Cardiovascular Pathology Flashcards
(127 cards)
1
Q
How many people live with CVD in the UK?
A
7 Million
2
Q
The group of syndromes resulting from myocardial ischaemia are collectively known as
A
Ischaemic Heart Disease
3
Q
What is IHD usually caused by?
A
coronary artery atherosclerosis
4
Q
What makes up acute coronary syndrome?
A
MI
Unstable angina
5
Q
How does prinzmetal angina differ from other types of angina?
A
It is caused by vasospasm rather than atherosclerosis
6
Q
What are risk factors for IHD?
A
High BP
High HDL
Low TC:HDL ratio
7
Q
In what layer does the atherosclerotic plaque develop?
A
Intima
8
Q
What are the types of MI?
A
Transmural- across the full thickness of the wall
Subendocardial- across the inner 1/3rd that is least well perfused
9
Q
What type of necrosis occurs in myocardium?
A
Coagulative
10
Q
STEMIs are associated with which type of MI? Will there be cardiogenic shock?
A
Transmural
Yes
11
Q
When will the following changes occur in the myocardium:
Yellow with haemorrhagic edge, myocyte necrosis and macrophages
A
Day 3-4
12
Q
What are complications of an MI?
A
Heart failure Arrhythmia Pericarditis Cardiac tamponade Cardiogenic shock
13
Q
What is Beck’s triad?
A
Hypotension
Distended JVD
Muffled heart sounds
14
Q
What is Virchow’s Triad?
A
Hypercoagubility
Altered blood flow
Endothelial cell injury
15
Q
Troponins T&I can be seen in what condition?
A
IHD
peak at 12 hours but can also be seen in PE, HF and myocarditis
16
Q
Creatinine Kinase MB (CKMB) peaks when?
A
10-24 hours
It is also found in skeletal muscle
17
Q
Myoglobin, Aspartate transaminase and Lactate dehydrogenase isoenzyme 1 are blood markers of what?
A
IHD
Lactate is detectable for up to 14 days after an MI
18
Q
What group is affected more by hypertension?
A
Africans
19
Q
BP=
A
Cardiac output x Peripheral resistance
20
Q
What does the RAAS regulate?
A
blood volume and systemic vascular resistance
21
Q
Where is renin produced?
A
Juxtaglomerular apparatus in the kidneys
22
Q
Where can AII be formed?
A
Lungs (primarily)
Heart
Brain
23
Q
What does aldosterone do?
A
Stimulates reabsorption of salt and water at the kidneys
24
Q
What does AII to?
A
stimulates aldosterone release
causes vasoconstriction
stimulates release of ADH to increase fluid retention
facilitates noradenaline release
25
Renal artery stenosis, polyarteritis nodosa and aortic coarctation can
cause secondary hypertension
26
BP over 180/120 shows signs of
malignant hypertension
27
A 'flea bitten' kidney, SAH and lacunar infarcts are
complications of hypertension
28
In left sided hypertensive heart disease, what occurs
hypertrophy of LV in response to pressure overload
29
Cor pulmonlae refers to
right sided hypertensive heart disease that causes:
RV hypertrophy and HF secondary to pulmonary artery hypertension caused by disorders of the lung
30
What are diseases of the lung parenchyma that can cause Cor Pulmonale?
COPD, CF, Pneumoconiosis, Bronchiectasis, Pulmonary interstitial fibrosis
31
Kyphoscoliosis, Pickwickian syndrome and neuromuscular diseases are causes of
Cor pulmonale
32
A breach in the vascular wall leading to an extravascular haematoma that communicates with the intravascular space is known as
a false aneurysm
33
Dissecting aneurysms occur
between the walls of the artery
34
Which type of double barreled aorta is associated with the descending aorta alone?
Type B
35
What are the main causes of aneurysms?
Atherosclerosis
| Cystic medial degeneration (associated with Marfan)
36
Insiduous HF is caused by
hypertension and valve diseases
37
HF is more common in
those over 40
males
postmenopausal women
38
Sudden HF is cause by
a large MI and fluid overload
39
What are other causes of HF?
