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Cardiovascular

Cardiovascular question

QuestionAnswer
Aschoff bodies are? Interstitial myocardial granulomas found typically in acute rheumatic carditis.
What are plump machrophages with abundant cytoplasm and central round to ovoid nuclei with central, slender chromatin ribbons Antischkow cells (caterpillar cells). When te larger macrophages become multinucleated they are reffered to as Aschoff giant cells.
Acute rheumatic fever is usually preceded by? episode of group A streptococcal pharyngitis 10 days to 6 weeks prior.
Viral myocarditis produces a predominantly what type of interstitial inflammatory inflitrate? lymphocytic, /w focal necrosis of myocytes adjacent to the inflammatory cells
Hypersensitivity myocarditis, as may result from a drug hypersensitivity rxn, is characterized histologically by? Interstitial inflammatory infiltrate of mononuclear inflammatory cells and eosinophils
Recent travel to Latin America is associated /w what dz. that is caused by intracellular protozoan parasite Trypanosoma cruzi? Chagas dz.
Chagas dz. is caused by what parasite? Protozoan Trypanosome cruzi
Chagas dz. can result in a myocarditis characterized histologically by? distension of individual myofibers /w intracellular trypanosomes
What histologically characterizes diphtheritic myocarditis? interstitial infiltrate of macrophages, without the distinct Aschoff body-type granulomas seen in ARF.
A child who has not been immunized against diptheria is susceptible to diphtheritic myocarditis a condition resulting from? Circulating toxin produced by a primary focus of infection in the upper aerodigestive tract (tonsillopharyngitis).
What congenital heart dz. that results in an anomalous connection between cardiac chambers is a normal variant in an adult pt. Patent foramen ovale.
What should be considered in a pt. that has evidence of deep venous thrombosis of the extremities and has developed a stroke? Patent foramen ovale
Endocardial cushion defect usually results in? a persistent AV canal, combined /w a continuous lower atrial and upper ventricular septal defect.
Endocardial cushion defect is associated /w what syndrome Down syndrome
What is dz. results form incomplete embryonic development of the aorticopulmonary septum, resulting in a single great vessel leaving the heart. Persistent truncus arteriosus
What is always associated /w persistent truncus arteriosus Ventricular septal defect
What will happen if persistent truncus arteriosus is not corrected? This defect causes cyanosis, and, if not corrected, results in death due to congestive heart failure within the first year of life.
When does the ductus arteriosus normally closes? by the 3rd month of life on response to high PaO2 of blood shunting form left to right through the ductus after birth.
Where does atherosclerotic plaques predominantly develope? Large elastic arteries (aorta, carotid, and iliac arteries), and in large or medium-sized muscular arteries (coronary and popliteal arteries).
What artery does atherosclerotic plaques usually first start? abdominal aorta /w lesion most prominent around the ostia of major arterial branches. Then coronary, popliteal, internal carotid, and circle of willis. Upper limbs usually spared + mesenteric and reneal except at their ostia
In the carotid system, the region most prone to atherosclerosis is likely where? The carotid sinus, at the origin of the internal carotid artery.
Supine dyspnea that is relieved by sitting up, known as orthopnea, is a relatively specific sign of what advanced heart problem? Left-sided heart failure
Pulmonary edema resulting in orthopnea can be seen in the absence of left ventricular dysfunction in patients with mitral stenosis
Blowing holosystolic murmur heard best over the apex and history of dyspnea and fatigue are together suggestive of what problem? mitral regurgitation
What are the erythematous, sometimes hemorrhagic,painless, macules on the sole of the foot called in bacterial endocarditis Janeway lesions
Janeway lesions are the result of septic embolization from infected cardiac valve vegetation.
What are the painful, papulopustules found in the pulps of the fingers and toes called found in bacterial endocarditis osler nodes
What is the most common cause of ventricular fibrillation in people younger than 30yrs of age? hypertrophic cardiomyopathy
congenital bicuspid aortic valves are strongly associated /w Accelerated onset of calcific aortic stensosis. With pt.'s valves showing stenosis beginning in the sixth decase.
What type of pt. are predisposed to infectious endocarditis? pt. /w prosthetic heart valves, prior valvular inflammation + scarring, which may occur following rheumatic fever
Rupture of chordae tendineae most commonly occurs in association /w? endocarditis or myocardial infarciton.
What dzs causes myocardial fibrosis dermatomyositis, muscular dystorphy, sarcoidosis and scleroderma
Myocardial hypertrophy occurs in? prolonged uncontrolled hypertension, or can be inherited as an autosomal dominant condition.
What is the most common causative organism of acute infective endocarditis? Staphylococcus aureus
What does the vegetations associated /w bacterial endocarditis represent? Fibrin and platelet deposition at a site of bacterial colonization
What is the underlying host key predisposing insult in the development of infectious endocarditis? endothelial damage
Pt. with endocardial thickening due to fibrosis present /w signs of heart failure due to restrictive cardiomyopathy.
