Pathology: Cardiovascular
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| 1. Most common cause of diastolic dysfunction. 2. Most common cause of systolic dysfunction. | show 🗑
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| Pathogenesis of dyspnea from left heart failure | show 🗑
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| show | 1. form of heart failure in which cardiac output is increased compared to normal values
2. since coronary vessels fill in diastole, tachycardia can result in ischemia by decreasing vessel filling time
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| Pathogenesis of: 1. Prinzmetal's angina 2. unstable angina | show 🗑
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| show | 1. decrease myocardial oxygen consumption by reducing heart rate
2. venodilation reduces preload
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| show | 1. equivalent to ventricular end diastolic volume
2. resistance ventricle contracts against to eject blood in systole
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| What are the two forms of ventricular hypertrophy? How are they related to preload and afterload? | show 🗑
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| What is the molecular pathologic change in: 1. Concentric hypertrophy 2. Eccentric hypertrophy | show 🗑
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| show | (↑ afterload)
1. essential or pulmonary hypertension
2. aortic or pulmonary stenosis
3. hypertrophic cardiomyopathy (similar to aortic stenosis)
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| show | (↑ preload)
1. aortic/mitral regurgitation
2. tricuspid or pulmonary valve regurg
3. left to right shunt
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| show | 1. systolic dysfunction - low ejection fraction (EF < 45%)
2. diastolic dysfunction - normal EF, physical signs of heart failure
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| Tetrology of Fallot | show 🗑
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| show | right-to-left through the VSD
difficult for blood to flow through the stenosed pulmonary valve so instead flows through VSD
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| What is Eisenmenger syndrome? | show 🗑
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| show | 1. VSD
2. ASD
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| show | 5 T's
1. tetrology of fallot
2. transposition of the great arteries
3. Truncus arteriosus
4. Tricuspid atresia
5. Total anomalous pulmonary venous connection
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| show | Coarctation of the aorta with PDA.
There is ↓ pressure after the coarctation and the pressure in the RV is able to push blood through the PDA to the lower extremities creating a R → L shunt.
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| 1. What maintains a patent ductus arteriosis? 2. What pharmacological intervention can be given to close a PDA? | show 🗑
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| show | 1. pulmonary hypertension → RV hypertrophy
2. upper extremity BP↑ from blockage of bloodflow; ↓ renal perfusion activates RAAS → water and sodium retention
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| What are the two types of myocardial infarction? How do they differ on ECG? What part of the heart do they involve? | show 🗑
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| What is the pathogenesis of an acute MI? | show 🗑
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| show | 1. sweating
2. No. pain from occluded artery. venodilation won't help
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| show | 1. ventricular fibrillation
2. cardiac troponins I and T
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| show | 1. STEMI(transmural)
2. LDH1 > LDH2; cardiac muscle contains LDH1 and releases it after injury
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| show | 1. areas of ischemia at periphery of infarct
2. areas of coagulation necrosis
3. injured myocardial cells surrounding necrosis
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| show | 1. mid LAD or circumflex
2. left circumflex
3. RCA
4. PDA
5. proximal LAD
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| show | 1. peripheral vascular resistance
2. renovascular
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| show | 1. increases plasma volume
2. opens calcium channels in smooth muscle cause vasocontriction
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| show | 1. atherosclerotic plaque
2. fibromuscular hyperplasia
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| 1. hypertension with hypokalemia 2. Kussmaul's sign 3. Pulsus paradoxus | show 🗑
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| show | 1. Hypercoagulability
2. Hemodynamic changes (stasis, turbulence)
3. Endothelial injury/dysfunction
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| show | 1. mitral regurgitation
2. tricuspid regurgitation
3. ventricular septal defect
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| 1. Right-sided heart sounds increase in intensity with ___. 2. Left-sided heart sounds increase in intensity with ___. | show 🗑
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| show | 1. weak and delayed pulses relative to ventricular contraction
2. aortic stenosis
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| show | 1. mitral stenosis
2. rheumatic fever
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| show | 1. mitral valve prolapse
2. patent ductus arteriosus
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| Difference between atherosclerosis and arteriolsclerosis. | show 🗑
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| 1. Port wine stain on face in distribution of ophthalmic branch of trigeminal nerve 2. What is Henoch-Schonlein purpura | show 🗑
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| show | 1. antineutrophilic cytoplasmic antibody
2. activates neutrophils to release their enzymes and free radicals resulting in vessel damage
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| What component of the neutrophil are the following directed against? 1. c-ANCA 2. p-ANCA | show 🗑
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| show | Takayusu arteritis (aorta thickens)
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| show | Kawasaki disease
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| show | 1. c-ANCA
2. p-ANCA
3. p-ANCA
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| 30 year old smoker with foot ulceration | show 🗑
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| 1. eosinophilia, asthma, pANCA 2. Fixed splitting of S2 | show 🗑
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| 1. Papules that do not blanch when pressure is applied. Recent respiratory tract infection 2. What is the cause? | show 🗑
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| show | Tet spell is dyspnea and cyanosis in tetrology of fallot.
