Cardiovascular Disease And intro of Heart Diseases

Question 1

What is the most common disease of arteries?

Answer 1

Atherosclerosis

-complications account for the majority of these deaths

Question 2

What progress are the lesions of atherosclerosis assumed to have?

Answer 2

From fatty streaks to fibrous plaques to “complicated lesions”

Question 3

What stage of atherosclerosis progression is asymptomatic and are considered to be precursors of advanced lesions?

Answer 3

Fatty streak

-seen first in very young

Question 4

What stage of atherosclerosis progression has characteristic features that include enlargement, plaque rupture and ulceration, hemorrage, degenerative changes, calcification and formation of superimposed thrombi?

Answer 4

complicated lesion (atheroma)

• Foam cells
• becomes asymptomatic (end stage)(advance)

MATURE

Question 5

What are traditional “hard” risk factors associated with atherosclerosis?

Answer 5

Hyperlipidemia, cigarette smoking, hypertension, diabetes mellitus

Question 6

What are the proposed mechanisms of atherosclerosis pathogenesis?

Answer 6

Reaction to injury and repair hypothesis, or monoclonal hypothesis

Question 7

What contributes to stable angina, chronic ischemic atrophy of myocardium, atherosclerotic dementia, leg claudication, intestinal angina?

Answer 7

Stable plaques (fixed stenosis)

Question 8

What is causing pain in angina?

Answer 8

Ischemic pain

Question 9

What type of occlusion manifestation of atherosclerosis gives rise to thrombosis?

Answer 9

Unstable plaques

-characterized by enlarged lipid core, thinner fibrous cap and accumulated inflammatory cells

Question 10

What is the sclerosis that is associated with degeneration and dystrophic calcification of media of “muscular” arteries, typically in older adults?

Answer 10

Monckebergs (medial) Sclerosis

- In tunica media

Question 11

What is the most common type of atherosclerosis?

Answer 11

Hyaline arteriolar sclerosis

Question 12

What causes increased risk for thrombosis, structural changes that lead to aneurisms and obliterating scars?

Answer 12

arteritis

• arterial disease of inflammatory origin
• increased risk for obstruction

Question 13

What is the most common form of arterial disease?

Answer 13

atherosclerosis

Question 14

What is Goodpasture’s syndrome?

Answer 14

Antibodies directed against components of vessel wall in arteritis

Question 15

What is the most common arteritis in older adults?

Answer 15

Giant cell (temporal) arteritis
-superficial temporal artery

Question 16

What is a disease of young male smokers?

Answer 16

Thromboangiitis obliterans (buerger’s disease)

Question 17

What is a segmental, necrotizing vasculitis of small and medium arteries?

Answer 17

polyarteritis nodosa

Question 18

What is called the “pulseless disease”?

Answer 18

Taykayasu’s arteritis “aortic arch disease”

-rare, idiopathic disease in younger adults

Question 19

What is associated with reversible spasmodic contraction and occlusion of arteries?

Answer 19

Raynaud’s phenomenon (or disease or primary)

-reaction to cold in small arteries (turns affected structures white then blue then red

Question 20

Where is the most common area that atherosclerotic (tension) aneurysms occur

Answer 20

Abdominal aorta, below level of renal arteries

Question 21

What is mostt famous for causing anurysms of proximal aorta that may rupture?

Answer 21

Syphilitic aneurism

- tree bark grooves on intima and occlusion of coronary and other ostia and it may cause dialation of aortic valve ring

Question 22

Most common places to find atherosclerotic?

Answer 22

aorta and common iliac

Question 23

what is associated with thoracic aorta aneurysm?

Answer 23

dissecting aneurism

-false aneurysm

Question 24

What is associated with dissecting aneurysm (defect in gene for fibrillin)?

Answer 24

Marfans syndrome

-cardiovascular: weakened aorta, floppy cardiac valves

Question 25

What location are most commonly associated with berry (congenital) annurysms?

Answer 25

branches of circle of willis and cererbral arteries | -over 40 years of age

Question 26

What are the most common disease of veins?

Answer 26

varicose veins

Question 27

What are common locations of varicose veins?

Answer 27

Superficial veins of lower extremities (saphenous veins), hemorrhoidal veins, esophageal veins, pampiniform plexus

Question 28

What does the panpiniform plexus of varicose veins feel like?

Answer 28

bag of gummy worms

Question 29

What is the most common location of varicose veins?

Answer 29

Saphenous veins

Question 30

Where are thrombi most common?

Answer 30

Deep veins of leg and pelvis

Question 31

Woman who are pregnant or on birth control and smoke are at high risk of developing what?

Answer 31

DVT

Question 32

What is associated with advanced cancer (mmalignant pancreatic cancer)?

Answer 32

Trousseau's migratory thrombophlebitis

Question 33

What does a positive Homan's sign mean?

Answer 33

Pain elicited with squeezing calf or dorsiflection of foot

Question 34

What are the most common causes of morbidity and mortality in many parts of the world?

Answer 34

Diseases of the heart and circulation

Question 35

What is the common manifestation of many cardiac diseases ?

Answer 35

Chronic (congestive) heart failure (CHF)

Question 36

What are the underlying causes of CHF?

Answer 36

- Myocardial dysfunction/damage - Impaired ventricular filling (diastolic dysfunction) ("increased stiffness") - Increased workload

Question 37

What is the Frank Starling mechanism

Answer 37

Ventricular dilation improves contraction by stretching myofibers

Question 38

What is the difference between compensatory and and decompensation mechanisms?

Answer 38

C: activated to maintain adequate blood flow with the onset of heart failure: maintain cardiac output D: associated with decreased ability to maintain minimum levels of output

Question 39

What would make a heart beat harder and faster?

Answer 39

Increased return, pumps back what was pumped in

Question 40

What does compensatory mechanisms effect?

Answer 40

Effects vasodialation, natriuresis

Question 41

What is the most common cause of CHF

Answer 41

Left side ventricular failure | -most important: coronary heart disease (IHD)

Question 42

What is the feeling of being out of breath when lying flat and improves on sitting up?

Answer 42

Orthopea | -accompanies pulmonary congestion (backward failure)

Question 43

What is associated with white sputum that may be tinged with blood ( Rusty sputum) and Pleural effusion (edema)?

Answer 43

Paroxysmal nocturnal dyspea

Question 44

What i reduced output?

Answer 44

- leads to decreased arterial perfusion and systemic hypoxia - renal ischemic activates vasopressor mechanisms & increased retention of fluids - organs become hypoxic - "Forward failure"

Question 45

The major effects upon circulation result from what in heart failure?

Answer 45

Reduced output ( forward failure) and venous congestion (backward failure)

Question 46

What develops in the absence of left ventricular failure and contributes to pulmonary hypertension and right ventricular failure?

Answer 46

Mitral stenosis

Question 47

What is characterized by congestion of systemic veins?

Answer 47

Right ventricular failure

Question 48

What is a very common heart disease?

Answer 48

Ishemic heart disease | -87% of this is caused by atherosclerosis

Question 49

What is associated with "fullness" of neck & abdomen (subcutaneous edema), "nutmeg" pattern and cardiac cirrhosis of liver, and portal hypertention with ascites?

Answer 49

Right ventricular failure

Question 50

What are the "four varients" of Ischimic heart disease?

Answer 50

chronic ischemic heart disease angina pectoris myocardial infarction sudden cardiac death

Question 51

What congestion is associated with pulmonary rales, rusty sputum and pleural effusion?

Answer 51

Pulmonary congestion | -Rusty sputum= foam cell lysis