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Flashcards in Random Cardio Path HY Deck (78)
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1
Q

heart originates from which germ cell layer

A

mesoderm

2
Q

heartbeat established when during gestation?

A

3th wk

3
Q

changes occurring at birth in baby

A

lungs expand –> inc BF, dec R, higher partial P of O2

inc SVR (removal of placenta)

inc systemic BP

inc LVP

4
Q

tissue that becomes infolding of muscular roof of common atrium, and door of foramen ovale

A

septum secundum

5
Q

origin of aorticopulmonary septum

A

neural crest cells

6
Q

trisomy 21

associated disorders

A

endocardial cushion defects (common AV canal), VSD, ASD, PDA

7
Q

Turner syndrome

associated disorders

A

coarctation of aorta

8
Q

trisomy 18

associated disorders

A

VSD

9
Q

LV hypOplasia

associated disorders

A

aortic stenosis

10
Q

persistent trucus arteriosus

associated disorders

A

aortic and pulmonic outflow tract

11
Q

portion of atrial septum adjacent to AV valves is developed from

A

endocardial cushion tissue

12
Q

secundum ASD

A

patent foramen ovale (most common ASD)

13
Q

muscular VSD

A

harsh, pan systolic murmur

little functional disturbances

14
Q

paramembranous VSD

A

most common form VSD

involves the membranous septum

15
Q

TOF mechanism

A

abnormal endocardial cushion development of conotruncus

16
Q

@ which level does mixing occur w/ untreated D-TGA

A

ASD or VSD

17
Q

T/F

D-TGA –> mixing of blood occurs at ductus arteriosus level

A

false

BUT keeping DA open does inc VR to LA and improve mixing at atrial level

18
Q

hypOplastic left heart can lead to

A

MS/atresia
AS/atresia
RVH
coarctation of aorta

19
Q

___ aneurysms most commonly involve aortic arch, abd aorta, iliac a.

A

fusiform aneurysms

20
Q

aortic aneurysms predisposing condn

A

ATHEROSCLEROSIS
cystic medial degeneration
other (trauma/congenital defects/vasculitis/infections)

21
Q

AAA rarely develop before age

A

AAA rarely develop before age 50

22
Q

AAA usual location

A

below renal a., above bifurcation of aorta

23
Q

AAA freq contains a

A

laminated mural thrombus

24
Q

T. palladium

A

syphilitic aneurysm

25
Q

condition leading to obliterative endarteritis (freq. involv vasovasorum)

A

syphilitic aneurysm

–> results in ischemic medial injury –> aneurysmal dilatation of the aorta and aortic annulus

26
Q

Homan sign

A

pain w/ dorsiflexion of foot

poss DVT

27
Q

myxomas

A

primary cardiac tumor
benign
most in LA
“ball in valve” (MS sx, syncope, sudden death)

28
Q

myxoma histo

A

mesenchymal cells

abundant ground substance (gelatinous appearance –> myxoid, fibrous, slender cells)

29
Q

rhabdomyoma

A

most comm primary tumor in infants/children
benign hamartoma
valvular obstruction
TUBEROUS SCLEROSIS

30
Q

rhabdomyoma histo

A

large round polygonal myocytes w/ glycogen-rich vacuoles (CLEAR cytoplasm)
(spider-cells)

31
Q

tuberous sclerosis

A

AD, mut TSC1 (hamartin) or TSC2 (tuberin)

mostly TSC2: more severe –> seizures, ash leaf spots, facial skin spots (angiofibromas), mental retardation

32
Q

Kaposi sarcoma

A

caused by Kaposi sarcoma herpesvirus (HHV-8)

most common HIV-related malignancy

often involves lymph nodes and disseminates widely to viscera early in course

33
Q

Kaposi sarcoma histo

A

dilated, irregular, not well-formed vascular channels w/ extravasated erythrocytes, hemosiderin-laden macrophages

34
Q

mutations in sarcolemma and nuclear membrane proteins

A

dilated cardiomyopathy

35
Q

mutations in b-myosin heavy chain sarcomeric protein

A

HCM

36
Q

global LV systolic dysfunction
inc LV cavity diameter
absence of HTN, valve disease, significant CAD

A

DCM

37
Q

inc weight of heart, may be 3x
four chamber dilatation
flabby, pale myocardium w/ subendocardial scars

