Cardiovascular System - Fung Flashcards
(270 cards)
1
Q
what is the normal weight of a female heart?
A
250 - 300 g
2
Q
What is the normal weight of a male heart?
A
300-350 g
3
Q
What is the normal wall thickness of the right wall?
A
0.3-0.5 cm
4
Q
what is the normal thickness of the left ventricle?
A
1.3-1.5 cm
5
Q
what cell type metabolizes hormones?
A
endothelial
6
Q
what cell type proliferates when stimulated?
A
smooth muscle
7
Q
what cell type regulates inflamm?
A
endothelial cells
8
Q
what cell type regulates cell growth?
A
endo
9
Q
what part of the vascular structure contains elastin, collagen, and glycosaminoglycans?
A
extracellular matrix
10
Q
what cell type modulates vascular resistance?
A
endotheilial cells
11
Q
what cell type mantains non-thrombogenic blood-tissue interface?
A
endothelial cells
12
Q
from lumen outward, what are the layers of a muscular artery?
A
internal elastic lamina
tunica media
external elastic lamina
tunica adventitia
13
Q
do arteries or veins contain valves?
A
veins
14
Q
what are the six mechanisms of cardiac dysfunction?
A
Pump failure Obstruction regurgitation shunt conduction rupture of a major vessel
15
Q
endothelial loss or dysfunction stimulates (blank) cell growth and ECM matrix thickening
A
smooth muscle cell
16
Q
ECM thickening leads to thickening of which layer of the vessel?
A
intima
17
Q
what are the complications of long term HTN?
A
atherosclerosis HTN heart disease multi-infarct dementia aortic dissection renal failure
18
Q
increased nitric oxide, prostacyclin, kinins, and ANP will lead to….
A
decreased peripheral resistance aka dilation aka decreased blood pressure
19
Q
decreased levels of neural factors (b-adrenergic) will lead to….
A
decreased peripheral resistance aka dilation aka decreased blood pressure
20
Q
Decreases in blood volume, heart rate, or contractility will have what affect on BP?
A
decreased
21
Q
increased levels of what five compounds will lead to increased peripheral resistance and therefore blood pressure?
A
ANG II catecholemines thromboxane endothelin a-adrenergic neural factors
22
Q
What affect does ANP have on the kidney?
A
excretes Na and Water leading to decreased blood volume and a drop in BP
23
Q
Low volume or low resistance measured by the kidney causes it to release what to increase blood pressure?
A
Renin
24
Q
Renin converts what enzyme from the liver?
A
angiotensin to angiotensin 1
25
what organ produce ACE?
lungs
26
what organ does ANG II affect?
adrenal glands to produce aldosterone
27
what organ does aldosterone affect and what does it do?
kidney; reabsorb Na and water
28
what are the two mechanisms by which ANGII causes an increase in blood pressure?
increase in blood volume and via vasoconstriction
29
what is normal BP?
120/80
30
What is prehypertensive?
120-139/80-89
31
What is abnormal BP?
>140/>89
32
What is malignant BP?
>200/>120
33
Single gene defects in what two areas can lead to essential hypertension?
aldosterone metabolism and sodium reabsorption
34
(blanks) in the angiotensin locus, ANG receptor, and renin-angiotensin system can lead to essential hypertension
polymorphisms
35
What are the vascular causes of essential hypertension?
vasoconstriction and structural changes
36
What are the environmental factors leading to essential hypertension?
```
diet
stress
obesity
smoking
being a lazy ass
```
37
what kinds of tumors can cause secondary HTN? where do you find them?
renin-producing tumors in the kidney
38
what are the renal causes of secondary HTN?
1. acute glomerulonephritis
2. chronic renal disease
3. polycystic kidney disease
4. renal artery stenosis
5. renal vasculitis
6. renin-producing tumors
39
What are the endocrine causes of secondary HTN?
1. adrenal dysfunction
2. exogenous hormones
3. pheochromocytoma
4. acromegaly
5. hypothyroidism
6. hyperthyroidism
7. pregnancy induced
40
what are the cardiac causes of secondary HTN? (think anatomy)
1. coarctation of the aorta
2. polyarteritis nodosa
3. increased intravascular volume
4. increaed cardiac output
5. rigidity of aorta
41
What are the neurologic causes of secondary HTN?
