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Pathology III > Quiz 2 > Flashcards

Quiz 2 Flashcards

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1
Q

What is the most common type of non-ischemic

cardiomyopathy?

A

dilated

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2
Q

What are the three types of cardiomyopathy?

A

dilated, hypertrophic, restrictive

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3
Q

What is the ejection fraction of cardiomyopathy?

A

<40%

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4
Q

Most common cause of non-ischemic dilated cardiomyopathy?

A

chronic alcoholism

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5
Q

What are three characteristics of hypertrophic cardiomyopathy?

A

myocardial hypertrophy, abnormal diastolic filling, and intermittent ventricular outflow

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6
Q

Hypertrophic cardiomyopathy is classified as a __________disease.

A

genetic

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7
Q

What part of the ventricle enlarges with hypertrophic cardiomyopathy?

A

The walls < SEPTUM

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8
Q

What are the most common causes of restrictive cardiomyopathy?

A

amyloidosis, hemochromatosis

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9
Q

Which valves are most commonly infected in endocarditis?

A

Left side: mitral and aortic

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10
Q

Most common community acquired endocarditis is a result of what organism(s)?

A

1) S. aureus 2) AH Strep (S. viridans) 3) Culture negative

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11
Q

Most common nosocomial-acquired endocarditis is a result of what organism(s)?

A

1) S. aureas (mostly MRSA) 2) AH Strep. 3) Culture negative

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12
Q

Portals of entry for organisms that may cause endocarditis:

A

Poor dental health, dental procedures, genitourinary infections, procedures of the GU tract, skin infections, pulmonary infections, IV drug use

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13
Q

Sub-acute vs. Acute endocarditis

A

Acute: normal heart valve, highly virulent organism, 50% death in days-weeks.

Sub-acute: already damaged valve, less virulent, recovery

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14
Q

What is the most consistent sign of endocarditis?

A

Fever

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15
Q

Sub-acute endocarditis may result in what sequelae from embolized vegetations?

A

petechiae (mouth, tongue), splinter hemorrhages, Roth’s spots

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16
Q

What are the risk factors for endocarditis?

A

Artificial valves, immunocompromised, IV drug use, alcoholics, indwelling catheters, vascular grafts, AND rheumatic heart dz

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17
Q

What organism is associated with endocarditis of native valves which may be damaged?

A

S. viridans -main cause of sub-acute endocarditis

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18
Q

Which organism is associated with endocarditis involving prosthetic valves?

A

Staph epidermitis

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19
Q

Which organism is associated with endocarditis involving IV drug abuse?

A

Staph aureus

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20
Q

Which organism is associated with endocarditis involving alcoholism?

A

anaerobes and oral cavity bugs

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21
Q

Which organism is associated with endocarditis involving procedures or indwelling catheters?

A

Gm neg : E. coli

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22
Q

Which organism is associated with endocarditis involving patient with carcinoma of the colon?

A

Strep bovis

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23
Q

What is the endocarditis of SLE called?

A

Libman-Sacks endocarditis (collagen vascular inflammatory endocarditis)

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24
Q

What’s the gross appearance of Libman-Sacks lesions vs. infectious endocarditis?

Study These Flashcards
A

Libman-Sacks: Flat and spreading

Infectious: Chunky and pedunculated

25
Endocarditis resulting from hypercoagulable state (Trousseau's syndrome)?
Marantic endocarditis -pancreatic and lung cancers
26
Causes of myocarditis:
Infection (VIRAL-MOST COMMON), autoimmune, drugs, or transplant rejection
27
Most common infectious agents causing myocarditis?
1) Coxsackie virus (group B), HIV, Meningococcus, R. typhi, Borrelia burgdorferi, toxoplasmosis
28
What can be found microscopically in viral myocarditis?
Lymphocyte infiltrates
29
Define stenosis
Failure of a valve to open completely
30
Define insufficiency
Failure of valve to close completely
31
Most common valve dz?
Aortic stenosis and mitral regurg and insufficiency (MVP?_
32
Partial fusion of cusps
Raphe
33
Mitral valve prolapse affects what population more readily?
Women, 20-40yo
34
How is MVP often found?
Incidentally, during routine exam
35
Complications of MVP
Infective endocarditis, mitral insufficiency, stroke/systemic infarct, arrhythmias
36
Rheumatic fever follows infection by what organism?
Grp A beta-hemolytic strep (S. pyogenes)
37
What marker in the blood can indicate the likelihood of developing rheumatic heart dz?
ASO titers remaining high
38
Acute rheumatic fever is likely due to an immune response caused by what Ab which cross-react with cardiac myosin?
anti-streptococcal M protein
39
What are aschoff bodies and what are they pathognomonic for?
Rheumatic fever/heart dz Aschoff bodies are granulomatous structures consisting of fibrinous material, lymphocytes, occasional plasma cells and macrophages with surround necrotic centers
40
What are fused macrophages called?
Caterpillar cells or Anitschkow cells, due to appearance of chromatin
41
Most important cardiac consequence of rheumatic heart dz?
Mitral stenosis (#2 aortic stenosis)
42
On physical exam, how is carditis most commonly detected?
Tachycardia (out of proportion with fever) and new murmur
43
What is the gross appearance of mitral stenosis?
"fish mouth"
44
What is the pathogenesis of chronic rheumatic heart dz?
Progressive deformity of the valve leading to stenosis combined with insufficiency.
45
Most common complications of prosthetic heart valves?
Thrombosis, infection, structural failure (bioprosthesis), dehiscence (prosthetic)
46
Non-cardiac manifestations of rheumatic heart dz?
polyarthritis (#1), Sydenham's chorea, erythema marginatum, subcutaneous nodules also: abdominal pain, arthralgias, fever, and development of pneumonia
47
Most common causes of pericarditis?
``` Idiopathic (viral?) -MOST COMMON Infectious Inflammatory Autimmune Drugs Trauma Misc -Tumors ```
48
What dz would you be concerned for if you appreciated a hemorrhagic pericardial effusion?
TB, cancer, trauma
49
What are the 5 types of pericarditis?
Serous, fibrinous, hemorrhagic, purulent, caseous
50
Characteristics of serous pericarditis?
Usually non-infectious (possibly viral) Uremia Autoimmune - SLE, RA Often complete resolution
51
Characteristics of fibrinous pericarditis?
``` Post-MI or Dressler's syndrome Post-cardiac surgery Trauma Chronic uremia Autoimmune -SLE, RA Bread and butter appearance Audible friction rub ```
52
Characteristics of hemorrhagic pericarditis?
TB, Tumor, Trauma Bacterial infection Bleeding disorder
53
Characteristics of purulent pericarditis?
Septic infection Exudative Resolution often involves scarring
54
Most common heart tumor?
Atrial myxoma -benign Most occur in the left atrium.
55
Microscopic findings of myxoma?
Polygonal or elongated cell shapes Mono or multi nucleated Eosinophilic cytoplasms
56
Most common primary pediatric tumor of the heart?
Rhabdomyoma -behavior benign, but positioning can lead to lethal arrhythmias and chamber obstruction Spontaneous regression
57
Neoplasm with the greatest propensity to metastasize to the heart?
Melanoma
58
Most common malignancy found in the heart?
Lung cancer -proximity to heart, lymphatic invasion | Bronchogenic carcinoma

Pathology III (2 decks)

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