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Flashcards in Path III Quiz 2 Deck (89):
1

What is the shape of the heart in dilated cardiomyopathy? What champers are affected?

Enlargement of all 4 chambers
- thin floppy walls don't contract well
- hypocontract

2

What is the most common cause of non-ischemic dilated cariomyopathy?

alcoholism

3

What does the heart look like in hypertrophic cardiomyopathy?

- Left ventricle wall thickens
- septum thickens
- hypercontracts

4

What is the cause of hypertrophic cardiomyopathy?

Genetic
- mutation of one of several genes that code for proteins within sarcomere

5

What cariomyopathy is most common in young boys?

hypertrophic

6

Is hypertrophic caused by HTN?

No

7

What does heart look like in restrictive cariomyopathy?

Looks normal, but can't contract properly

8

What is most common cause of restrictive m?

amyloidosis and hemochromatosis

9

You see pale, pink, amorphous material between myocardial fibers. What is this indicative of?

Restrictive cardiomyopathy due to amyloidosis

10

What valves are affected by endocarditis?

Left side valves (M + A)

11

What is the exception to left heart valves being affected in endocarditis?

IV drug users have right sided valves effected

12

What is most common bacteria in community acquired IE

Staph aureus (non-MRSA)

13

What is most common bacteria in nosocomial IE

Staph aureus (MRSA)

14

What is the second most common bacterial cause of IE in both nosocomial and community aquired?

Alpha hemolytic strep viridans

15

bacteria causing IE in prosthetic valves?

St epidermitis

16

bacteria causing subacute IE?

S. Viridans

17

bacteria causing acute IE?

Staph

18

What causes vegetations

colonization of microbes

19

What are risk factors for IE?

-poor dental health
-GU infections
-skin infections
-pulmonary infections
-IV drug use

20

Risk factors for endocarditis?

-artificial valves
-immunocompromised
-IV drug abusers
-alcoholics
-catheters
-vascular grafts

21

bacteria causing alcoholics to get IE?

anaerobes and oral cavity bugs

22

bacteria causing pt with catheter to get IE?

E. Coli.

23

bacteria causing IV drug users to get IE?

Staph aureus

24

What causes Libman-Sacks Endocarditis?

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