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Year 1 - Term 2: Carriage of Oxygen > Cardiovascular Spotter > Flashcards

Flashcards in Cardiovascular Spotter Deck (17)
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Define infarct.

Where is the infarct in this image?

Area of necrotic tissue resulting from sudden absolute or relative reduction in blood flow.

Bright red area


Describe the histopathologic changes in the infarct after:

a) 0-12hrs

b) 12-24hrs

c) 24-72hrs

d) 3-10 days

e) weeks-months

a) no changes

b) bright eosinophilia of muscle fibres reflecting onset of coagulation necrosis; intracellular oedema

c) coagulative necrosis - loss of nuclei and striations; beginning of acute inflammatory

d) replacement of infarcted area by granualtion tissue (vascularised with active fibroblasts)

e) collagenous scar tissue


What stage of the histopathologic change is this - what can you see?

1 day infarct showing coagulative necrosis with wavy fibres


What stage of the histopathologic change is this - what can you see?

3-4 days post infarct wiht neutrophil infiltrate


What stage of the histopathologic change is this - what can you see?

7-10 days post infarct, nearly complete removal of necrotic tissue


What kind of tissue is this? What can you see?

Granulation tissue, loose collagen and abundant blood supply


What stage of the histopathologic change is this - what can you see?

Well healed infarct with dense collagen and a few remaining myocetes


Which image, L or R, is the older infarct?

L (prob about 10 days since MI - vascularised tissue with active fibroblasts = granualisation tissue)


What is the most common pathology underlying myocardial infarction?

List the factors involved in the pathogenesis of MI.

Coronary artery disease - atherosclerosis of coronary arteries (also coronary artery vasospasm)

Smoking, hypertension, family history, stress, diabetes, hyperlipidaemia, obesity, age, gender


What are the complications of MI:

a) short-term

b) long-term

a) L ventricular failure, cardiac dysrhythmias, rupture of ventricle wall, papillary muscle infection, formation of mural thrombus, fibrinous pericarditis, DVT

b) chronic intractable L ventricular failure, ventricular aneurysm formation, dressler's syndrome (uncommon immune mediated pericarditis), recurrant MI


Label A-C

A: vavle cusp

B: chordae tendinae

C: papillary muscle


What type of tissue is found in the centre of the venous valve (*)?

What cells are found on the edge of the venous valve (arrows)?

Which direction would blood normally be flowing through this vein?

Dense irregular CT


R -> L


What do the arrows indicate?

Pericarditis - diffuse granularity over pericardial surface indicating fibrinous (bread and butter)


What do the arrows indicate?

Endocarditis - small vegetations on the free edges of the vale cusps


What histological changes do you see in the myocardium? What are indicated by the arrows?

What is pancarditis?

Areas devoid of myocardial fibres where groups of cells are found. This is myocarditis.

Arrows = Aschoff bodies formed by epitheloid macrophages and lymphocytes.

Pericarditis, endocarditis and myocaridits


What is the most likely diagnosis for a patient who has pancarditis with Aschoff bodies?

What other symptoms may the patient have?

Rheumatic fever

Flitting joint pains, fever, tachycardia


How does rheumatic fever arise?

What are the acute and long-term complicatons of RF?

Immune disrder occuring several weeks after pharyngeal group A streptoccol infection, usually in kid 5-15yrs, relatively rare now due to prompt treatment

Acute: heart = pancarditis, joints = flitting polyarthritis, skin = subcutaneous nodules and skin rashes, arteries = arteritis, CNS = Sydenham's chorea

Long-term: chronic rheumatic heart disease (>50% will after 10/20yrs suffer with rheumatic valve disease).


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