Myxomatous degeneration often affects what valve mitral valve resulting in mitral valve prolapse, and is seen in the setting of connective tissue dz. such as Marfan syndrome
What are the normal morphological change in the heart that are associated /w aging? decrease in left ventricular chamber apex-to-base dimensions, development of a sigmoid-shaped ventricular septum, myocyte atrophy /w interstitial fibrosis, and accumulation of cytoplasmic lipofuscin pigment.
hypertensive heart dz. is associated /w what type of hypertrophy of the left ventricle? concentric
What are the histological findings in chronic ischemic heart dz? Myocardial hypertrophy, diffuse subendocardial vacuolization, and fibrotic scars of previously healed infarcts.
What is the description of chest pain of pericarditis origin? sharp and pleuritic in nature
What decreases the pain associated /w pericarditis? pt. sits up and leans forward
Fibrinous or serofibrinous pericarditis in most instances is causes by? Myocardial infarction, rheumatic fever, or uremia, though a viral infeciton may occasionally cause a fibrinous exudate to accumulate in the pericardial space.
What is the name for a paradoxical increase in jugular venous pressure /w inspiration Kussmaul's sign
Where is Kussmaul's sign most often found? chronic constrictive pericarditis, a condition that takes months or years to develop.
In the absence of tamponade (as is true for a normaltensive pt.)we would not expect Kussmaul's sign in a case of acute pericarditis
What is the differential diagnosis for Kussmaul's sign? cardiac tamponade, restrictive cardiomyopathy, severe right-sided heart failure, and tricuspid stenosis.
The presence of an S3 heart sound reflects? A rapid rate of diastolic ventricular filling with a large volume of blood (as in ventricular volume overload) and/or reduced ventricular compliance (diastolic dysfunction).
What is called a drop in systolic blood pressure of 20mmHg or more during inspiration? Pulsus paradoxus
When is pulsus paradoxus found? Cor pulmonale, constrictive pericardial dz, and cardiac tamponade.
What is a brief, high frequency precordial sound heard in early diastole (shortly after S2) in pt. with constrictive pericarditis? Pericardial knock
Pericardial knock can be confused /w ? Opening snap of mitral stenosis
What is the most striking physical finding of acute-onset pericarditis: fibrinous or serofibrinous? pericardial friction rub.
Ingestion of fenfluramine, dexfenfluramine, and phentermine for more than three months' duration has been associated /w the development of? secondary pulmonary hypertension.
Pt. /w pulmonary htn generally present /w? Exertional dyspnea(and possible exeertional pre-syncope), due to an inability of the right heart to adequately increase cardiac output against increased pulmonary vascular resistance during exercise. systemic bp may fall during exercise
Cerebral berry aneurysms are associated /w genetic disorders such as autosomal dominant? polycystic kidney dz, and Ehlers-Danlos syndrome
Bilateral upper lobe pulmonary fibrosis may be caused by? progressive massive fibrosis (coal worker's pneumoconiosis and silicosis), tuberculosis, histoplasmosis, sarcoidosis, allergic bronchopulmonary aspergillosis, and ankylosing spondylitis.
Renal vascular sclerosis may result from atherosclerosis, fibromuscular dysplasia, or systemic vasculitis (polyarteritis nodosa).
MI results in what type of necrosis coagulative necrosis
irreversible ischemic injury to the brain tissue results in what type of necrosis liquefactive
Where is fibrinoid necrosis seen? vasculitides
Caseous necrosis results from? tuberculosis
Fat necrosis results form? enzymatic action of abnormally released pancreatic lipases on adipose tissue.
Histologic pattern of injury seen in the walls of blood vessels affected by immune complex vasculitis fibrinoid necrosis
When the hypercoagulability is the result of the procoagulant effects of circulating products of cancers, the resulting resulting cardiac valve vegetations may also be called? marantic endocarditis
The pathophysiology of nonbacterial thrombotic endocarditis is similar to that of ? which may also be induced by disseminated cancer Trousseau's syndrome (migratory thrombophlebitis)
Lambert-Eaton syndrome is what type of syndrome? Autoimmune paraneoplastic myasthenic syndrome
What does Lambert-Eaton syndrome affect? Presynaptic calcium channels, resulting in decreased presynaptic acetylcholine relese
In most cases Lambert-Eaton syndrome is associated in most cases /w Oat cell carcinoma of the lungs
Cancer metastases to the heart usually involves what part of the heart? pericardium or myocardium. Valve metastases are less frequent.
Humoral hypercalcemia of malignancy, the most common causes of hypercalcemia in hospitalized pt, is due to? Production of parathyroid hormone like substance by tumors
Small, sterile, non-destructive fibrinous vegetations along the lines of closure of cardiac valve cusps are characteristic of? Non-bacterial thrombotic endocarditis
There is a particularly strong association of NBTE /w what type of cancers Mucinous adenocarcinomas of the pancrease and adenocarcinomas of the lung
When there is acute infective endocarditis to the aortic valve what usually happens aortic regurgitation
Created by: schrla