Diseases of Organ Systems CARDIOVASCULAR - 34% Flashcards

1
Q

What is cyanotic heart disease due to?

A

Right to left shunt in the heart

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2
Q

What is acyanotic heart disease due to?

A

Left to right shunt in the heart as in: VSD, ASD, PDA VSD = ventricular septum defect (most common congenital heart disease 30%) ASD = atrial septum defect (failure of the ostium secundum to close PDA = patent ductus arteriosus (should close shortly after birth)

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3
Q

What is the most common congenital heart disease?

A

Ventricular septum defect (30% of congenital heart disease). Causes acyonotic heart disease

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4
Q

What is the most common cyanotic congenital heart disease?

A

Fallot’s tetralogy

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5
Q

What is Fallot’s tetralogy?

A
  1. Pulmonary stenosis 2. Ventricular septal defect 3. Right ventricular hypertrophy 4. Overriding (dextro-position) aorta
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6
Q

What is transition of the great vessels of the heart?

A

Aorta is connected to the right ventricle and the pulmonary trunk to the left ventricle

  • an uncommon cause of congenital cyanotic heart disease
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7
Q

What is coarctation of the aorta

A

Narrowing of the arch of the aorta near the ligament upon arteriosum

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8
Q

Rheumatic fever is due to

A

post-strep infection

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9
Q

What is rheumatic fever characterized by

A

aschoff bodies (granulomas with giant cells), antischkow cells and MacCallum’s patches (in left atrium)

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10
Q

What is Jones major criteria in diagnosing rheumatic fever?

A

SPECS

  1. Sydenham’s chorea
  2. Polyarthritis
  3. Erythema marginatum
  4. Carditis
  5. Subcutaneous nodules
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11
Q

What is endocarditis and what can cause it?

A

Inflammation of the endocardium (affecting the valves)

  • streptococcus pyogenes, streptococcus viridans, staphylococcus aureus
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12
Q

What is subacute bacterial endocarditis and what is it a sequele of?

A

Infection of previously damaged valves

  • rheumatic fever (S. Viridans)
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13
Q

What are the signs of subacute bacterial endocarditis?

A

Fever, new mumur, splinter hemorrhages, olser’s nodes and Janeway nodules

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14
Q

What is acute bacterial endocarditis?

A

infection of previously healthy valves

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15
Q

What is libman sacks endocarditis? What is it associated with?

A

Sterile (non-infective) endocarditis of pulmonary and tricuspid valves seen in SLE (systemic lupus erythmatosus)

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16
Q

What is syphilitic aortitis? What does it lead to?

A

Treponema pallidum infection often affecting the arch of the aorta leading to aortic aneurysm, aortic stenosis, angina pectoris

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17
Q

What is a thrombus

A

a clot formed within an atherosclerotic vessel with lines of Zahn

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18
Q

What is an embolism?

A

a dislodged mass of undissolved material in blood vessel traveling in the blood

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19
Q

What are signs of an arterial embolism?

A

Painful, pale, pulseless, perishingly cold limb

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20
Q

What is arteriosclerosis?

A

Thickening of the arteries with loss of elasticity and contractility due to infiltration of the tunica intima by collagen and smooth muscle fibers

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21
Q

What is atherosclerosis

A

lipid/calcium deposits in tunica intima

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22
Q

What are risk factors for atherosclerosis?

A

Cigarette smoking, fatty diet, obesity, hypertension, diabetes and homocysteinemia and high LDL

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23
Q

How does atherosclerosis progress?

A

subendothelial fatty streak ->fibrosis -> atheroma -> rupture with eventual occlusion or embolus formation

24
Q

What causes ischemic heart disease and what does it lead to?

A

Coronary atherosclerosis

  • angina, myocardial infarction, congestive heart failure
25
Q

What is angina pectoris

A

A reversible inadequately perfumed myocardium that is relieved by rest

26
Q

What is prinzmetal angina? What causes it?

A

Angina that occurs at rest

  • coronary artery spasm
27
Q

What is myocardial infarction

A

ischemic necrosis of myocardium due to blocked coronary artery, mainly the lest anterior descending artery

*pain is not relieved by rest

28
Q

What does myocardial infarction release?

A

Cardiac enzymes such as troponin and creatine kinase - myocardial band and lactic dehydrogenase

29
Q

What is an aneurysm?

A

localized dilation of an artery. Can be congenital or acquired

30
Q

What is an abdominal aortic aneurysm due to? What are the signs?

A

atherosclerosis

  • pulsatile abdominal mass with a bruit and LBP
31
Q

What is a dissecting aneurysm? What pathologies is it associated with?