1. psychogenic
2. increased ICP
3. sleep apnea
4. acute stress
42
what are the two types of arteriosclerosis?
hyaline
| hyperplastic
43
what are the three things that can happen when an atheroma forms?
obstruction of blood flow
rupture and vessels thrombosis
aneurysm formation
44
Describe the make up of an atheroma fibrous cap?
fibrous cap of smooth muscle cells, macrophages, collagen, elastin proteoglycans, and NEOVASCULIZATION
45
describe the make up of the necrotic center of an athermoa?
cell debris, cholesterol crystals, foam cells, and calcium depositis
46
what are the constitutional risk factors in atherosclerosis?
age
gender
genetics
47
what are the modifiable risk factors for atherosclerosis?
hyperlipidemia
hypertension
cigarette smoking
diabetes
48
what are the miscellaneous risk factors for atherosclerosis?
1. inflamm
2. hyperhomocystenemia
3. metabolic syndrome
4. lipoprotein a
5. hemostatic factors
6. sedentary life style
7. type A personality
8. obesity
49
Describe the process of atheroma formation?
1. endothelial injury
2. lipoprotein accumulation
3. monocyte adhesion and formation of foam cells
4. PLT adhesion
5. smooth muscle recruitment
6. smooth muscle proliferation and ECM production
7. lipid accumulation
50
what are the causes of endothelial INJURY?
mechanical denudation
immune complex deposition
irradiation
chemicals
51
what are the causes of endothelial DYSFUNCTION?
1. hemodynamic disturbances
2. hypercholesterolemia
3. hypertension
4. smoking
5. infectious agents
6. homocysteine
52
where do plaques tend to occur?
at the ostia of exiting vessels
branch points
POSTERIOR wall of the aorta
53
what type of flow protects against atherosclerosis?
laminar flow
54
What are the dominant lipids in plaques?
cholesterol and cholesterol esters
55
Genetic (blank) is associated with accelerated atherosclerosis
hyperlipoprotenemia
56
DM and HYPOthyroidism are associated with....
hypercholesterolemia
57
Lowering serum cholesterol lowers the rate of....
atherosclerosis
58
Lipid accumulatoin reduces the ability of vessels to...
vasodilate
59
Hyperlipidemia increases the production of (blank) which then accelerates nitric oxide decay
free radical production
60
Atherosclerosis increases the production of what cell type?
foam cells
61
Oxygen free radicals oxidize what type of cholestero[l?
LDL
62
How is oxidized LDL taken up by mac's?
via a scavenger receptor
63
Oxidized LDL increases the release of (blank) factors which leads to increased monocyte recruitment
growth factors, cytokines, and chemokines
64
oxidized LDL is cytotoxic to what two cell types?
endothelial cells and SMC causing endothelial cell dysfunction
65
Atherosclerotic lesions in smooth muscle cells are in a chronic (blank) state
inflammatory (t cell infiltrate)
66
Chemokines and growth factors produced promote (blank) cell proliferation and ECM synth
smooth muscle cell
67
The ECM and smooth muscle proliferation converts the fatty streak into a mature (blank)
atheroma
68
critical stenosis occurs at what percent occlusion?
70%
69
chronically decreased perfusion leads to what four major complications?
bowel ishemia
chronic IHD
ischemia encephalopathy
intermittent claudication
70
What are the three types of acute plaque change?
1. rupture/fissure
2. eorsion/ulceration
3. hemorrhage into the atheroma
71
mural thormbosis, embolization, and wall weakening will do what to an unstable plaque?
cause aneurysm and rupture
72
Plaque rupture, erosion, hemorrhage, mural thrombosis, or embolization will do what to an unstable plaque?
occlusion by thrombosis
73
Progressive plaque growth will cause a (blank) stenosis
critical
74
90% of ischemic heart disease arises from (blank) lesions in the coronary arteries
obstructive atherosclerotic lesions
75
what are the three complications of IHD?
tachycardia
myocardial hypertrophy
hypoxemia
76
besides atherosclerotic lesiosn, what three other things can cause IHD?
coronary emboli
blockage of coronary arteries
severe hypotension
77
Late manifestation of coronary atherosclerosis may have started when in life?
childhood or adolescence
78
According to Fung, what are the the four things included in ACS?