Squatting increases systemic vascular resistance forcing blood through the VSD (left to right) and into the pulmonary artery.
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| What is a Tet spell | show 🗑
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| show | 1. First degree AV block
2. Mobitz I
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| show | 1. atrial enlargement from congestive heart failure
2. atrial flutter
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| show | if the ratio for conduction of atrial to ventricular beats is 2:1 (or higher) cardioversion, or carotid massage, could ↓ atrial beats so that the conduction ratio is 1:1. This would actually ↑ ventricular rhythm.
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| 1. Patient with palpitations and delta wave on EKG 2. Prolongation of the QT interval can lead to which arrhythmia? | show 🗑
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| show | stable angina
1. atherosclerotic coronary artery disease
2. aortic stenosis or hypertension with LVH
3. hypertrophic cardiomyopathy
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| show | 1. inadequate perfusion of tissues from failure of ventricles
2. pericarditis
3. autoimmune pericarditis (Dressler's syndrome)
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| 1. Best enzyme marker to diagnosis reinfarction after MI 2. Child with joint and chest pain, fever | show 🗑
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| show | 1. streptococcus viridans
2. staphylococcus aureus
3. staphylococcus epidermidis
4. streptococcus bovis
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| Heart valve involved in endocarditis 1. most commonly involved 2. IV drug users | show 🗑
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| show | 1. Libman-Sacks endocarditis
2. coxsackievirus
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| show | Pericarditis
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| show | 1. Hypertrophic cardiomyopathy
2. aortic stenosis
squatting ↑ preload (via ↑ afterload) → more blodd forced through aortic valve. Stenosis of HOCM is ↓ with ↑ preload
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| Treatment for hypertrophic cardiomyopathy | show 🗑
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| show | 1. atrial myxoma
2. tuberous sclerosis
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| show | 1. Diabetes - glycosylation of proteins in basement membranes cause leakage of protein into vessel wall
2. Hypertension - pushes plasma proteins into the vessel wall
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| Why is an aortic aneurysm more likely to form below the renal arteries? | show 🗑
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| show | 1. Superior vena cava syndrome.
