except: 

A. Chronic passive congestion of the liver

B. Congestion of the kidneys with pronounced azotemia

C. Hypoxic encephalopathy 

D. Severe pulmonary congestion and edema

E. Pitting edema of the extremities

- left sided heart failure

- In right sided failure, blood pools systemically (extremities, brain...)

- In left sided failure, blood pools in the lungs -> edema

16

Occlusion of the RIGHT coronary artery corresponds to MI in which of the following region area(s)?

A. Anterior 2/3 of interventricular septum

B. Inferior/posterior wall of the left ventricle

C. Posterior 1/3 of the interventricular septum

D. A and B

E. B and C

Occlusion of the RIGHT coronary artery corresponds to MI in which of the following region area(s)? 

A. Anterior 2/3 of interventricular septum 

B. Inferior/posterior wall of the left ventricle

C. Posterior 1/3 of the interventricular septum 

D. A and B 

E. B and C

17

Potential complications of a MI include all of the following except?

A. Thromboembolism

B. Left ventricular aneurysm and rupture of the free wall

C. Primary pulmonary HTN

D. Arrhythmia

E. Rupture of papillary muscle

Potential complications of a MI include all of the following except? 

A. Thromboembolism

B. Left ventricular aneurysm and rupture of the free wall 

C. Primary pulmonary HTN

D. Arrhythmia 

E. Rupture of papillary muscle

- Primary pulmonary HTN is more of a genetic thing

18

Potential complications of infective endocarditis include which of the following?

A. Hypocoagulable state

B. Diffuse glomerulonephritis

C. Extracardiac abscesses and infarcts

D. A and B

E. B and C

Potential complications of infective endocarditis include which of the following? 

A. Hypocoagulable state 

B. Diffuse glomerulonephritis 

C. Extracardiac abscesses and infarcts 

D. A and B 

E. B and C

- Infective process, so you will have extra-cardiac Sx as well

19

Classic microorganisms associated with the development of myocarditis include all of the following, except?

A. Influenza A and B

B. Trypanosoma cruzi (Chaga's)

C. Borrelia burgdorferi

D. Escherichia coli

E. Trichinella spiralis

Classic microorganisms associated with the development of myocarditis include all of the following, except? 

A. Influenza A and B 

B. Trypanosoma cruzi (Chaga's) 

C. Borrelia burgdorferi

D. Escherichia coli 

E. Trichinella spiralis

20

Microorganisms classically associated with infective endocarditis include which of the following?

A. Strep viridans

B. Staph epidermidis

C. Staph aureus

D. All of the above

Microorganisms classically associated with infective endocarditis include which of the following? 

A. Strep viridans 

B. Staph epidermidis 

C. Staph aureus 

D. All of the above