Angina pectoris
MIS
Chronic IHD with heart failure
sudden cardiac death
79
what is the causes of angina pectoris?
transient myocardial ischemia that falls short of inducing myocyte necrosis
80
Unstable angina is also known as....
crescendo angina
81
stable angina is also known as....
typical angina
82
what percent occlusion is needed to cause stable angina?
75%
83
what things relieve stable angina?
rest or vasodilators
84
what two meds can relieve prinzmetal angina?
vasodilators and calcium channel blockers
85
at what percent occlusion do you see unstable angina?
90% or greater`
86
what are the two things that can precipitate unstable angina?
acute plaque change with superimposed thrombus/embolism
| vasospasm
87
unstable angina is a warning of an impending....
acute MI
88
Describe the sequence of events in an acute MI
1. acute change of atheromatous plaque exposes thrombogenic contents
2. PLTs adhere to exposed plaque
3. PLTs degranulate
4. degranulation initiates vasopasm
5. tissue factor activates coag cascade
6. thrombus occludes lumen of the vessel
89
what are the vaspasm causes of MI without coronary vascular path?
cocaine abuse
| PLT aggregation
90
What are the emboli causes of MI w/o vascular path?
A-fib of left atrium
Vegetations from infective endocarditis
L sided mural thrombus
Paradoxical R sided emboli
91
What are the causes of ischemia without atherosclerosis or thrombosis?
```
Vasculitis
sickle cell disease
amyloid deposition
vascular dissection
shock (severe hypotension)
```
92
reversible ischemia cannot last longer than...
20-30 minutes
93
how soon after ischemia onset does aerobic metabolism stop?
within seconds
94
how soon after ischemia onset does contractility stop?
within 60 seconds
95
Necrosis is complete within (blank) hours of onset
6
96
T/F: heart rate, cardiac rhythm, and O2 sat determine the morphologic features of an MI
true
97
myocardial ischemia begins in what layer of the heart and travels in which direction?
in the endocardium and travels outward
98
A transmural necrosis involves how much of the wall?
full thickness
99
a (blank) infarction is associated with chronic atherosclerosis, acute plaque change, and superimposed thrombus
transmural
100
What type of infarct is ST elevated?
transmural
101
How much of the wall thickness is involved in a subendocardia infarct?
one third to one half
102
what type of infarct is due to ANY reduction in coronary flow, aka plaque disruption with lysed thrombus, global hypotension
subendocardial infarct
103
what type of infarct is non-ST elevated?
subendocardial
104
why is the endocardium the first layer to experience ischemia?
its the farthest way from the coronary vessels! (which lie on the outside of the heart :) )
105
what areas of the heart does that LAD supply?
Apex
anterior wall of the LV
anterior 2/3 of the ventricular septum
106
What areas of the heart does that right coronary artery supply?
posterior 1/3 of septum (dominant/ common form)
RV free wall
posterobasal wall of LV
107
What areas of the heart does that LCx feed?
LV myocardium
108
List the three cardiac markers in order of first to last to appear
Myoglobin 0-2 hours
CK-MB 2-4 hours
Troponin I and T 2-4 hours
109
Which cardiac biomarker takes the longest to peak
Troponins, 48 hours
110
Which cardiac biomarker is the most sensitive and specific?
troponins
111
CK-MB is sensitive or specific?
sensitive but not specific
112
In what other tissues do we find myoglobin?
skeletal muscle
113
CK-MM is found in what two tissues?
cardiac and skeletal muscle
114
CK-BB is found in what two tissues?
brain and lung
115
CK-MB is found in what two tissues?
mostly cardiac, some skeletal
116
when does myoglobin peak?
6-8 hours
117
when does CK-MB peak?
