Path III Quiz 2 Flashcards
1
Q
What is the shape of the heart in dilated cardiomyopathy? What champers are affected?
A
Enlargement of all 4 chambers
- thin floppy walls don’t contract well
- hypocontract
2
Q
What is the most common cause of non-ischemic dilated cariomyopathy?
A
alcoholism
3
Q
What does the heart look like in hypertrophic cardiomyopathy?
A
- Left ventricle wall thickens
- septum thickens
- hypercontracts
4
Q
What is the cause of hypertrophic cardiomyopathy?
A
Genetic
- mutation of one of several genes that code for proteins within sarcomere
5
Q
What cariomyopathy is most common in young boys?
A
hypertrophic
6
Q
Is hypertrophic caused by HTN?
A
No
7
Q
What does heart look like in restrictive cariomyopathy?
A
Looks normal, but can’t contract properly
8
Q
What is most common cause of restrictive m?
A
amyloidosis and hemochromatosis
9
Q
You see pale, pink, amorphous material between myocardial fibers. What is this indicative of?
A
Restrictive cardiomyopathy due to amyloidosis
10
Q
What valves are affected by endocarditis?
A
Left side valves (M + A)
11
Q
What is the exception to left heart valves being affected in endocarditis?
A
IV drug users have right sided valves effected
12
Q
What is most common bacteria in community acquired IE
A
Staph aureus (non-MRSA)
13
Q
What is most common bacteria in nosocomial IE
A
Staph aureus (MRSA)
14
Q
What is the second most common bacterial cause of IE in both nosocomial and community aquired?
A
Alpha hemolytic strep viridans
15
Q
bacteria causing IE in prosthetic valves?
A
St epidermitis
16
Q
bacteria causing subacute IE?
A
S. Viridans
17
Q
bacteria causing acute IE?
A
Staph
18
Q
What causes vegetations
A
colonization of microbes
19
Q
What are risk factors for IE?
A
- poor dental health
- GU infections
- skin infections
- pulmonary infections
- IV drug use
20
Q
Risk factors for endocarditis?
A
- artificial valves
- immunocompromised
- IV drug abusers
- alcoholics
- catheters
- vascular grafts
21
Q
bacteria causing alcoholics to get IE?
A
anaerobes and oral cavity bugs
22
Q
bacteria causing pt with catheter to get IE?
A
E. Coli.
23
Q
bacteria causing IV drug users to get IE?
A
Staph aureus
24
Q
What causes Libman-Sacks Endocarditis?
A
SLE (SLE causes LSE)
25
If you see strep bovis what would you be worried that the pt has?
carcinoma of the colon
26
The causative organism is not found on blood cultures in what % of cases of pt with IE?
5-20%
27
What type of endocarditis is caused by SLE and other autoimmune disease. It may also not have any symptoms.
Libman-Sacks Endocarditis
28
Marantic Endocarditis
Hypercoagulative state
| - can be cancerous state
29
What type of cancers are common with mar antic endocarditis?
Lung or pancreatic
30
What is another term for an underlying hypercoagulative state in Marantic endocarditis?
Trousseau's syndrome
31
What is number one cause of myocarditis?
Coxsackie virus
32
If viral cause, what do you see in the tissue of myocarditis?
lymphocytes
33
What are the 3 most common types of valvular disorder in order?
1. aortic stenosis
2. MVP
3. Mitral Regurgitation
34
Which side is more likely to stenos?
Left
35
What is one pan systolic pan diastolic murmur?
patent ductus arteriosus
36
Who is more at risk for MVP
Young women 20-40
37
What is a risk factors for aortic stenosis?
- bicuspid valve
| - calcification from age
38
What is happening to valves in MVP?
One or both leaflets are floppy and prolapse back into left atrium during systole. Click sound.
39
What are some complications of MVP?
- IE
- Mitral insufficiency
- Stroke
- arrhythmias
40
What bacteria causes Rheumatic fever
Group A Beta hemolytic strep
41
What causes rheumatic fever?
autoimmune response due to anti strep M protein antibodies cross-reacting with cardiac myosin
42
What is pathognomic for thematic heart disease?
Aschoff bodies
| -nodules found in heart
43
What is most important sequelae of rheumatic fever?
mitral stenosis with fish mouth
44
What is a skin rash associated with rheumatic heart disease?
Erythema marginatum
45
What are major non-cardiac diagnostic criteria for diagnosis of Rheumatic fever?