Beriberi
anaemia
hyperthyroidism
40
Atrial natriuretic peptides are released in
cardiac dysfunction
41
Left sided HF is due to
pulmonary congestion
| low CO and hypoperfusion of tissues
42
What are symptoms seen in left sided HF?
```
Increased hydrostatic pressure in pulmonary circulation
Orthopnoea
PND
Blood tinged sputum
'Wedge' pressure
```
43
What causes left sided HF?
Cor pulmonale or left heart failure
44
A nutmeg liver is seen in what condition?
| What is it caused by?
Right sided HF
| Passive congestion
45
Hydrothorax and distention of the jugular veins are symptoms of which sided HF?
Right
46
Aortic stenosis occurs via
calcification of a congenitally bicuspid valve
calcification in those over 70
rheumatic heart disease
47
What is the only cause of mitral stenosis?
Rheumatic heart disease
48
What causes a 'collapsing pulse'?
Aortic regurgitation
49
What can cause aortic regurgitation?
Rheumatological disorders
Syphilis
Marfan's
50
MVP is the main cause of
Mitral regurgitation
51
Fen-phen (appetite suppressant) induces valvular fibrosis that causes
Mitral regurgitation
52
Problems with the chordae tendinae and papillary muscle can cause
mitral regurgitation
53
myxamatous degeneration of the mitral valve is also known as
mitral valve prolapse
54
MVP is associated with
Marfan syndrome
55
Which congenital heart diseases are associated with a L to R shunt?
Ventricular septal defect
Atrial septal defect
Patent ductus arteriosus
AV septal defect
56
Which congenital heart diseases are associated with a R to L shunt?
```
ToF
Transposition of the great arteries
Truncus arteriosus
Tricuspid atresia
Total anomalous pulmonary venous connection
```
57
What congenital heart defects are associated with DiGeorge syndrome?
conotruncus
58
mutations of the TBX5 gene leads to
ASD, VSD
59
mutations of the NKX2.5 and GATA4 genes leads to
ASD
60
Congenital rubella syndrome can cause
Congenital heart diseases
61
R to L shunts cause
cyanosis
62
L to R shunts cause
pulmonary hypertension
63
Eisenmenger syndrome is
where in a VSD, the L to R shunt is reversed to a R to L shunt with cyanosis
64
Patent foramen ovale does not cause a
Atrial septal defect
65
Secundum is the most common type of
ASD
66
VSDs are common in
ToF
67
A boot shaped heart is characteristic of
TOF
68
The common features of TOF are
VSD
Overriding aorta
RV hypertrophy
Pulmonary stenosis
69
What does survival with TOF depend on
the severity of the pulmonary stenosis
70
Tet spells are experienced by babies when they
feed/cry
71
Which direction is the shunt in TOF?
R to L
72
Coarctation of the aorta is common in what condition
Turners syndrome
73
In infants, what does coarctation of the aorta cause
cyanosis in lower half of the body (due to patent ductus arteriosus)
74
In adults, what does coarctation of the aorta cause
hypertension in UL
hypotension in LL
notching on undersurface of the ribs
claudication and coldness
75
What are the 6 Ps of acute ischaemia?
```
pallor
pulseless
painful
paralysed
perishing cold
paraesthetic
```
76
Chronic granulolmatous inflammation of arteries is known as
giant cell arteritis
77
GCA is usually
immune mediated
78
temporal arteritis is a form of
GCA
79
GCA can be treated with
corticosteroids
| anti-TNF therapy
80
vegetations on valves is indicative of
endocarditis
81
SLE and NBTE are causes of
non-infective endocarditis
82
subacute infective endocarditis is caused by
organisms of a lower virulence
83
When is S. viridans likely to cause infective endocarditis ?
late (60 days after surgery)
usually to damaged valves
84
IVDUs are likely to get infective endocarditis from what organism?
