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Integrative Pathology > Week 1 - Cardio/Resp/G.I.T Disorders > Flashcards

Week 1 - Cardio/Resp/G.I.T Disorders Flashcards

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1
Q

Name the types of left-to-right shunt

A

Atrial septal defect - failure of foramen ovale to close at birth.

Ventricular septal defect - most common, hole in ventricular septum.

Patent ductus arteriosus - failure of ductus arteriosus (pulmonary trunk to aorta) to close at birth.

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2
Q

What are some problems caused by left-to-right shunts?

A

Overloaded pulmonary circulation - pulmonary hypertension. Blood pools in venous system.

Hypertrophy of right ventricle

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3
Q

Describe patent ductus arteriosus

A

Vessel connecting pulmonary trunk to aorta fails to close at birth, blood from aorta is pushed back into pulmonary system (higher pressure) and overloads pulmonary system, leading to PHT

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4
Q

What are pulmonary stenotic lesions and their symptoms?

A

Narrowing of pulmonary valve/artery preventing adequate oxygenation of blood. Symptoms: cyanosis - blue tinge to skin due to low blood oxygen levels.

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5
Q

What defects make up Fallot’s tetralogy?

A
  1. Pulmonary Stenosis
  2. High ventricular septal defect
  3. Overriding of septum by aorta
  4. Right ventricular hypertrophy
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6
Q

Define coarctation of the aorta

A

Narrowing or blockage of the aorta, preventing adequate systemic blood flow. Symptoms include headaches and dizziness due to lack of blood flow to brain.

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7
Q

Explain the difference between dextrocardia and situs inversus

A

Dextrocardia: heart on correct/left side with apex pointed to the right side instead of left

Situs inversus: organs positioned on opposite sides of the body to normal (eg. heart on right, liver on left, etc.)

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8
Q

List and describe the morphological classifications of acute pericarditis

A
  • Serous: excess fluid build-up (SLE)
  • Fibrinous: build-up of fibrin (friction rub - “bread and butter”)
  • Suppurative: invection, causing pus formation
    Haemorrhagic: tumour/trauma causing bleeding into pericardium
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9
Q

List and describe the morphological classifications of acute pericarditis

A
  • Serous: excess fluid build-up (SLE)
  • Fibrinous: build-up of fibrin (friction rub - “bread and butter”)
  • Suppurative: infection, causing pus formation
    Haemorrhagic: tumour/trauma causing bleeding into pericardium
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10
Q

Causes of chronic pericarditis

A
  • Organisation of acute pericarditis (fibrin replaced with collagen/scar tissue)
  • Diseases like SLE, TB, Syphillis
  • Radiation or cardiac surgery
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11
Q

What is Pick’s disease?

A

progression of pericarditis (bacterial/viral) from acute to chronic. Collagen/scar tissue deposition in pericardium causing rigid fibrous capsule. Cardiac tamponade - restricts filling of heart in diastole.

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12
Q

Symptom of chronic pericarditis?

A

Distended neck veins due to impeded venous return and increased venous pressure

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13
Q

List the non-inflammatory pericardial disorders and a common resulting disorder

A
  • Hydropericardium: fluid build-up in pericardium
  • Haemopericardium: bleeding into pericardial space
  • Pneumopericardium: air within space, eg. from surgery

All may lead to cardiac tamponade

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14
Q

Describe angina pectoris

A

Gradual occlusion of cardiac vessel resulting in hypoxia of tissue and sudden chest pain upon exertion. Pain radiates down left arm, but resolves after rest.

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15
Q

List the types of myocardial infarction

A
  • Transmural
  • Subendocardial
  • Septal
  • Subpericardial
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16
Q

Describe a transmural MI

A

Involves the full thickness of the wall of the heart.

May result in thrombus and subsequent infarct (eg. cerebral).

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17
Q

Describe a subendocardial MI

A

Involves partial thickness of the wall closest to the lumen of the chamber (endocardium).
May result in thrombus and subsequent infarct (eg. cerebral).