A

intraluminal tearing of the ascending thoracic aorta

  • Marfan’s, Ehlers-Danlos syndromes, longstanding hypertension
32
Q

What is syphilitis aneurysm?

A

Results from tertiary syphilis and mainly affects the arch of the aorta

33
Q

What is a berry aneurysm?

A

Congenital weaknesses that only present in the 3rd decade and onwards that commonly affects the anterior part of the circle of Willis

34
Q

What is a berry aneurysm associated with? what might it cause in young adults?

A

Adult polycystic disease of the kidney

  • subarachnoid hemorrhage
35
Q

What are the signs of a berry aneurysm?

A

severe sudden headache,neck stiffness, loss of consciousness

36
Q

How is hypertension diagnosed?

A

>140/90 on 3 or more occasions

37
Q

What is the most common type of hypertension? What are the risk factors?

A

essential (unknown) - 95%

  • family history, high salt intake, stress, obesity
38
Q

What type of hypertension accounts for 5% of hypertension? what causes it?

A

secondary

  • unilateral artery stenosis, hyperthyroidism, Cushing’s, pheochromocytoma
39
Q

What is malignant hypertension?

A

rapidly progressing with severe vascular damage

  • ma lead to early death from a stoke or heart failure
40
Q

What causes congestive heart failure?

A

Coronary artery disease, hypertension, valvular heart disease, congenital heart disease or cardiomyopathy

41
Q

What is cardiomyopathy? What causes it? What are the three types?

A

disease myocardium

  • alcohol, pregnancy, viral infection
  • dilated (most common), hypertrophic, restrictive (rare)
42
Q

What is Cor pulmonale? What causes it?

A

right heart failure

  • COPD, pulmonary embolism
43
Q

When does cardiac tamponade occur?

A

when the heart is compressed due to excess fluid in pericardial sac

44
Q

What is Beck’s triad and what is it for?

A

3 H’s

  • hypotension, heart sounds are distant, high venous pressure
  • cardiac tamponade
45
Q

What causes peripheral vascular disease? How does it present?

A

atherosclerotic narrowing of large arteries

  • intermittent claudication. Pain in calves on walking and relieved by rest
46
Q

What is Virchow’s triad? What is it for?

A

3 V’s

  • viscosity (increased clotting which may be related to contraceptive pill), venous stasis, vessel wall damage
  • deep vein thrombosis may present with painful swollen leg
47
Q

What is a pulmonary embolism? what does it cause? What are the signs?

A

related to DVT in leg or pelvis when a piece of the clot breaks off (embolus), travels to the inferior vena cava into the heart, up the plenary trunk, concludes the pulmonary arteries or smaller branch,

  • causes ventilation/perfusion mismatch
  • shortness of breath, pleuritic chest pain and hemoptysis (caugh blood)
48
Q

What are varicose veins? what may they lead to?

A

tortuous dilated superficial veins

  • thrombophlebitis
49
Q

What is thrombophlebolitis? what might is lead to? What are the signs

A

inflammation in the vein wall

  • thrombosis
  • swollen tender superficial cord under the skin
50
Q

What is Raynaud’s? what are the signs? Who get’s it?

A

Decreased blood flow triggered by cold and emotion

  • vasospasm (white), cyanosis (blue), vasodilation (red)
  • young females with no known cause
51
Q

What can Raynaud’s phenomenon be secondary to?

A

SLE, atherosclerosis, scleroderma

  • may be part of CREST (calcinosis cutis, raynaud’s Phenomenon, esophageal dysfunction, scleroderma, telangiectasia)
52
Q

What does CREST stand for?

A

calcinosis cutis, Raynaud’s phenomenon, Esophageal dysfunction, Scleroderma, Telangiectasia

53
Q

What is polyertritis nodosa? what does it affect? What might it be associated with?

  • What are the signs?
A

inflammation due to a type II hypersensitivity reaction. Affects medium size arteries, 30% are seropositive for Hep B

  • fever, joint, abdominal pains and palpable purpura
54
Q

What is thromboangitis obliterans (Buerger’s disease)? Who get’s it?

A

Intermittent claudication and weakened distal pulses due to idiopathic segmental inflammation of medium size arteries and veins

  • male smokers between 20 and 40 years
55
Q

What is temporal arteritis? who get’s it? What can it cause?

A

Localized giant cell inflammation in small arteries like branches of the ICA and vertebral arteries. Associated with elevated ESR

  • in elderly
  • may cause blindness if not treated promptly
56
Q

What is Takayasu’s arteritis? what are the signs? Who is it more common in?

A

Pulseless disease

  • due to inflammation of the aorta: possible autoimmune
  • absent pulses, mainly in upper limbs
  • Asian females <40
57
Q
A