24 hours
118
how long do the troponins stay elevated after an MI?
7-10 days
119
What are the treatments for ischemic heart disease MI?
```
Aspirin
Heparin
Oxygen
Nitrates
Beta-adrenergic inhibitors
ACE inhibitors
Reperfusion
```
120
what is the benefit of reperfusion?
rescues myocardium and limits infarct size
121
what are the four ways of reperfusing?
thrombolysis
angioplasty
stent placement
CABG
122
what are the things that limit reperfusion?
size of the lesion
| how fast you can actually clear the obstruction
123
(reperfusion/beta blockers) can cause arrhythmias
reperfusion
124
What treatment can result in myocardia hemorrhage with contraction bands?
reperfusion
125
What is a reperfusion injury?
irreversible cell damage superimposed on the original infarct
126
Reperfusion can cause (micro/macro)vascular injury
microvascular
127
What is myocardial stunning?
prolonged ischemic dysfunction post reperfusion
128
T/F: pericarditis is a potential complication of an MI
true
129
T/F: a ventricular aneurysm can arise from an MI
true
130
explain the mechanism of chronic IHD? (aka ischemic cardiomyopathy)
function decompensation of hypertrophied noninfarcted myocardium
131
Sudden cardiac death is the consequence of a lethal (MI/arrhythmia)
arrhythmia TRIGGERED BY mycardial ISCHEMIA
132
Describe the very generally the electrical rhythm in sudden cardiac death
asystole followed by V-fib
133
T/F: the arrhythmia in sudden cardiac death usually occurs within the main conduction system
false; at a site DISTANT from the conduction system;
134
the arrhythmia in sudden cardiac death usually pops up near what type of tissue?
scars of a previous MI
135
what two valve conditions can cause sudden cardiac death?
aortic valve stenosis
| mitral valve prolapse
136
What type of HTN causes sudden cardiac death?
pulmonary HTN
137
what two street drugs can cause sudden cardiac death?
cocaine and meth
138
(myo/peri)carditis can cause sudden cardiac death
myocarditis
139
T/F: Congenital structural or coronary arterial abnormalities
and cardiomyopathies can cause sudden cardiac death
true
140
what are the hereditary or acquired cardiac arrhythmias?
```
Long QT
Short QT
WPW
Sick sinus syndrome
Catecholamine polymorphic VT
```
141
what Rx drug can induce an arrhythmia?
catecholemines
142
what are the causes of heart failure?
chronic or acute valve dz
chronic HTN
IHD with MI
fluid overload
143
What is forward failure heart failure?
decreased cardiac output and tissue perfusion
144
what is backward failure heart failure?
pooling of blood in the venous system seen as pulmonary and/or peripheral edema
145
Apply the Frank-Starling mehanism as a compensatory system to heart failure
dilation and increased filling pressure increases contractility to keep yo ass alive
146
What is ventricular remodeling?
hypertrophy with or without dilation to adapt to heart failure
147
What neurohormone is released to increase HR in heart failure?
NorEpi
148
What hormone axis is activated to adjust filling volumes and pressures in fluid overload heart failure?
renin-angiotensin-aldosterone
149
Release of (ANP/BNP) adjusts filling volumes and pressures
ANP
150
What part of the myocyte increases in number during hypertrophy?
sarcomeres
mitochondria
nuclear size due to ploidy
151
What are the two types of "overload" heart failure
pressure
| volume
152
T/F: cardiac weight is increased in both volume and pressure overload hypertrophy
true
153
In (pressure/volume) overload hypertrophy, sarcomeres increase in parallell to long axes of the cell
pressure
154
In (pressure/volume) overload hypertrophy, sarcomeres increase in series with existing cells
volume
155
T/F: ventricle wall thickness always increases in volume overlad hypertrophy
false; may be up, normal, or low
156
how does hypertrophy lead to muscle failure?
```
no increase in capillaries along with muscle mass
increased metabolism
alteration in handling of calcium
reprogramming of gene expression
apoptosis of myocytes
```
157
Systolic left sided heart failure is pumping or filling issue
pumping issue
158
The clinical symtpoms of left sided heart failure are caused by what complications?