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18
Q

Describe a septal MI

A

Involves the septum between the heart chambers (uncommon)

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19
Q

Describe a subpericardial MI

A

Involves partial thickness of the wall of the heart closest to the outside (pericardium).

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20
Q

Which is the most commonly infarcted coronary vessel and what area does this affect?

A

Left anterior descending (LAD)/Anterior interventricular artery. Results in anterior, apical infarct. 50% of all MI’s

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21
Q

What type of infarct does a right coronary artery occlusion cause?

A

Posterior infarct (left ventricle), 30% of all MI’s

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22
Q

What happens when the circumflex artery is occluded?

A

Lateral infarct (LV), 20% of all MI’s

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23
Q

Tests to investigate MI

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A
  • Troponin levels: proteins released upon cardiac damage
  • Cardiac enzymes: proteins released upon cardiac AND skeletal muscle damage, less specific
  • Blood lipids: indication of atherosclerosis
  • FBE: looking for neutrophils present due to inflammatory respone
  • Imaging: heart and blood flow
24
Q

Management of MI

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A
  • Defibrillator: correct rhythm abnormalities (implantation of pacemaker may be option)
  • Morphine for breathing
  • Fluid replacement for perfusion
  • Oxygen therapy for perfusion
25
Some outcomes of MI
Death suddenly/after shock (cardiogenic shock) | Scarring/fibrosis, pericarditis, secondary infarct (eg. cerebral), aneurism, arrhythmia's.
26
Describe amyloidosis and the types of protein involved.
Deposition of amyloid proteins in organs. Can affect skin, muscle, heart, lungs, spleen, kidney. ``` Amyloid Light chain (AL): immunoglobulin origin, produced by plasma cells Amyloid Associated (AA): apoprotein derived, HDL ```
27
Primary vs Secondary amyloidosis
Primary: (AL) idopathic - no known cause or pre-existing disease Secondary: (AA) pre-existing disease - eg. multiple myeloma, chronic inflammatory diseases, Rheumatoid arthritis Mainly spleen, liver & adrenals affected
28
Amyloid staining
Iodine: stains amyloid brown | Congo Red: stains amyloid red - under polarised light, appears APPLE GREEN (birefringence)
29
How does amyloidosis affect the heart?
Deposits between cardiac muscle cells, causes pressure atrophy of cells.
30
How are Cardiomyopathies diagnosed?
By exclusion of other disorders - not hypertension, Coronary Heart Disease or Rheumatic Heart Disease, but still experience chest pain, heart failure, palpitations
31
List the types of cardiomyopathy
- Congestive/Dilated - Hypertrophic - Restrictive
32
Explain Congestive/Dilated cardiomyopathy
Dilated ventricles/spaces in the heart, can be idiopathic, viral or alcoholic in cause
33
Explain Hypertrophic cardiomyopathy
Thickening of ventricular walls due to increased size of cells, can be idiopathic or genetic
34
Explain Restrictive cardiomyopathy
Stiffening/hardening/loss of elasticity of the walls of the heart resulting in reduced or restricted contractility, can be idiopathic or due to amyloidosis
35
What are the two types of Myocarditis?
- Infective: viruses (most common), protozoa (toxoplasma gondii), bacteria (staph. aureus) - Aseptic: alcohol/drug/toxin, autoimmune, idiopathic
36
Describe Rheumatic Heart disease (RHD)
Autoimmune disease following strep. pyogenes infection. Excess antibodies react with connective tissue. Causes Rh. Pancarditis - Aschoff Nodules Valvulitis Polyarthritis Genetic predisposition
37
What is the difference between Cor Bovinum and Cor Pulmonale