```
carditis
polyarthritis
chorea
erythema marginatum
subcutaneous nodules
```
46
What is the most common cause of paricarditis?
idiopathic
47
What is Dresslers Syndrome?
Autoimmune condition that shows up weeks to months after MI
48
What is Post MI Pericarditis?
Inflammatory reaction occurs 1-2 days after MI
49
What are the 5 categories of pericarditis?
```
Serous
Fibrinous
Hemorrhagic
Purulent
Caseous
```
50
Serous Pericarditis
non-infectious
autoimmune
uremia
51
Fibrinous Pericarditis
```
Bread and Butter
Post MI and Dresslers Syndrome
Post cardiac surgery
Autoimmune
uremia
```
52
Hemorrhagic pericarditis
```
TB
Tumor
Bacterial Infection
Bleeding disorders
Trauma
```
53
Purulent Pericarditis
exudative fluid
infectious
resolution = scarring and potential constrictive pericarditis
54
What would you see on a CXR of someone with pericarditis due to TB?
calcified area within pericardium
55
What is most common tumor of the heart?
Atrial Myxoma
56
What is the histology of dilated cardiomyopathy?
non-specific cellular abnormalities including variation in myocyte size, myocyte vaculolization, fibrosis
57
What is the histology of hypertrophic cardiomyopathy?
Hypertrophy of myocardial fibers, prominent dark nuclei, interstitial fibrosis
58
What is the histology of restrictive cardiomyopathy?
excessive iron deposits for hemachromatosis
| deposits of pale pink material between myocardial fibers for amyloidosis
59
What are two types of culture negative endocarditis?
Libman-Sacks endocarditis
| Marantic endocarditis
60
What do vegetations of Libman-Sacks endocarditis look like?
flat, spreading vegetations
61
What do vegetations of Marantic endocarditis look like?
small, pink vegetations
62
What is the histology of dilated cardiomyopathy?
non-specific cellular abnormalities including variation in myocyte size, myocyte vaculolization, fibrosis
63
What is the histology of hypertrophic cardiomyopathy?
Hypertrophy of myocardial fibers, prominent dark nuclei, interstitial fibrosis
64
What is the histology of restrictive cardiomyopathy?
excessive iron deposits for hemachromatosis
| deposits of pale pink material between myocardial fibers for amyloidosis
65
What are two types of culture negative endocarditis?
Libman-Sacks endocarditis
| Marantic endocarditis
66
What do vegetations of Libman-Sacks endocarditis look like?
flat, spreading vegetations
67
What do vegetations of Marantic endocarditis look like?
small, pink vegetations
68
Atrial Myxoma
benign
left atrium
amorphous hypocellular mass
69
What is the most common cancer that metastases to the heart?
Melanoma
70
What does melanoma look like in the heart?
Brown black pigment
71
What is most common cancer that moves through blood or lymph to get to heart?
lung
72
what is most common benign tumor in children?
rhabdomyoma
73
What percentage of untreated pharyngeal strep lead to RF?
.3 to 3%
74
How many pt with acute RF develop some type of cardiac pathology?
1/3 of pt
75
What causes cardiomyopathy?
ischemic heart disease, hypertension, and valvular heart disease.
76
What is the most identified specific cause of dilated cardiomyopathy?
Ischemic Cardiomyopathy
77
What types of symptoms are seen in subacute endocarditis?
Petechiae
splinter hemorrhages
roth spots
78
What is the cause of endocarditis in native heart valves?
Strep viridans
79
What is a paraneoplastic syndrome associated with malignancies?
Marantic endocarditis or Trouseau's syndrome
80
Asside from coxackie virus, what else causes myocarditis?
infection of the heart
autoimmune (RHD SLE RA)
drugs
transplant rejection
81
What could cause aortic stenosis?
IE or other infection
82
What could cause mitral stenosis?
RHD
83
What percentage of valvular diseases are found in aortic and pulmonic valves?
2/3
84
What is another word for MVP?
Myxomatous degeneration (accumulation of derma tan sulfate) a glycosaminoglycan.
85
What do fully developed aschoff bodies consist of?
Granulomatous structures consisting of fibrinous material, lymphocytes, plasma cells, and macrophages surrounding necrotic center.
86
What valve/disease is most affected/caused by RHD?
Mitral valve with mitral stenosis (fish mouth)
| aortic is second most affected
87
What is the second most common complication of RHD?
Carditis
| dx: new murmur and tachycardia out of proportion to fever.
88
What are new or changing murmurs consistent with?
rheumatic valvular disease
89
What is the most common malignant heart tumor?
angiosarcoma