Congestion of pulmonary circulation
Stasis of blood in left chambers
Hypoperfusion of tissues
159
what are the Sx of left sided heart failure?
```
Cough
Dyspnea
Orthopnea
Paroxysmal nocturnal dyspnea
Renal failure
Loss of attention span, restlessness
```
160
What is the latin term for right sided heart failure?
Cor pulmonale
161
what is the most common cause of right sided heart failure?
left sided heart failure
162
What are the causes of pulmonary HTN in R sided heart failure?
Parenchymal disease of the lung
Pulmonary vasculature disorders
Pulmonary thromboembolism
Hypoxic conditions
163
What are the Sx of the venous congestion assc'd with R sided heart failure?
```
Hepatosplenomegaly
Peripheral edema
Pleural effusions
Ascites
Abnormal mental function
Renal failure
```
164
What are the three firstline treatments for heart failure?
Diuretics
ACEI
B-blockers (to lower adrenergic tone)
165
What are the diagonstic criteria for systemic HHD?
Left ventricular hypertrophy without any other cardiovascular pathology
History or pathologic evidence of hypertension
166
What is the acute cause of pulmonary HHD?
pulmonary embolus
167
valve stenosis leads to (pressure/volume) overload
pressure overload
168
valve insufficiency/regurg leads to (pressure/volume) overload
volume
169
What is the most common path causing mitral stenosis?
rheumatic heart disease
170
What are some things on your DDx for mitral regurg?
```
Rheumatic heart disease
Infective endocarditis
Mitral valve prolapse
Drugs
Rupture of papillary muscle
Papillary muscle dysfunction
Rupture of chordae tendinae
LVH
Calcification
```
171
what are some things on your DDx for Aortic stenosis?
Rheumatic heart disease
Senile calcifications
Calcification of a congenitally deformed valve
172
what are some things on your DDx for aortic regurg?
```
Rheumatic heart disease
Infective endocarditis
Marfan syndrome
Degenerative aortic dilation
Syphilitic aortitis
Ankylosing spondylitis
Rheumatoid arthritis
Marfan syndrome
```
173
T/F: calcific aortic stenosis is due to normal wear and tear
true
174
aortic stenosis leads to what complication?
pressure overload and LVH
175
What is the most frequent congential cardiac malformation?
calcific stenosis of a congenitally bicuspid aortic valve
176
What type of valve calcification does not affect valvular function?
mitral annular calcification
177
What are the rare complications of mitral annular calcification?
Regurgitation
Stenosis
Arrhythmias and sudden cardiac death
178
mitral valves can prolapse into the left...
atrium
179
a "myxomatous degeneration" by an unknown mechanism is characteristic of what valvular prolapse?
mitral valve prolapse
180
T/F: most pts are asymptomatic that have mitral prolapse
true
181
what heart sound will you hear with a mitral prolapse?
midsystolic click
182
What are the rare complications of mitral prolapse?
Infective endocarditis
Mitral insufficiency
Stroke
Arrhythmias
183
rheumatic fever happens after infx with which bug?>
group A strep
184
What the clinical findings in rheumatic fever?
```
Migratory polyarthritis of large joints
Pancarditis
Subcutaneous nodules
Erythema marginatum of the skin
Sydenham chorea
```
185
The (blank) criteria is used to diagnose rheumatic fever
Jones criteria
186
acute rheumatic heart disease is characterized by (blank) bodies
Aschoff bodies
187
What three cell types are found in Aschoff bodies?
Lymphs
plasma cells
Anitschkow cells
188
Aschoff bodies can be found in (blank) layers of the heart
any (therefore it is a pancarditis)
189
in acute rheumatic heart dz, MacCallum plaques form in what chamber?
left atrium
190
the vegetations in acute rheumatic heart dz have underlying fibrinoid (blank)
necrosis
191
Chronic rheumatic heart dz is a deforming (blank) valvular dz
fibrotic
192
T/F: CRHD is the only cause of mitral stenosis
true!
