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PATHOLOGY II > chapter 10 > Flashcards

chapter 10 Flashcards

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1
Q

MC mechanism of heart disease

A

contractile (pump) failure

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2
Q

causes of heart failure

A

decrease cardiac output (MC), increase tissue demands

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3
Q

causes of decreased cardiac output

A
  1. systolic dysfunction
  2. diastolic dysfunction
  3. Valvular dysfunction
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4
Q

systolic dysfunction

A

weak contraction

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5
Q

diastolic dysfunction

A

failure of relaxation/filling. MC in females

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6
Q

Valvular dysfunction

A

stenosis, endocarditis

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7
Q

Forward heart failure

A

insufficient output = hypoxia

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8
Q

Backward heart failure

A

venous congestion. increase venous volume/ pressure

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9
Q

T/F Forward heart failure is almost always combined with Backward heart failure

A

True

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10
Q

Fran-Starling mechanism

A

increased ventricular stretch = stronger contraction

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11
Q

Neurohumoral mechanisms

A

NE: increase HR and contractility, R-A-A system
ANP: vasodilation

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12
Q

Cardiac hypertrophy

A

overload -> cardiac hypertrophy. increased O2 consumption

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13
Q

Eccentric heart

A

large lumen in left ventricle

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14
Q

concentric heart

A

thick muscle wall in leftventricle

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15
Q

Most common cause of left sided heart failure

A

Ischemic heart disease

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16
Q

decreased out put in left sided heart failure leads to

A

pulmonary edema. (R-A-A system)

