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Pathology Flashcards

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1
Q

emryonic defect which results in tetralogy of fallot

A

anterosuperior displacement of the infundibular septum

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2
Q

exposure to what can cause ebstein anomaly

A

lithium exposure in utero

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3
Q

risk factors of persistent pulmonary hypertension in the newborn

A

aspiration of meconium-stained amniotic fluid
neonatal pnuemonia

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4
Q

neonate with diabetic mother may be at risk of what cardiac complications

A

transportation of great arteries
truncus arteriosus
tricuspid atresia
VSD

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5
Q

cardiac defect associated with williams syndromec

A

supravalvular aortic stenosis

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6
Q

cardiac defect associated with 22q11 deletion syndrome

A

truncus arteriosus, tetralogy of fallot

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7
Q

cardiac defects associated with downs syndrome

A

AVSD (endocardial cushion defect), ASD, VSD

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8
Q

cardiac defects associated with congenital rubella

A

PDA, pulmonary artery stenosis, septal defects

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9
Q

string of beads appearance of renal artery

A

fibromuscular displasia
most common cause of secondary HTN in females

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10
Q

2 main types of arteiolosclerosis

A

thickening of arteries and artioles
1. hyaline - vessel wall thickening due to leakage of protein into subendothelial due to diabetes and hypertension

  1. hyperplastic - ‘onion skinning’ in severe hypertension with proliferation of smooth muscle cells
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11
Q

stanford vs DeBakey classification of aortic dissection

A

stanford (2 syllables = 2 types)
type 1 - ascending +/- arch/descending
type 2 - descending only

DeBakey (3 syllables = 3 types)
type 1 - ascening + descening
type 2 - ascending only
type 3 - descending only

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12
Q

at what point does the asending become the descending aorta

A

becomes the descending aorta just below the left subclavian artery

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13
Q

subclavian steal syndrome pathophysiology

A

occlusion of the subclavian artery proximal to the vertebral artery = hypoperfusion distal to stenosis
causes reversed blood flow in the vertebral artery = reduced cerebral perfusion on exertion of affected arm

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14
Q

subclavian steal syndrome features

A

BP difference in L vs R arm
arm ischaemia, pain, paraesthesia
vertebrobasillar insufficiency = dizziness, vertigo

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15
Q

risk factors for coronary artery vasospams

A

tobacco (number 1 risk)
cocaine
amphetamines
alcohol
triptans

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16
Q

treatment for coronary artery vasospams

A

CCB
nitrates
smoking cessation

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17
Q

MI complication;
- acute mitral valve regurgitation –> cardiogenic shock, severe pulmonary oedema

A

papillary muscle rupture

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18
Q

MI complication;
- cardiac tamponade, sudden death

A

ventricular free wall rupture

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19
Q

pathophysiology of dresslers syndrome

A

autoimmune pericarditis which develops 2 weeks after MI
cardiac antigens released after injury -> deposition of immune complexes in pericardium -> inflammation

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20
Q

MI complication;
- chest pain, murmur, HF, embolus

A

pseudoaneurysm

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21
Q

what is more likely to rupture and why - ventricular pseudoaneurysm or true ventricular aneurysm

A

pseudoaneurysm as its not contained within endocardium or myocardium

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22
Q

most common gene in familial dilated cardiomyopathy

A

TTP gene encoding the sarcometric protein titin

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23
Q

type of hypertrophy found in dilated cardiomyopathy

A

eccentric hypertrophy (sarcomeres added in series)

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24
Q

mutations in genes encoding what are responsible for familial hypertrophic cardiomyopathy

A

mutations in genes encoding sarcometric proteins such as myosin binding protein C and beta-myosin heavy chain

