cardio pathology
Terms
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- True of false: 50% is classified as secondary HTN (usually resulting from renal disease)
- false. (90% essential/primary, 10% secondary)
- read the questioner's mind: HTN predisposes individuals to this disease (the one John Ritter died of)
- aortic dissection
- Pathology changes associated with HTN
- hyaline thickening & atherosclerosis
- This awful term refers to a stiffening of the arteries that invovles the media. Particularly likely to occur at the radial & ulnar arteries.
- Monckeberg arteriosclerosis
- Atherosclerosis: True or false: atherosclerosis is a disease of small sized arteries
- false. affects elastic, large & medium muscular arteries.
- Atherosclerosis: Earliest sign of atherosclerotic disease
- fatty streak
- Atherosclerosis: most likely location
- abdominal aorta. (then coronary artery, popliteal artery, and carotid artery)
- Type of angina resulting from coronary artery spasm
- Prinzmetal's variant
- This coronary artery branch is most commonly implicated in myocardial infarction
- LAD (left anterior descending)
- most common cause of sudden cardiac death
- (lethal) arrhythmia
- Solid tissues like the heart, brain, kidney and spleen have only a single blood supply (not so good collaterals). Therefore infarcts are more likely to be --?
- pale
- 2 instances where red infarct is likely
- (1) reperfusion (2) loose tissues with good collaterals - like the lungs or intestine
- Evolution of MI: Rank the following vessels from most to least commonly occluded: RCA, LAD, circumflex
- LAD>RCA>circumflex
- Evolution of MI: Histologic changes on day 1 of an MI?
- pallor of infarcted area; coagulative necrosis
- Evolution of MI: days 2-4?
- dilated vessels (hyperemia); neutrophil invasion; extensive coagulative necrosis
- Evolution of MI: days 5-10?
- yellow-brown softening of infarcted region; macrophages present; granulation tissue begins to grow in
- Evolution of MI: after 7 weeks?
- infarct is gray-white; scar complete
- Diagnosis of MI True or false: ECG is not diagnostic during the first 6 hours following an MI
- False; it is the gold standard within this time period
- Diagnosis of MI What is the test of choice within the first 24 hours?
- CK-MB
- Diagnosis of MI This enzyme is elevated from 4 hours up to 10 days after an MI and is the most specific protein marker
- cardiac troponin I
- Diagnosis of MI on ecg, transmural infarction causes ______
- ST elevation, Q wave changes
- MI complications: Most common (90% of patients)
- arryhthmias, esp. 2 days after infarct
- MI complications: automimmune phenomen several weeks post-MI that results in fibrinous pericarditis
- Dressler's syndrome
- MI complications: high risk of mortality
- cardiogenic shock (large infarcts)
- MI complications: seen about a week after the infarction
- rupture of ventricular wall, septum, or papillary muscle
- Cardiomyopathies Most common
- dilated (congestive) cardiomyopathy; heart looks like a ballon on X-ray
- Cardiomyopathies True or False: substance abuse is a common cause of dilated cardiomyopathy
- True; cocaine and alcohol especially
- Cardiomyopathies These two infectious diseases are associated with dilated myopathy
- coxsackievirus B and Chagas' disease
- Cardiomyopathies True or false: hypertrophic cardiomyopathy causes systolic dysfunction
- False; dilated myopathy causes systolic dysfunction, hypertrophic causes diastolic
- Cardiomyopathies Half of hypertrophic myopathies are inherited as an _________ trait (x-linked, dominant, etc.)
- autosomal dominant; major cause of sudden death in young athletes
- Cardiomyopathies On echo in hypertrophic disease, the LV thickens and the chamber looks how?
- like a banana
- Cardiomyopathies These "-osis" diseases are major causes of restrictive/obliterative cardiomyopathy
- sarcoidosis, amyloidosis, hemochromatosis, endocardial fibroelastosis, endomyocardial (Loffler's) fibrosis⬦.also, scleroderma but it's not an -osis
- Name two causes of holosystolic murmurs
- 1) VSD, 2) mitral regurg, and 3) tricuspid regurg
- Widened pulse pressure seen with this diastolic murmur
- aortic regurg
- Describe the murmur associated with the most common valvular lesion
- Mitral prolapse; late systolic murmur following mid-systolic click
- True or false: aortic stenosis causes a decrescendo-crescendo murmur following an ejection click
- False; ejection click is followed by a crescendo-decrescendo systolic murmur
- cause of a continuous murmur loudest at time of S2?
- patent ductus artieriosis
- opening snap followed by late diastolic rumbling?
- mitral stenosis
- most common heart tumor?
- metastasis
- primary cardiac tumor in 1) adults and 2) children
- adults=myxoma (almost always in left atrium); children=rhabdomyoma
- fun gross pathologic term for changes in liver with CHF?
- nutmeg
- what are "heart failure cells"?
- hemosiderin-laden macrophages in lung
- dyspnea on exertion, pulmonary edema, and paroxysmal nocturnal dyspnea are symptoms of?
- left heart failure
- patient says "I have to sleep upright." the clinical term for this is?
- orthopnea
- most pulmonary emboli arise from?
- DVT
- True or false: Amniotic fluid can lead to DIC
- TRUE
- what are the component of virchow's triad?
- stasis, hypercoagulability, endothelial damage
- what is pulsus paradoxus?
- greater than 10 mmHg drop in systolic on inspiration
- what is electrical alternans?
- characteristic of tamponade on ECG in which QRS complex height varies beat-to-beat