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17
Q

Right sided heart failure MC results from…

A

Left sided failure

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18
Q

right sided heart failure resulting from pulmonary Hypertension

A

cor pulmonale

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19
Q

valve disorder resulting in right sided heart failure involve which valves

A

pulmonary or tricuspid

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20
Q

Congenital heart disease accounts for what percent of all birth defects

A

30%

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21
Q

causes of congenital heart disease

A

fetal chromosomal abnormalities, maternal diabetes, infections, teratogens

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22
Q

right-to-left shunts

A

blood bypasses lungs, cyanosis

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23
Q

Causes of right-to-left shunts

A

tetralogy of fallot, transposition of great arteries

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24
Q

left-to-right shunts

A

pulmonary hypertenstion, ASD VSD PDA

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25
which shunt is more common
left-to-right
26
`What does coarctation mean
congenital narrowing
27
Most likely to get Aortic coarctation
Males and turner syndrome
28
Infantile (pre-ductal) Aortic coarctation
proximal to PDA
29
Adult (post-ductal) Aortic coarctation
infolding near the ligamentum arteriosum. | MC asymptomatic
30
coronary artery disease makes up what percent of Ischemic heart disease cases
90%
31
dysfunction occurs when during Ischemic heart disease
1-2 minutes
32
necrosis occurs when during Ischemic heart disease
20-40 minutes
33
Angina pectoris
"chest pain" | Ischemia, NO CELLULAR DEATH
34
when does Angina pectoris occur
with >70% occlusion
35
Angina pectoris with > 90% occlusion
unstable angina (at rest)
36
Stable (typical) angina
Episodic, exertional. | Relieved at rest with vasodilators
37
Variant angina (prinzmetal)
Vasospasm at rest. | responds to vasodilators.
38
unstable Angina pectoris is aka
crescendo angina or pre-infarction angina
39
characteristics of unstable Angina pectoris
Increased frequency,intensity, and duration of pain. | 90% coronary occlusion
40
MC cause of myocardial infarction
acute coronary artery thrombosis 90%
41
MC artery involved in myocardial infarction
left anterior descending coronary artery
42
MC cause of sudden cardiac death
Ventricular fibrillation 80-90%
43
In myocardial infarction is the angina relieved by nitroglycerine
NO
44
Laboratory markers of myocardial infarction
Creatine kinase and cardiac troponins
45
T/F Patients having an acute myocardial infarction present a strong pulse?
false. fast and weak pulse
46
Sudden Cardiac death is MC a lethal arrhythmia that involves what part of the heart
Left ventricle
47
What is the MC arrhythmia involved in Sudden Cardiac death
V-fib (80-90%)
48
Commotio cordis
(baseball player) | blow to the sternal region that disrupts heart rhythm. Causing arrythmia and SCD.
49
Is there structural damage with Commotio cordis
NO
50
Is Commotio cordis reversible
yes with drfibrillation
51
who is at risk for Commotio cordis
adolescent males (underdeveloped chest)
52
"silent killer"
systemic hypertensive heart disease
53
what does systemic hypertensive heart disease produce
left sided heart disease
54
Cor pulmonale
pulmonary HTN that leads to right sided heart failure
55
Valvular Stenosis
narrowing, failure to completely open
56
Valvular Insufficiency
failure to completely close
57
MC cause of aortic valve stenosis
calcific aortic stenosis
58
what kind of hypertrophy is present with calcific aortic stenosis
concentric hypertrophy
59
What does Rheumatic valvular disease occur after
Group A B-hemolytic streptococcal pharyngitis
60
Rheumatic valvular disease
inflammation of all parts of heart, but valvular inflammation and scaring produces the most important clinical features
61
Rheumatic valvular disease MC dx
5-15 years old
62
Acute Rheumatic valvular disease
Aschoff bodies**
63
MC cause of infective endocarditis
bacteremia
64
Symptoms when infective endocarditis is lethal
arrhythmia, renal failure
65
acute infective endocarditis
sestructive, virulent, difficult to treat. | previously normal valve
66
cause of acute infective endocarditis
staph aureus
67
subacute infective endocarditis
easy to treat, previously abnormal tissue
68
cause of subacute infective endocarditis
strep viridans
69
MC prosthetic cardiac valves
mechanical
70
mechanical prosthetic cardiac valves
tilted disk device. anti-coagulation. can cause thrombosis, hemolysis
71
Bioprosthetic cardiac valves
porcine, bovine, humans. | NO anti-coagulation. Ca+ can cause stenosis
72
Cardiomyopathies are primary to
disorder of myocardium
73
Cardiomyopathies are secondary to
systemic disorders (muscular dystrophy)
74
T/F Most cases of Cardiomyopathies are idiopathic
True
75
types of Cardiomyopathies
dilated (MC) hypertrophic restrictive (LC)
76
Dilated Cardiomyopathies
characterized by progressive cardiac dilation and contractile dysfunction.
77
risk for Dilated Cardiomyopathies
genetic, viral infxns, hemochromatosis, decreased thiamine, dystrophinopathy
78
Hypertrophic Cardiomyopathies
is characterized by myocardial hypertrophy, defective diastolic filling and in 1/3 of cases ventricular outflow obstruction.
79
Restrictive Cardiomyopathies
primary decrease in ventricular compliance, resulting in impaired ventricular filling during diastole
80
three forms of Restrictive Cardiomyopathies
Amyloidosis, endomyocardial fibrosi, irradiation and idiopathic
81
MC cause of myocarditis in USA
viral infections | 9 (Coxsackievirus A & B, HIV, CMV, flu)
82
Non-viral cause of myocarditis
SLE, Lyme disease, Chagas
83
Morphology in myocarditis
normal or dilated
84
Does myocarditis cause pain
its variable. sometimes its asymptomatic and others it causes pain and fever
85
MC type of myocarditis
acute
86
acute myocarditis has what type of cells
diffuse lymphocytes
87
chronic myocarditis has what type of cells
multinucleate giant cells
88
MC cause of pericarditis
viral
89
secondary pericarditis caused by
MI, irradiation, rheumatic fever,SLE, CA
90
severe pericarditis
cardiac tamponade. (pericardial compression which decreases filling)
91
MC malignancy to the heart is due to what
metastasis to the heart
92
MC CA to metastasize to the heart
lung
93
MC primary cardiac benign neoplasms
myxoma
94
MC primary malignant tumor
angiosarcoma
95
Location of Myxomas
90% on the fossa ovalis in left atrium
96
size of myxomas
large, up to 10 cm
97
are myxomas benign or malignant
benign
98
whats the appearance of a myxoma
"gelatinous appearance"
99
MC long term limitation of cardiac transplants
allograft arteriopathy. ( 5 years 50%, 10 years 100%)
100
complications of cardiac transplants
rejection and allograft arteriopathy

PATHOLOGY II (3 decks)

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