2. Primary lung tumor
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| show | 1. Temporal (Giant cell) arteritis
2. Erythrocyte sedimentation rate
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| show | 1. before the ductus arteriosus
2. After the ligamentum arteriosus (remnant of ductus arteriosum)
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| show | 1. left to right
2. coagulation necrosis
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| show | 1. type II hypersensitivity - antibody complexes to M protein cross-react with heart tissue
2. polyarteritis nodosa
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| show | 1. tuberculosis and tumor metastasis
2. uremia from renal failure
3. tuberculosis (worldwide), cardiac surgery (US)
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| Pathology associated with the following: 1. Fibrillar-1 2. KCNQ-1 3. NOTCH 4. Transthyretin | show 🗑
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| show | constrictive
amt of fluid and fibrin are not great so no tamponade occurs in fibrinous pericarditis
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| show | microemboli formation from blood clots and clumping of bacteria
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| show | 1. hyperplastic arteriosclerosis
2. hyaline arteriosclerosis
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| Biggest risk factor for early, accelerated, and advanced atherosclerosis? | show 🗑
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| 1. Pericardial knock 2. Most common cause of MI in children? 3. Congenital heart disease associated with congenital rubella | show 🗑
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| show | 1. pericardial effusion
2. ↓ lung compliance: interstitial fibrosis, severe pulmonary edema
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| show | 1. weakening of a cerebral vessel wal secondary to an infectious process
2. Bartonella (same organism as cat scratch disease)
3. Charcot-Bouchard aneurysm
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| show | 1. ventricular fibrillation
2. 1 day; 3 days
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| show | ↑ positive intrathoracic pressure → ↓ filling of right heart (in contrast to squatting →↑venous return to right heart)
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| What mitral valve anomaly occurs in: 1. acute rheumatic fever 2. chronic rheumatic fever | show 🗑
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| 1. How does hypercalcemia affect the QT interval? 2. Pathogenesis of mitral valve prolapse | show 🗑
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| 1. How long after an MI do ruptures occur? 2. Most common cause of death in acute MI? 3. Mitral regurgitation 4 days after an acute MI? | show 🗑
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| 1. Tall, peaked T waves on EKG? 2. Temporal headache, ipsilateral blindness with flu-like symptoms and joint pain | show 🗑
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| 1. only vasculitis that involves the neurovascular compartment adjacent to the artery. 2. Which arteries are involved in Kawasaki disease | show 🗑
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| show | Monckeberg arteriosclerosis (medial calcification)
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| show | 1. ostium secundum
2. ostium primum
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| What is a truncus ateriosus? | show 🗑
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| show | 1. Marfans, Ehler's Danlos
2. Turner's syndrome
3. rubella
4. diabetic mother
5. arfans, Ehler's Danlos
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| 1. When is Kussmaul sign usually seen? 2. When can be acute? | show 🗑
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| show | marantis endocarditis (cancer causes hypercoagability resulting in thrombi that in turn cause endocarditis
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| show | 1. ostium primum ASD, regurgitant AV valves
1. tetralogy of Fallot
2. hypertrophic cardiomyopathy
3. rhabdomyomas
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| Severe nosebleeds, pink lesions on oral and nasal mucosa, face and arms | show 🗑
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| 1. Lymphedema of hands and feet in newborn. 2. Difference between ostium secundum ASD and a patent foramen ovale? | show 🗑
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| 1. Adult with fibrosis of the tricuspid and pulmonary valves is usually seen in... 2. What is the underlying cause? | show 🗑
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| show | Subendocardial in depression. Transmural is elevation.
1. ST depression
2. ST elevation
3. ST depression
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| sudden drop of QRS complex with no gradual lengthening of PR interval | show 🗑
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| show | 1. polyarteritis nodosa
2. lung
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| What two conditions can lead to fibrinoid necrosis? | show 🗑
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| show | 1. aspirin (only time can give children aspirin)
2. corticosteroids, cyclophosphamide
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| show | Wegener's granulomatosis involves:
1. nasopharynx
2. lungs
3. kidneys
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| Difference in pathogenesis of thrombi and emboli in atherosclerosis? | show 🗑
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| show | 1. medium
2. small
3. small
4. medium
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| Which section of the aorta wall does blood flow through in an aortic dissection? | show 🗑
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| Which valvular disorder: 1. acute rheumatic fever 2. chronic rheumatic fever | show 🗑
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| Patient with increased pulse pressure and bounding pulse. | show 🗑
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| Nonbacterial, sterile vegetations along mitral valve in patient with adenocarcinoma. | show 🗑
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| show | Loeffler syndrome
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| 1. Cause of S3 2. Cause of S4 | show 🗑
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| show | 1. dilated
2. dilated
3. restrictive
4. dilated
5. either restrictive or dilated
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| show | Jervell and Lange-Nielsen syndrome
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| show | 1. Anterior wall (LAD)
2. Anteroseptal (LAD)
3. Anterolateral (LCX)
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| Where is the infarct if the following leads have Q waves: 1. I, aVL 2. II, III, aVF | show 🗑
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| Which heart block is associated with syncope? | show 🗑
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| 23 year old woman with fatigue is found to have a systolic murmur and higher than normal cardiac output. What is the differential? | show 🗑
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