A

DCM

38
Q

anthracycline toxicity

A

DCM

39
Q

pregnancy/peripartum –> _CM

A

DCM

40
Q

HCM clinical features

A
sudden cardiac death (arrhythmia) 
syncope (LVOT obstruction)
mitral regurgitation (LVOT tugs MV)
41
Q

asymmetric bulging of lg inter ventricular septum into LV chamber

A

HCM

42
Q

microfiber disarray, especially in interventricular septum

A

HCM

disarray via xs branching–> block beneath AV, can’t get blood across –> syncope during exercise

43
Q

_____ may mimic constrictive pericarditis

A

RESTRICTIVE CM may mimic constrictive pericarditis

44
Q

R sided sx

cardiomegaly w/ thickened myocardial wall, dec contractility

A

amyloidosis
(systemic senile amyloidosis) –> RCM

apple green birefringence, Congo red, pink amorphous material

45
Q

causes of myocarditis

A

influenza
rocky mounted spotted fever
Chagas
drug rxns (penicillin, sulfonamide)

46
Q

Coxsackie B

A

viral myocarditis

47
Q

URI hx w/ + throat culture for specific virus

most pts recover, few die of congestive HF/arrhythmias

unusually severe in preg women/children

A

viral myocarditis

48
Q

patchy/diffuse interstitial infiltrate of T lymphocytes, macrophages, rare giant cells, focal myocyte necrosis

A

viral myocarditis

49
Q

T. Cruzi

A

chagas disease

pseudocyst in myocardial fiber –> MYOCARDITIS

50
Q

flabby/dilated heart

A

giant cell myocarditis

rare, unkown cause (seen w/ SLE, hypERthyroidism, thymoma)

young/mid age pts

histo: chronic inflamm w/ many giant cells

51
Q

most pericarditis are acute or chronic?

A

acute

52
Q

post-MI (Dressler’s) can lead to

A

pericarditis

53
Q

most viral causes of acute pericarditis

A

likely coxsackie virus

54
Q

hyperemic border (red) around infarct

age of infarct?

A

3-7 d

55
Q

2-4 d post MI

A

PMNs

interstitial edema, hemorrhage, necrotic myocytes (nuclei disappear)

56
Q

5-7 d post MI

A

macrophages

disintegration of dead myofibers

57
Q

2-8 wks post MI

A

well-stab granulation tissue

new blood vessels

increased collagen dec

dec cellularity

58
Q

MVP

A

mid systolic click

59
Q

rheumatic fever dx criteria

A

2 major

or 1 major, 2 minor Jones criteria

60
Q

minor jones

A

fever
arthralgia
acute phase reactants

61
Q

___ occurs as pancarditis

A

acute rheumatic carditis

62
Q

caterpillar cells

A

anitschkow cells

acute rheumatic carditis

63
Q

Aschoff body

A

focus of fibrinoid necrosis surr by inflamm cells (plasma cells, lymphocytes, anitschkow cells, Aschoff giant cells)

64
Q

acute rheumatic endocarditis

A

vegetations on closure line of cusps

65
Q
infective endocarditis 
(subacute)

most come organism

A

strep viridans

usu w/ predisposing factor (MVP etc)

66
Q
infective endocarditis 
(acute)

most come organism

A

staph aureus

high virulence, can occur w/o predisposing factor

67
Q

infective endocarditis

A

bulky, friable, destructive vegetations anywhere in valve

vegetations = fibrin, inflamm cells, bacteria ….later… fibrosis calcification

68
Q

Which form of AV block may be physiologic?

A

mobitz I Wenckebach

69
Q

cardiogenesis is completed by

A

6th week

70
Q

cardiogenesis weeks of gestation

A

3-6 wk

71
Q

closes archway of septum secundum, becomes valve of foramen ovale

A

remainder of septum primum

72
Q

T/F

EtOH abuse contributes to risk of intracranial aneurysm

A

True

73
Q

DCM is associated with which viruses

A

likely caused by AI attack on myocardium (viral myocarditis)

74
Q

Is HCM a common cause of CM?

A

No

75
Q

Restrictive CM usually presents with R or L sided sx?

A

R

76
Q

most comm cause of acute pericarditis in immunocompromised

A

CMV

77
Q

causes of fibrinous pericarditis

A
MI
uremia
chest radiation
rheumatic fever
lupus
trauma
78
Q

2-4 d post MI

A

mottling w/ yellow-tan softening

risk for arrythmia