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cardio pathology


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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 --?
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
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?
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?
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?
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?
most pulmonary emboli arise from?
True or false: Amniotic fluid can lead to DIC
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

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