- Cor Bovinum: Left Ventricular Hypertrophy (LVH), can be concentric and progress to eccentric, due to SYSTEMIC hypertension - Cor Pulmonale: Right Ventricular Hypertrophy (RVH)/right sided heart failure, pooling in pulmonary arteries, again concentric which may progress to eccentric, due to lung/valve disorders
38
Acute Bacterial Endocarditis causes and symptoms
Septicaemia: bacteria within bloodstream infecting endocardium due to damage there. Can also present as vegetation on healthy valves. Seen in IV drug users - drug toxins damage endocardium, unclean needles allow bacteria into bloodstream. Splinter haemorrhages in fingernails due to septic emboli/damage to microvasculature
39
Sub-acute Bacterial Endocarditis causes and symptoms
Strep. viridans infection in immunocompromised/older patients. History of valve damage - vegetation on already damaged valves Splinter haemorrhages on fingernails
40
What are some valve disorders/lesions?
- Stenosis: don't OPEN properly - reduced flow - Incompetent: don't CLOSE properly - regurgitation/back flow Can have one/other or both Can be congenital, due to RHD or septic causes
41
Define phlebothrombosis vs thrombophlebitis
Plebothrombosis: formation of thrombus in a vein Thrombophlebitis: presence of a thrombus in a vein causing inflammation
42
Raynaud's disease vs Raynaud's phenomenon
Disease is idiopathic, vasospasm in hands of women (often young). Turns hands/fingers white/blue/red Phenomenon is associated with (secondary to) a pre-existing condition, eg. SLE, RA or lead poisoning
43
What is arteritis?
Disease affecting muscular and small arteries. Can be due to Type III hypersensitivity or autoimmune condition (Eg. SLE).
44
List the congenital respiratory conditions.
- Bronchial atresia - Hypoplasia of lung - Bronchogenic cysts - Bronchopulmonary sequestration - Kartagener's Synddrome Neonatal Respiratory Distress syndrome (NRDS)
45
What is Bronchial atresia?
narrowing of the bronchus, which restricts air flow
46
Define hypoplasia of the lung
Lungs develop incompletely - smaller than normal, less alveoli
47
Explain bronchogenic cysts and where they are found
Mucous-filled cyst formation in the airways, generally inside the trachea. These obstruct the air flow in/out of the lungs
48
What is bronchopulmonary sequestration?
When a section of lung is not connected to the bronchial tree and cannot function properly or contribute to air exchange. Sometimes it also lacks a blood supply
49
Define Kartagener's Syndrome
Also called Immotile Cilia Syndrome - lung cell cilia are defective and do not work to move mucous and trapped particles up out of the lungs. can cause excess mucous deposition preventing gas exchange
50
Explain NRDS
Neonatal respiratory distress syndrome - lack of surfactant in the lungs of an infant, causing collapse of alveoli and atelectasis. Common in very premature babies, treated with synthetic surfactant
51
What is Cystic Fibrosis and what other organs does it affect?
Multisystem disease caused by genetic mutation (recessive). Produces abnormally viscous mucous in lungs and G.I. tract - difficult to clear. Can cause: recurrent infections, pneumothorax, necrosis/scarring, pulmonary HT/cor pulmonale
52
How does chronic venous congestion affect the respiratory system?
Reduced LV output, pooling of blood in pulmonary circulation, alveolar capillaries rupture causing bleeding into lung. "Brown Induration" -necrosis/scarring. Haemosiderosis due to breakdown of RBCs. Cells engulfing bloof called "heart failure cells."
53
Describe pulmonary oedema
LV Heart failure, fluid movement out of vessels onto lung tissue, leading to pneumonia (hypostatic). Infection risk.
54
What is a pulmonary embolism?
Blood clot lodged in pulmonary artery (usually from deep leg vein). Can lead to infarction of lung, can be fatal.
55
Define the types of pulmonary hypertension
Primary: idiopathic, rare, hard to treat Secondary: due to lung or heart disease, eg COPD, thickened arterial walls and reduced lumen, difficulty breathing/dyspnoea

Integrative Pathology (2 decks)

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