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Path Exam III > Chapter 10 > Flashcards

Chapter 10 Flashcards

(103 cards)

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1
Q

MC mechanism of heart disease

A

contractile (pump) failure

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2
Q 
contractile (pump) failure
obstruction of flow
regurgitant flow
shunted flow
dysfunctional cardiac conduction
ruptured vessels or heart walls
are all:
A

mechanisms of heart disease

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3
Q

heart cannot supply tissue demand; common ENDPOINT for cardiac diagnosis

A

heart failure

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4
Q

two components of heart failure

A

DECREASE cardiac output (MC)

INCREASE tissue demand

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5
Q

3 causes of decreased CO (3 types of dysfunction)

A

systolic dysfunction
diastolic dysfunction
valvular dysfunction

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6
Q

dysfunction with:
weak CONTRACTION
risks: CAD, systemic HTN, decrease pH

A

systolic dysfunction

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7
Q

dysfunction with:
failure of relaxation/filling
MC-FEMALES
myocardial fibrosis, amyloidosis, LT-sided hypertrophy

A

diastolic dysfunction

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8
Q

dysfunction with:
stenosis
endocarditis

A

valvular dysfunction

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9
Q

heart failure almost always has a combined _____ and ______ failure
-affects virtually every organ

A

forward failure

backward failure

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10
Q

body’s attempt to preserve homeostasis in response to reduced contractility

A

adaptations

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11
Q

3 types of adaptations to HF

A

1 Frank-starling mechanism
2 Neurohurmoral mechanism
3 Cardiac hypertrophy

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12
Q

adaptation with:
overfill chambers to cause stretch
- INCREASE ventricular stretch = STRONGER contraction
- benefit: INCREASE output, cost: INCREASE O2, INCREASE tension

A

frank-starling mechanism

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13
Q

adaptation with:
NE: increase HR, increase contractility, RAA system (increase BP)
ANP: vasoDILATION

A

neurohumoral mechanims

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14
Q

adaptation with:

  • most pronounced in LV
  • overload –> ______
A

cardiac hypertrophy (MC adaptation)

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15
Q

enlarged PATHOLOGICAL FORM of heart dilation

  • attempt to overcome increased pressure
  • usually LV
A

concentric hypertrophy

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16
Q

enlarged PHYSIOLOGICAL form of heart dilation

  • fibers becoming larger and longer
  • does NOT increase likelihood to get cardiac disease
A

eccentric hypertrophy

ATHLETE’s HEART

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17
Q

______ HF caused by:
IHD, HTN, valve disorders (mitral and aortic)
LV hypertrophy, DILATION (LATE)
decrease output –> PULMONARY EDEMA

A

left-sided HF

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18
Q

risks of left-sided HF

A

dyspnea
rales (congestion in lungs when listening)
orthopnea (supine- increase dyspnea, decreased with incline)
cough

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19
Q

_____ HF comes from LEFT-sided HF
-isolated right-sided HF
-pulmonary HTN –> cor pulmonale
_________ congestion and edema systemic and portal veins

A

right-sided

peripheral congestion and edema

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20
Q

_______ INCREASES risk of congenital heart disease

30% of birth defects

A

prematurity

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21
Q

structural malformation from mild –> lethal in congenital heart disease (CHD)

A 
cardiac walls
SVC
IVC
pulmonary artery
pulmonary vein
aorta
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22
Q