S. aureus
85
When are murmurs present in IE?
Left sided cases
86
What are clinical signs of IE?
Splinter haemorrhages
Janeway lesions
Oslers nodes
Roth spots
87
What causes rheumatic fever?
Group A streptococci
88
Veruccae and Aschoff bodies are typical of
rheumatic fever
89
'Fish mouth' and 'buttonhole' stenosis are seen in
on the mitral valve in rheumatic fever
90
Diagnosis of rheumatic fever requires
Jones criteria
91
Coxsackie B can cause what cardiovascular infection?
Pericarditis
92
What is Dressler's?
secondary form of pericarditis and occurs post MI (years later) and it is an autoimmune response
93
What type of pericarditis is caused by non-infectious aetiologies?
Serous pericarditis
94
What is the most common form of pericarditis?
Serofibrinous pericarditis
95
Suppurative pericarditis can extend to cause
mediostino-pericarditis
96
In which type of pericarditis is complete resolution rare
Suppurative pericarditis
97
Neoplasia and cardiac tamponade can cause what type of pericarditis?
Haemorrhagic
98
The treatment for what type of pericarditis is to remove the 'shell' by surgery?
Chronic pericarditis
The pericardial sac becomes fibrosed and leads to limited cardiac function
99
What relieves pericarditis?
Sitting forwards
100
What type of cardiomyopathy is associated with cytoskeleton protein gene mutations?
Dilated cardiomyopathy
101
In what cardiomyopathy is there diastolic dysfunction with preserved systolic function?
Hypertrophic cardiomyopathy
102
What can be used to treat hypertrophic cardiomyopathy?
beta-adrenergic blockers
103
What is the rarest cardiomyopathy?
Restrictive
104
A disorder of cell-cell desmosomes causes
Arrhythmic RV cardiomyopathy
105
Chaga's disease and Lyme disease can cause
myocarditis
106
an inflammatory process of leptomeninges and CSF is known as
meningitis
107
meningoencephalitis is
inflammation of the meninges and brain parenchyma
108
What are the three forms of meningitis?
acute pyogenic (bacterial)
aseptic (viral)
chronic (TB, neurosyphilis and cryptococcis neoformans)
chronic meningitis is where CSF remains abnormal for >4 weeks
109
Haematogenous spread of CNS infections is
the most common and usually via an arterial route (can also be retrograde)
110
Direct implantation of CNS infections is normally
traumatic
111
CNS infections can spread from local regions such as
the mastioid, frontal sinuses and infected teeth
112
Clinical feature of meningitis include
```
headache
irritability
photophobia
fever
rash
```
113
In the young, meningitis can be caused by
```
S. agalactiae
Listeria monocytogenes
Klebsiella
Salmonella
H. influenzae
```
114
What does the CSF look like in meningitis?
cloudy and turbid
100-2000 polymorphs
high protein
115
Viral meningitis can start as
respiratory or intestinal infections
116
What type of meningitis has an insidious onset and high frequency of complications?
Tubercular meningitis
117
What commonly causes encephalitis?
viruses, especially Herpes
118
What are the clinical features of encephalitis?
behavioural changes
Headache
seizures
focal neurological consciousness
119
What can cause severe haemorrhage encephalitis affecting the temporal lobe?
Herpes encephalitis
120
When is the rabies infection cycle complete?
When the virus replicates in the salivary glands
121
What are symptoms of the prodromal phase of rabies?
fever
nausea
fatigue
burning
122
what are symptoms of the furious phase of rabies?
agitation
disorientation
hydrophobia
seizures
123
What are the last two phases of the rabies infection?
Dumb phase and coma phase
124
What causes tabes dorsalis?
Neurosyphilis
125
Brain abscesses are often
polymicrobial
126
What pathogen commonly causes brain abscesses after trauma/surgery?
S. aureus
127
How is a brain abscess managed?
Drainage
small abscesses can be treated with Abx