193
T/F: CRHD can involve other valves besides the mitral
true
194
Can you see Aschoff bodies in CRHD?
nope
195
Describe the changes to the mitral valve in CRHD?
leaflet thickening
commissural fusion and shortening
Thickening and fusion of the tendinous cords
196
In infective endocarditis, what are the vegetations made of?
thrombotic debris and organisms
197
what are the two forms of IE?
acute and subacute
198
What are the three Duke Criteria for IE?
pathologic
major clinical
minor clinical
199
what type of IE affects normal valves by highly virulent bugs?
acute
200
what type of IE is this?
| necrotizing, ulcerative, destructive lesions
acute
201
Do you cure acute or subacute with abx?
subacute
202
what type of IE infects already damaged valves with a lower virulence bug?
subacute
203
What but infects healthy OR deformed valves?
S. aureus
204
what bug infects prosthetic valves?
S. epidermidis (coag neg. staph)
205
WHat bug infects damaged or abnl valves?
S. viridans
206
What are the non-strep bugs that may also cause IE?
HACEK
Enterococci
gram neg. baccili
fungi
207
what are the HACEK bugs?
Hemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella)
208
non-infective aka sterile endocarditis is caused by what two things?
non-bacterial thrmbotic
| Libman-Sacks endocarditis (SLE)
209
da fuck is marantic endocarditis?
old term for non-bacterial thrombotic endocarditis
210
what type of valve issue is characterized by deposition of small sterile thrombi on the leaflets of cardiac valves
Non-bacterial thrombotic endocarditis
211
T/F: Non-bacterial thrombotic endocarditis does not elicit an inflamm response
true; no bacteria!
212
Non-bacterial thrombotic endocarditis may be the source of systemic....
thrombi
213
In what type of cancer do you get Non-bacterial thrombotic endocarditis?
mucinous adenocarcinoma
214
In what other severely compromised states do you get Non-bacterial thrombotic endocarditis?
sepsis or hypercoagulable states
215
Where are the vegetations in Libman-Sacks dz?
mitral and tricuspid valves
Valvular endocardium
Chords
Mural endocardium of the atria
216
what type of vegetations are composed of finely granular, fibrinous eosinophilic material with hematoxylin bodies?
Libman-Sacks
217
Libman-Sacks also causes intense valvulitis with fibrinoid (blank) of the valve
necrosis
218
prosthetic valves can get IE with a (blank) abscess
ring abscess
219
What valvular dz has lesions that firm plaque-like endocardial fibrous thickenings of the tricuspid and pulmonary valves
carcinoid heart dz
220
The carcinoids that cause dz occur outside the portal system and empty directly into the..
IVC
221
what are the three classes of primary cardiomyopathies?
dilated
hypertrophic
restrictive
222
dilated cardiomyopathy shows (blank) dysfucntion
ERECTILE
jk!
contractile
223
what is the leading cause of unexplained LVH?
hypertrophic cardiomyopathy
224
the poor (blank) of the LV in hypertrophic cardiomyopathy leads to abnl diastolic filling and ventricular outflow obstruction
compliance
225
Restrictive cardiomyopathy has a decreased compliance that leads to impaired filling during....
diastole
226
which is the only systolic dysfunction cardiomyopathy?
dilated cardiomyopathy
227
what are the two types of diastolic dysfunction cardiomyopathy?
hypertrophic and restrictive
228
What are the causes of dilated cardiomyopathy?
```
Genetic
Myocarditis
Alcohol abuse
Childbirth
Chronic anemia
Medications
Hemochromatosis
```
229
What is the only cause of hypertrophic cardiomyopathy?
genetics
230
what are the causes of restrictive cardiomyopathy?
Idiopathic
Amyloidosis
Radiation induced
Fibrosis
231
what AD, variably penetrant disorder causes R ventricular failure and rhythm distrubances?