genetic component of CHD are ______

environmental component of CHD are ____

A

trisomies 13, 18, 21

teratogens, maternal diabetes, infxn

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23
Q

over 90% of CHD cases are ______
42% are ______ defects
10% are _____ defects

A

idiopathic
ventricular septal defects
atrial septal defects

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24
Q

shunt abnormal communication between chambers or blood vessels

A

congenital heart disease

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25
_____ shunt is MC for CHD
left-to-right
26
CYANOSIS (dark blue) occurs with ______ shunts in CHD
right-to-left
27
3 categories of CHD
right-to-left shunt left-to-right shunt obstruction of flow
28
3 different types of left-to-right shunts
ASD VSD PDA
29
____ is type of left-to-right CHD that MC asymptomatic until adulthood
ASD
30
____ is type of left-to-right CHD that MC structural abnormality
VSD
31
two types of right-to-left shunt
tetralogy of fallot | transposition of great arteries
32
MC CHD to cause cyanosis is _____ and is known for a "boot shaped" heart
tetralogy of fallot
33
``` VSD right ventricular outflow obstruction overriding aorta right ventricular hypertrophy *are all components for* ```
tetralogy of fallot
34
CHD in which arteries connect to wrong ventricle right ventricle --> aorta left ventricle --> pulmonary artery *shunting is REQUIRED*
transposition of great arteries
35
congenital narrowing males 2x MC turner syndrome
aortic coarctation
36
______ aortic coarctation is PROXIMAL to a PDA
infantile (pre-ductal)
37
______ aortic coarctation is infolding near ligament arteriosum, MC asymptomatic
adult (post-ductal)
38
group of conditions that lead to myocardial ischemia necrosis: 20-40 minutes CAD makes up 90% of these cases
ischemic heart disease (IHD)
39
``` angina pectoris acute myocardial infarction chronic IHD --> CHF sudden cardiac death *are all syndromes of* ```
syndromes of IHD
40
sub-sternal chest pain, "crushing" IHD that if >70% occlusion: "critical stenosis" >90% occlusion: unstable angina (rest)
angina pectoris
41
three components of angina pectoris
inflammation thrombosis vasoconstriction
42
____ angina is episodic, exertional; relieved with rest and vasodilators
stable angina
43
_____ angina is vasospasm at rest; responds to vasodilators
variant angina
44
``` ____ angina is AKA crescendo or pre-infarction angina increase frequency increase intensity increase duration provoked by decreased exertion 90% coronary artery occlusion ```
unstable angina
45
- dyspnea, unexplained fatigue, lower chest discomfort/pressure - back pain - nausea, dizziness
angina pectoris in females
46
AKA heart attack 1.5 million americans/year acute coronary artery thrombosis: 90% plaque disruption
myocardial infarction (MI)
47
-loss of myocardial contractility, 1-2 minutes myocardial necrosis, 20 minutes -*ARRHYTHMIA*- electrical instability (leads to death) -REPERFUSION
coronary artery ischemia
48
angina that is UNRELIEVED by nitroglycerine pulse is rapid and weak dyspnea
myocardial infarction
49
laboratory diagnosis for MI
CK-MB | troponins
50
survival of an MI viable myocardium is overloaded (deconditioned) hypertrophy and dilation --> failure
chronic ischemic heart disease
51
``` sustained arrhythmia lethal arrhythmia asystole v-fib defibrilation ```
sudden cardiac death
52
arrhythmia that MC involved LT ventricle
lethal arrhythmia
53
improves prognosis of SCD
defibriliation
54
CAD is MC stimulus for ______
SCD
55
blow to sternal region that disrupts heart rhythm - arrhythmia - SCD risks: adolescent males
commotio cordis
56
``` concentric hypertrophy ventricular dilation -possible in proximal atrium INCREASE in metabolic demands NO increase blood supply to compensate eventually loss of contractility ```
hypertensive heart disease
57
MC asymptomatic "silent killer" 1. history/current HTN 2. left ventricular hypertrophy heart: increase myocyte diameter, fibrosis, CHF, arrhythmia brain: stroke kidneys: renovascular HTN
systemic hypertensive heart disease
58
pulmonary HTN --> right sided heart failure (for pulmonale) | multiple causes-- pulmonary fibrosis, cystic fibrosis, PE, kyphoscoliosis
pulmonary hypertensive heart disease
59
_____ pulmonary hypertensive heart disease is a LARGE pulmonary embolism; >50% occlusion
acute
60
____ pulmonary hypertensive heart disease is PROLONGED COPD or pulmonary fibrosis
chronic
61
narrowing, failure to completely open (valvular heart disease)
stenosis
62
failure to completely close (valvular heart disease) is called _____ or AKA
insufficiency | regurgitation (incompetence)
63
turbulent flow through diseased valve
murmur
64
MC cause of aortic valve stenosis asymptomatic in early stages -possible murmur decrease cardiac output --> INCREASE LEFT ventricular contraction
