Chapter 13: Cardiac Pathology

Question 1

CK-MB is elevated by what time in an MI?

Answer 1

4-8 hours

Question 2

When is CK-MB at its peak after an MI?

Answer 2

18 hours

Question 3

When does CK-MB return to normal after an MI?

Answer 3

2-3 days

Question 4

When is Cardiac specific troponin I and T elevated after an MI?

Answer 4

3-6 hours

Question 5

When does cardiac specific troponin I and T hit its peak after MI?

Answer 5

16 hours

Question 6

When does cardiac specific troponin I and T return to normal after a MI?

Answer 6

7-10 days

Question 7

When is LDH elevated by after MI?

Answer 7

24 hours

Question 8

When does LDH hit its peak after MI?

Answer 8

3-6 days

Question 9

When do LDH levels return to normal after an MI?

Answer 9

8-14 days

Question 10

Chart out the gross changes of after an MI timeframes.

Answer 10

Question 11

Chart out microscopic changes to the heart see after an MI?

Answer 11

Question 12

Chart the complications in the heart seen after an MI?

Answer 12

Question 13

Bicuspid valve aortic valve mutation?

Answer 13

NOTCH1

Question 14

Degenerative calcific aortic valve stenosis.

Answer 14

common valvular abnormality characterized by age-related dystrophic calcification, degeneration and stenosis of the aortic valve

Question 15

What are the requirements to making a diagnosis of rheumatic fever based on Jones criteria?

Answer 15

2 major or 1 major and 2 minor criteria, plus a preceding group A strep infection

Question 16

What is Jones criteria?

Answer 16

Used in order to establish diagnosis of rheumatic fever

Question 17

Acute endocarditis is often caused by what organisms?

Answer 17

staph auerus and high virulence organisms

Question 18

Subacute endocarditis is usually caused by what organisms?

Answer 18

low virulence organisms such as strep group viridans

Question 19

Which type of endocarditis, acute or subacute, mostly affects the tricuspid valve.

Answer 19

subacute

Question 20

Tricuspid valve association in endocarditis is most associated with what?

Answer 20

IV drug abuse

Question 21

What are some major characteristics to remember about S. Viridans?

Answer 21

alpha-hemolytic
bile resistant
optochin-resistant

Question 22

What are some signs and symptoms of bacterial endocarditis?

Answer 22

janeway lesions
roth spots
osler nodules
splinter hemorrhage
anemia
fever

Question 23

What is the Dukes criteria for determining endocarditis?

Answer 23

Major:
blood culture postiive
endocardial involvement

Minor:
fever
immunologic phenomena
vascular phenomena
predisoposition
microbiological evidence

Diagnosis:

2 major criteria;

1 major and 3 minor;

5 minor criteria

Question 24

What are the HACEK organisms?

Answer 24

the HACEK organisms are a group of fastidious Gram-negative bacteria that are an unusual cause of infective endocarditis, (typically subacute.)

Haemophilus species, Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae

Question 25

What is Libman-Sacks endocarditis?

Answer 25

manifestation of SLE

Question 26

What infections can cause myocarditis?

Answer 26

Coxsackie A and B viruses, and Chagas

Question 27

What are some non-infectious causes of myocarditis?

Answer 27

SLE, RA and drug hypersensitivity reactions

Question 28

Inheritance pattern of tuberous sclerosis?

Answer 28

AD

Question 29

Mutation found in tuberous sclerosis?

Answer 29

TSC1 and TSC2 which encode tumor suprressor proteins hamartin and tuberin respectively

Question 30

C/F of tuberous scleorosis?

Answer 30

mult hamartomas
cortical tubers
renal angiomyolipomas
cardiac rhabdomyomas
pulmonary hamartomas

Question 31

What is a hamartoma?

Answer 31

a local malformation made up of an abnormal mixture of cells and tissue

Question 32

Cardiac myxoma features?

Answer 32

commonly arises in adults and from left atrium

Question 33

Cardiac rhabdomyoma associations/characteristics.

Answer 33

benign tumor usu. arising within the myocardium that is associated with tuberous sclerosis

Question 34

Be able to describe the types and sizes of vegetations found with different conditions like RHD, NBTE, IE, LS?

Answer 34

Question 34

What is NBTE?

Answer 34

non- bacterial thrombotic endocarditis

is a rare condition that refers to a spectrum of noninfectious lesions of the heart valves that is most commonly seen in advanced malignancy.