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25
what drugs are avoided in hypertrophic cardiomyopathy
nitrates betablockers diuretics
26
eosinophillic infiltrates in myocardium
loffler endocarditis (associated with eosinophillic syndrome)
27
causes of restrictive / infiltrative cardiomyopathy
PLEASe Help postradiation fibrosis loffler syndrome endocardial fibroelastosis amyloidosis sarcoidosis haemochromatosis
28
cardiomyopathy that causes diastolic dysfunction
hypertrophic cardiomyopathy restrictive/infiltrative cardiomyopathy
29
cardiomyiipathy that causes systolic dysfunction
dilated cardiomyopathy
30
condition which causes ventricular concentric hypertrophy vs eccentric hypertrophy
concentric = hypertrophic CM eccentric = dilated CM
31
primary disturbance driving each type of shock
hypovolaemic - decrease in PCWP cardiogenic - decrease in CO obstructive (PE, tamponade) - decrease in CO distrubutive (sepsis, CNS) - decrease in SVR
32
pathophysiology of pulsus paradoxus
decrease in systolic bP > 10mmHg during inspiration inspiration causes increase in venous return --> increase rv filling --> interventricular septum bows toward LV (due to decrease pericardial compliance ) --> reduced LV ejection = reduced BP
33
what conditions is pulsus paradoxus found in
constrictive Pericarditis obstructive pulmonary disease (Croup, OSA, Asthma, copd) cardiac Tamponade (P COAT)
34
most common valve involved in endocarditis
mitral valve
35
most common valve involved in endocarditis in IVDU
tricuspid valve (dont tri drugs)
36
causative organism of endocarditis in prosthetic valves
staph epidermidis
37
causative organism of endocarditis in IVDU
staph aureus, pseudomonas, candida
38
causative organism of endocarditis colon cancer
s gallolyticus
39
causative organism of endocarditis in GI/GU procedures
enterococcus
40
causative gram negative organism of endocarditis
HACEK haemophillus, aggregatibacter, cardiobacterium, eikenella, kingella
41
causative culture negative organism of endocarditis
coxiella, bartonella
42
causative organisms of endocarditis; acute and sub onset
acute - staph aureus subacute - viridans strep
43
libman sacks endocarditis
aseptic endocarditis found in SLE due to hypercoaguable state
44
tree bark appearance of aorta
tertiary syphyillis - calcification of aorta
45
consequences of syphillitic heart disease
aortic aneurysms aortic insufficiency
46
causative organisms of rheumatic fever
group A beta haemolytic streptococci
47
heart valve most affected in rheumatic fever
mitral
48
what typ eof hypersenstivity is rheumatic fever
type II
49
diagnostic features of rheumatic fever
JONES (with a love heart for O) Joint (migratory polyarthritis) carditis Nodules in skin Erythema marginatum (evanscent rash with ring margin) Sydenham chorea (involuntary irregular movements of limbs and face)
50
pathology and immunologic features associated with rheumatic fever
aschoff bodies anti streptolysin O anti-DNase B titres
51
what are aschoff bodies and what condition are they found in
rheumatic fever granuloma with giant cells and anitschkow cells (enlarged oval wavy rodlike nucleus)
52
what condition might rhabdomyomas be associated with
tuberous sclerosis
53
where in the heart do myxomas typically occur
atria
54
what type of interleukin does myxomas produce
IL-6
55
histology - gelatinous material, cells immersed in glycosaminoglycans
myxoma
56
ST elevation in leads V4-V6 would be due to thrombus in what vessel
distal left anterior descending
57
ST elevation in lead V1-V4 would be due to thrombus in what vessel
proximal left anterior descending
58
ST elevation in lead V1-V6 would be due to thrombus in what vessel
main left anterior descending
59
what is the preferred medication to lower high triglyceride levels ? and their mechanism of action
fibrates active PPAR alpha to decrease expression of 7-alpha-hydroxylase which is the rate limiting step of bile acid synthesis
60
side effect of fibrates
cholesterol gallstones
61
hereditary angioedema pathophsyiology
inherited disorder of dysfunctional or deficient C1 esterase inhibitor leading to increased levels of bradykinin or C1 complement pathway products which cause vasodilation and increased permeability
62
hereditary angiodema presentation
episodic oedema of arms, face, genitals etc
63
what medication should be avoided in patients with hereditary angiodema
ACE inhibitors
64
underlying mechanism of AF
autonomous bursts of electrical activity within pulmonary veins
65
underlying mechanism of sick sinus syndrome
age related degeneration of SA node
66
mechanism of carotid massage in SVT
massaging carotid sinus stimulates carotid baroreceptors which decreases HR via activation of parasympathetic nervous system (via glossopharyngeal nerve)
67
post MI - hypotension, tachycardia, respiratory distress
papillary muscle rupture leads to mitral regurgitation and acute pulmonary oedema
68
post MI - enlarged heart sillohette, hypotension, muffled heart sounds
left ventricular free wall rupture causes tamponade and sudden death
69
macophages with wavy nuclei
aschoff bodies found in rheumatic fever
70
pathological features of cardiac tissue hours after MI
eosiophil infiltration large influx of Ca which results in hypercontraction of sarcomeres
71
JVC distention, bilateral upper limb swelling, facial swelling and skin blanching
SVC syndrome
72
severe complications of SVC syndrome
increased risk of aneurysm or rupture of intracranial arteries
73
pancoast tumour which causes horner syndrome is due to obstruction of what structure
stellate ganglion
74
arrythmias, dilated cardiomyopathy, megacolon, megaoesophagus
chagas disease (trypanosoma cruzi)
75
pathological features of HOCM
ventricular concentric hypertrophy (sarcomeres added parralel) mitral regurgitation asymmetric septal hypertrophy systolic motion of anterior mitral valve (ASK MR SAM)
76
pathology of HOCM
77
pathophysiology of rhuematic fever
cross-reactivity between bacterial antigen and host immune system at the mitral valve (molecular mimicry) type II hypersensitivity reaction
78
what type of virus causes rubella
positive single-stranded RNA virus of the gene rubivirus
79
what type of bacterium is syphillis
a helically coiled spirochete
80
what type of heart failure would be found in amyloidosis
restrictive cardiomyopathy
81
causes of dilated cardiomyopathy
alcohol beriberi chagas disease coxsachie B cocaine doxorubicin
82
mumur found in rhematic heart disease
mid-diastolic rumble with opening snap at the apex
83
mid-systolic murmur with wide, fixed S2
ASD
84
most common cause of sudden death shortly after MI and its mechanism
arrythmias re-entrant circuits
85
what is the most common causative organism of infective endocarditis in a patient on haemodialysis
staph aureus
86
what type of bacteria is staph aureus
gram psitive, catalase positive, coagulase positive, cocci
87
pathophysiology of tertiary syphillis heart disease
endarteritis in the vasa vasorum which causes ischaemia of the aorta = aortic aneurysms and aortic insufficiency
88
why is betablockers contraindicated in patients with MI + cocaine use
unopposed vascular smooth muscle contraction via alpha 1 receptors

Cardiology (7 decks)

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