Heart pathology

Question 1

Heart failure cells

Answer 1

Left sided heart failure

Question 2

Cor pulmonale

Answer 2

Right sided heart failure

secondary to lung disease

Question 3

Pitting edema and hepatosplenomegaly

Answer 3

right sided heart failure

Question 4

Lower extremity cyanosis

Answer 4

Infantile coarctation of the aorta

associated with a PDA

Question 5

Hypertension in upper extremities and weak pulses in lower extremities

Answer 5

Adult coarctation of the aorta

Collateral circulation develops across the intercostal arteries; engorged arteries cause rib notching

Associated with bicupsid aortic valve

Question 6

NKX2.5

Answer 6

ASD or conduction defects

Question 7

TBX1 (deletion in 22q11.2)

Answer 7

DiGeorge syndrome- ASD, VSD, or outflow tract obstruction

Question 8

FBN1

Answer 8

Marfan syndrome- aortic aneurysms, valve abnormalities

Question 9

Eisenmenger syndrome

Answer 9

Large VSD with irreversible pulmonary hypertension

Can lead to shunt reversal

Question 10

Types of atrial septal defects

Answer 10

1. Secundum- involves fossa ovalis
2. Primum- adjacent to AV vale
3. Sinus venosus- near superior vena cava

Question 11

continuous harsh machine like murmur

Answer 11

patent ductus arteriosus

Question 12

Tetralogy of fallot

Answer 12

1. Stenosis of the R ventricular outflow tract
2. Right ventricular hypertrophy
3. Ventricular septal defect
4. Aorta that overrides the VSD

Question 13

Boot shaped heart

Answer 13

tetralogy of fallot

Question 14

Rupture of an atherosclerotic plaque with thrombosis and complete occlusion of a coronary artery

Answer 14

MI

Question 15

Transposition of the great vessels

Answer 15

aorta from R ventricle
pulmonary artery from L ventricle

Incompatible with life unless you have a septal defect

Question 16

4 clinical syndromes of ischemic heart disease

Answer 16

1. Sudden cardiac death
2. Angina pectoris
3. Myocardial infarction
4. Chronic ischemic heart disease

Question 17

prinzmetal angina

Answer 17

sustained vasospasm causing angina

Question 18

Kills young athletes

Answer 18

Sudden cardiac death

Question 19

Subendocardial infarction

Answer 19

Area of ischemic necrosis limited to inner 1/2
May occurs as a result of acute plaque change and thrombosis

May result from reduction in systemic blood pressure- shock

Question 20

Transmural infarction

Answer 20

Ischemic necrosis involves >50% of the ventricular wall thickness
commonly associated with acute plaque change from thrombosis

Question 21

myocardial stunning

Answer 21

prolonged ischemic dysfunction with CHF

Reversible

Question 22

criteria for diagnosing left sided hypertensive heart disease

Answer 22

o Left Ventricular Hypertrophy- usually concentric, in the absence of other cardiovascular pathology that may have induced it
o A history of HTN or pathologic evidence of systemic htn in other organs

Question 23

Crescendo-decrescendo murmur

Answer 23

aortic stenosis

Question 24

mid-systolic click followed by a regurgitation murmur

Answer 24

mitral valve prolapse

Question 25

dilation of annulus and jet lesions

Answer 25

mitral valve prolapse

Question 26

Acute rheumatic fever

Answer 26

1. Migratory polyarthritis 2. Pancarditis- mitral valve vegetations, Aschotf bodies, and pericardial rub 3. Subcutaneous nodules 4. Erythema marginatum 5. Sydenham chorea

Question 27

Most common cause of endocarditis

Answer 27

strep viridans

Question 28

Most common cause of endocarditis in IV drug users

Answer 28

Staph aureus | High virulence organism that infects normal valves, most commonly the tricupsid

Question 29

Most common cause of endocarditis or prosthetic valves

Answer 29

staph epidermidis

Question 30

sterile vegetations along lines of closure

Answer 30

nonbacterial thrombotic endocarditis

Question 31

Thrombotic vegetations associated with lupus anticoagulant

Answer 31

Libman-sacks

Question 32

Fenfluramine/phenterimine, methysergide, ergotamine therapy

Answer 32

carcinoid heart disease produce serotonin

Question 33

EF less than 40%

Answer 33

Dilated cardiomyopathy

Question 34

arrythmias that involve the right heart

Answer 34

arrythomogenic right ventricular dysplasia

Question 35

myocarditis causes

Answer 35

- coxsackieviruses A and B - Lyme disease- borrelia burgoferi - Chagas disease - Trichinosis

Question 36

mutation in chromosome 14

Answer 36

hypertrophic cardiomyopathy

Question 37

amyloidosis

Answer 37

transthyretin mutation

Question 38

antiphospholipid syndrome

Answer 38

Lupus --> libman-sacks endocarditis

Question 39

Janeway lesions, oslier nodes, splinter hemorrhages

Answer 39

infectious endocarditis janeway lesions- erythematous nontender lesions on palms and soles osier nodes- tender lesions on fingers and toes splinter hemorrhages- in nail beds due to embolization of septic vegetations

Question 40

viral cause

Answer 40

myocarditis

Question 41

transthyretin

Answer 41

amyloid --> restrictive cardiomyopathy

Question 42

subendocardial necrosis

Answer 42

less than 50% of the myocardial thickness

Question 43

transmural necrosis

Answer 43

greater than 50% of myocardial thickness