Histopathology 6 - Vascular and Cardiac pathology Flashcards Preview

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Flashcards in Histopathology 6 - Vascular and Cardiac pathology Deck (36)
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1

What are the 3 stages of atheroma development?

1. Raised lesion
2. Soft lipid core
3. White fibrous cap

2

Recall the 7 steps of atheroma pathophsyiology

1. Endothelial injury
2. LDL enters intima and gets trapped in intimal space
3. LDL is converted into oxidised LDL --> inflammation
4. Macrophages take up OxLDL via scavenger receptors --> foam cells
5. Foam cell apoptosis --> inflammation and cholesterol deposition to form plaque core
6. Endothelium expresses more adhesion molecules --> more macrophages and T cells enter plaque
7. VSMCs form fibrous cap

3

What % atheroma of a vessel lumen is considered 'critical stenosis'?

70%

4

What is prinzmental angina?

Coronary artery spasm

5

Which parts of the cardiac muscle are affected by an infarction of the LAD?

Anterior wall of left ventricle, anterior septum and apex

6

Which parts of the cardiac muscle are affected by an infarction of the RCA?

Posterior wall of left ventricle, posterior septum and posterior wall of right ventricle

7

Which parts of the cardiac muscle are affected by an infarction of the LCx?

Lateral wall of left ventricle

8

What are the 4 most important complications of MI?

1. Contractile dysfunction (eg cardiogenic shock)
2. Arrhythmia
3. Myocardial rupture
4. Pericarditis

9

What is Dressler's syndrome?

Pericarditis occuring weeks-months post-MI

10

What is the average time between MI and myocardial rupture?

4-5 days

11

What is the prognosis of papillary muscle rupture following MI?

Rubbish - very high mortality

12

What is the most common cause of sudden cardiac death?

Lethal arrhythmia

13

What is restrictive cardiomyopathy?

Normal size heart but with large atria - may be due to amyloidosis

14

Recall 3 possible causes of aortic regurgitation

Infective endocarditis
Marfan's
Ankylosing spondylitis

15

What is Monckeberg atherosclerosis?

Focal calcification of the media of small-medium sized vessels; no associated inflammation

16

What histological findings would be found within 6 hours of an MI?

Normal histology and normal CK-MB

17

What histological findings would be found 6 -24 hours following an MI?

Loss of nuclei
Homogenous cytoplasm
Necrotic cell death

18

What histological findings would be found 1-4 days following an MI?

Infiltration of polymorphs and macrophages

19

What histological findings would be found 5-10 days following an MI?

Removal of debris

20

What histological findings would be found 1-2 weeks following an MI?

Granulation tissue
New blood vessels
Myofibroblasts
Collagen synthesis

21

What histological findings would be found in the months following an MI?

Strengthening, de-cellularising scar tissue

22

Recall the possible complications of MI

Mnemonic = PACE MAKERED

Papillary muscle dysfunction
Arrhythmia
Ccf
Effusion (pericardial)

Mural thrombus
Aneurism (ventricular)
(K)ontractile dysfunction
Early pericarditis
Rupture of venticular wall
Elevation of ST segment
Dressler's syndrome

23

What types of cardiomyopathy can be caused by sarcoidosis?

Dilated and restrictive

24

Which type of cardiomyopathy is associated with alcohol misuse?

Dilated

25

Is the pathology of cardiomyopathy systolic or diastolic dysfunction in
a) dilated CM
b) hypertrophic CM
c) restrictive CM?

Dilated: systolic

Hypertrophic and restrictive: diastolic

26

What is the HOCM?

Hypertrophic obstructive CM = septal hypertrophy resulting in an outflow tract obstruction

27

What mutation is associated with Hypertrophic CM?

Beta-myosin heavy chain
(Beta-HMC - HMC is HCM rearranged)

28

Recall the major criteria for Rheumatic fever diagnosis

CASES
Carditis
Arthritis
Sydenham's chorea
Erythema marginatum
Subcutaneous nodules

29

What is the main pathogen in rheumatic fever?

Lancefield group A strep

30

How is 'antigenic mimicry' involved in rheumatic heart fever?

Cell-mediated immunity and antibodies to streptococcal antigen cross-react with myocardial antigens

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