calcific aortic stenosis
65
_____ hypertrophy, late dilation is symptom of calcific aortic stenosis and avg age of diagnosis is ____ y.o.
concentric | 60-80
66
group A B-gemolytic streptococcal pharyngitis - rheumatic fever results in 3% of untreated patients 2-3 weeks post infection
rheumatic valvular disease
67
``` fever carditis migratory polyarthritis sydenham's chorea subcutaneous nodules or skin rash abnormal ECG ```
hypersensitivity reaction
68
MC hypersensitivity reaction in children with rheumatic valvular disease
carditis
69
MC hypersensitivity reaction in adults
migratory polyarthritis
70
fibrotic mitral valve deformation (stenosis) is associated with:
rheumatic valvular disease
71
group A B-hemolytic strep -reaction to erythrogenic toxins 1-4 days- infection, pharyngeal, cutaneous hallmark: pink punctuate skin rash (dots) sandpaper-like texture pyrexia, nausea, vomiting, bright red tongue
scarlet fever
72
circumoral pallor is associated with _____
scarlet fever
73
infection in heart chambers or valves bacteremia is MC funghi can be acute or subacute
infective endocarditis
74
``` flu-like symptoms such as: pyrexia chills fatigue weight loss murmur ```
infective endocarditis
75
``` type of infective endocarditis in which: destructive virulent difficult to treat *previously NORMAL valve* staph aureus ```
acute infective endocarditis
76
``` type of infective endocarditis in which: low virulence easy to treat *previously ABNORMAL valve* strep viridans ```
subacute infective endocarditis
77
location of infective endocarditis
aortic | mitral valves
78
sources of infection for infective endocarditis
skin infection dental procedures surgical procedures
79
intervention for valve diseases
prosthetic cardiac valves
80
two types of intervention for prosthetic cardiac valves
mechanical | bioprosthetic
81
tilting disc device, durable continued anti-coagulation thrombosis, hemolysis *MC* prosthetic cardiac valve
MECHANICAL cardiac valves
82
porcine, bovine, human NO anti-coagulation, ECM deteriorates Ca++ --> stenosis
bioprosthetic cardiac valves
83
heart, muscle, disease PRIMARY disorder of _______ SECONDARY to _______
cardiomyopathies myocardium systemic disorder
84
pathophysiological groups of cardiomyopathies
dilated (MC) hypertropic restrictive (LC)
85
90% of all cardiomyopathy cases are _______ risks include: genetics, viral infections, toxins- ALCOHOL, hemochromatosis, decrease thiamine, dystrophinopathy age: 20-50 y.o. poor prognosis
dilated cardiomyopathy
86
cardiomyopathy with contractile gene mutations MC is B-myosin "asymmetrical septal hypertrophy"
hypertrophic cardiomyopathy
87
4 types of hypertrophic cardiomyopathy
1 hyper-contractile sarcomeres 2 massive left ventricular hypertrophy 3 diastolic dysfunction (won't relax) 4 decrease stroke volume/cardiac output
88
type of cardiomyopathy with: interstitial fibrosis: stiff myocardium diastolic dysfunction: decrease filling
restrictive cardiomyopathy
89
2 types of restrictive cardiomyopathy
``` amyloidosis endomyocardial fibrosis (and misc types- irradation, idiopathic) ```
90
MC type of restrictive cardiomyopathy with fibrosis: ventricular endocardium occurs in pediatrics/young adults in Africa malnutrition and helminth infection
endomyocardial fibrosis
91
infectious and/or inflammatory pathologies tissue injury, commonly immune-mediated *VIRAL infections* are MC cause in US
myocarditis
92
diffuse lymphocytes are MC with _____ myocarditis, as well as edema
ACUTE myocarditis (MC type of myocarditis)
93
- multinucleate giant cells are seen with ______ myocarditis - hypersensitivity reactions - edema - possible necrosis
CHRONIC myocarditis
94
- pericardial inflammation | - sac-like covering, fibrinous inflammation
pericarditis
95
primary pericarditis is MC _______, bacterial or fungal | severe: cardiac tamponade
viral
96
fibrinous inflammation is a sign of _____, includes severe increase in permeability, allows fibrin out of circulation, friction rub, "squeaky leather"
pericarditis
97
- MC metastasis to the heart that is the MC _______ | - Cancer met. to heart from ____ MC, breast, leukemia, lymphoma, liver, colon
cardiac neoplasm | lung
98
primary cardiac neoplasms are _____, ____ is MC | _______ may occur in children
rare myxoma rhabdomyomas
99
_____ is MC primary malignant tumor
angiosarcoma
100
MC primary cardiac tumor among adults; benign 90% on/near _______ (LEFT ATRIUM) can be large- up to 10 cm
myxoma | fossa ovalis
101
____ may have a gelatinous appearance
myxoma
102
common treatment for CHF or DCM; complications include REJECTION or ALLOGRAFT ARTERIOPATHY (MC)
cardiac transplant
103
MC cardiac treatment rejection- long-term limitation, rapid stenosis of coronary arteries
allograft arteriopathy

Path Exam III (2 decks)

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