Arrhythmogenic right ventricular cardiomyopathy
232
which ventricular wall is thinned in Arrhythmogenic right ventricular cardiomyopathy?
right ventricle
233
```
The myocytes of the R ventricle in Arrhythmogenic right ventricular cardiomyopathy
have a (blank) infiltration and fibrosis
```
fatty
234
Arrhythmogenic right ventricular cardiomyopathy is caused by a defective cell (blank) proteins in the desmosomes that link adjacent myocytes
cell adhesion proteins
235
what viruses can cause myocarditis?
Coxsackie A and B
Enterovirus
HIV
CMV
236
what bacteria can cause myocarditis?
chlamydia
neisseria
Borrelia
Rickettsia
237
Besides bacteria and fungi, what other infectious agents can cause myocarditis?
```
fungus
trypanosoma (protozoa)
helminths
```
238
hypersensitivity to what drugs can cause immune-mediated myocarditis?
methyldopa
| sulfonomides
239
WHat are the immune-mediated causes of myocarditis
```
Post-viral
Poststreptococcal
SLE
Drug hypersensitivity
Methyldopa
Sulfonamides
Transplant rejection
```
240
what two zebra processes can cause myocarditis?
sarcoidosis
| giant cell myocarditis
241
what is normal pericardial fluid like?
30-50 mL of thin, clear, straw colored fluid
242
how much pericardial fluid can collect in a chronic pressure effusion?
500mL
243
a rapid pericardial effusion can allow what volume of fluid to collect?
200-300mL
244
Describe the three types of pericardial effusions
Pericardial effusion: pericardial space distended by serous fluid
Hemopericardium: pericardial space distended by blood
Purulent pericarditis: pericardial space distended by pus
245
What are the types of acute pericarditis?
```
Serous pericarditis
Fibrinous/serofibrinous pericarditis
Purulent pericarditis
Hemorrhagic pericarditis
Caseous pericarditis
```
246
what are the types of chronic pericarditis?
Adhesive pericarditis
| Constrictive pericarditis
247
(blank) pericarditis is a non-infectious inflammatory process with a mild lymphocytic infiltrate in the epicardial fat
serous pericarditis
248
What is the most frequent type of pericarditis that also tends to present with a loud pericardial friction rub?
fibrinous/serofribrinous
249
What type of pericarditis is associated with MI, postinfarction syndrome, uremia, chest radiation, RF, SLE, trauma
fibrinous/serofribrinous
250
what are the methods of microbes accessing the pericardial space?
Direct extension
Seeding from the blood
Lymphatic extension
Introduction during cardiotomy
251
acute purulent pericarditis can cause an inflamm reaction that can produce a....
mediastinopericarditis
252
what type of pericarditis arises as a result of the healing process post purulent pericarditis?
constrictive
253
Hemorrhagic pericarditis has blood with what kind of effusion?
suppurative or fibrinous effusion
254
what is the most common cause of a hemorrhagic pericarditis?
metastatic malignant neoplasm
255
besides cancer, when else do you see a hemorrhagic pericarditis?
in TB and bacterial infections and post cardiac-surgery
256
What causes caseous pericarditis?
TB; Leads to a disabling, fibrocalcific, chronic constrictive pericarditis
257
T/F: chronic pericarditis is fatal
false; no clinical consequence
258
Adhesive mediastinopericarditis follows what things?
Follow infectious pericarditis, cardiac surgery, radiation
| Pericardial sac is obliterated and pericardium adheres to surrounding structures
259
constrictive pericarditis mimmics...
restrictive cardiomyopathy; heart sounds are muffled or distant
260
what is the most common primary cardiac tumor in adults?
myxoma
261
which two chromosome are abnormal in myxoma?
12 and 17
262
what cell line does a myxoma arise from?
mesenchymal cells
263
Where in the heart do you see a myxoma?
atria; but can be in any chamber
264
10% of cases of myxoma are assoicated with what complex?
Carney complex
265
what is the most common primary cardiac tumor in kids?
rhabdomyoma
266
rhabdomyoma is associated with what dz?
tuberous sclerosis
267
a rhabdomyoma is a type of....
hamartoma
268
T/F: lipomas are malignant
false
269
where in the heart do you find lipomas?
LV, RA, or atrial septum
270
T/F: papillary fibroelastomas are benign
true; resemble Lambl excrescences
