Pathology of the Heart IV Flashcards Preview

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Flashcards in Pathology of the Heart IV Deck (53):
1

LVH

with systemic hypertension (>140/90)***

CHF or arrhythmias

2

cor pulmonale

pulmonary disorder causes pulmonary HTN

leads to right side hypertensive heart disease

COPD, interstitial lung disease, recurrent PE, kyphoscoliosis, obesity

3

stenosis

valve can't open completely
-cusp abnormality
-almost always chronic

4

insufficiency

regurg or incompetence
-reverse flow

5

functional regurg

valve fine
-dilated annulus

6

most common cause of valve problems

rheumatic heart disease - mitral valve

7

aortic stenosis

calcified aortic valve

8

aortic insufficiency

dilation of ascending aorta - HTN and aging

9

mitral stenosis

rheumatic heart disease

10

mitral insufficiency

myxomatous degeneration - prolapse

11

calcific aortic stenosis

senile - in elderly 60-80yo

calcium mass in sinuses of valsalva

lead to LVH (concentric)

12

bicuspid aortic stenosis

in 2% population
-congeintal

more susceptible to calcification
-develps earlier

40-50yo

13

mitral annular calcification

women over 60yo
-occasional associated with arrhythmias
-not often affect valvular function

14

myxomatous degeneration of mitral valve

mitral valve prolapse
-ballooning of leaflets
-midsystolic click - leaflets hit inside vnetricle wall
-regurg murmur

secondary dilation of annulus, fibrosis of leaflets, jet lesions, thrombi

-marfan syndrome
-young women

15

young women with midsystolic click, anxiety and depression

mitral valve prolapse

aka myxomatous dengeration of mitral valve

16

acute rheumatic fever

from strep pharyngitis - 10 days - 6 weeks after
-antibodies for group A strep attack heart

pancarditis - every layer affected
-myocardium, endocardium, pericardium

also get polyarthritis

immune problem, NOT infection

17

aschoff bodies

acute rheumatic fever

granuloma - macros, lymphos, other inflamm cells

18

mononuclear in aschoff bodies

anitschkow cells

19

multinucleated in aschoff bodies

achoff cells

20

linear chromatin in aschoff bodies

caterpillar cells

21

chronic rheumatic heart disease

rheumatic heart disease
-long term after acute rheumatic fever
-chronic valvular disease - mitral and aortic

often mitral stenosis**

22

jones criteria

for acute rheumatic fever

previous group A strep infection
AND 2 major finding, or 1 major and 2 minor findings

Major - polyarthritis, carditis, subQ nodules, erythema marginatum of skin, chorea
minor - fever, arthralgia, acute phase reactants

23

acute vs. chronic rheumatic?

acute - vegetations on valve (majority mitral)
chronic - diffuse fibrous thickening

VEGF - with revascularization

24

rheumatoid heart disease

NOT rheumatic
-no aschoff bodies

25

infective endocarditis organisms

strep viridans
staph aureus
HACEK - haemophilus, actinobacillus, cardiobacterioum, eikenella, kingella

26

artificial valves

often strep epidermidis causing infective endocarditis

27

infective endocarditis

bulky vegetations of fibrin/platelet clot and organisms
-erode away valves
-possible for systemic emboli

usually left heart valves

unless IV drug user - right side

28

acute bacterial endocarditis

worse
-very high fever, heart problems

staph aureus

IV drug users

29

subacute bacterial endocarditis

-intermittent fevers
-strep viridans

more common

30

diagnosis for infective endocarditis

3 cultures in 24 hours


use duke criteria
2 major, 1 major/3 minor, 5 minor

31

janeway lesions

new bumps on palms and soles of feet

from infective endocarditis

32

osler noes

nodes in pulp of digits

from infective endocarditis

33

roth spots

oval retinal hemorrhage with pale centers

from infective endocarditis

34

duke criteria

for diagnosis of infective endocarditis
2 major, 1 major/3 minor, 5 minor

MAJOR
-positive blood culture
-EKG findings diagnostic
-new murmur

MINOR
-IV drug use
-fever
-vascular lesions
-immune - osler, roth, janesaw
-EKG consistent

35

nonbacterial thrombotic endocarditis

NBTE
-along lines of closure of valve leaflets
-sterile - no microorganisms
-risk fx - hypercoag


aka - marantic endocarditis

thrombi can embolize

36

libman sacks disease

non-infected vegetations
-pt with SLE
-malar rash
-new murmur

any surface of mitral/tricuspid valves

37

vegetation both sides of valve

libman sacks - SLE

38

vegetations that extend to chordae tendinae

infective endocarditis

39

small bland vegetation at line of closure

NBTE

40

small, warty vegetations, on line of closure

rheumatic heart disease

41

carcinoid syndrome

metastatic tumor - releases substances
-serotonin, kallikrein, bradykinin, prostaglandins, histamine
-diarrhea, flushing, skin rash, bronchoconstriction
-and fibrous intimal thickening of endocardial surfaces

gut tumor - right heart
-tumor in lung - left heart

42

fen/phen

old drug for weight loss - can lead to thickening of endocardial surfaces

43

cardiomyopathy

heart disease from primary abnormality of myocardium

44

dilated cardiomyopathy

majority

large flabby heart

45

hypertrophic cardiomyopathy

thick left ventricle - banana shaped space

46

restrictive cardiomyopathy

uncommon
-increase in mass without increased volume of left ventricle

47

myocarditis

inflammation cause of myocardial injury

48

coxsackie A and B

major cause of myocarditis

49

major causes of myocarditis

coxsackie A and B viruses
lyme disease - borrelia burgorferi
hypersensitivity - eosions
-trichinosis - helminths from undercooked meat
-chagas disease - trypsanoma cruzi

50

trypsanoma cruzi

chagas disease

cause of myocarditis

51

round nucleus myocarditis

lymphocyte
-mononuclear

viral infection

52

bi-lobated nucleus myocarditis

eosinophils

hypersensitivity myocarditis

53

giant cells in myocarditis

giant cell myocarditis