Path- Cardio 3

untimely's version from 2015-04-14 01:25

Inflammation ctd

Question Answer
what are the two portals of entry for the myocardium?(1) hematogenous dissemination (2) embolic dissemination of infective material fragments from vegetative (friable yelow lesions) endocarditis lesions into coronary arterial tree
what is the one defense mechanism of the myocardium?immunologic- humoral and innate
what are three things to consider about the pathogenesis of myocarditis?(1) hematogenous infection (2) host factors such as age, sex, strain, nutritional status, ambient temperatures, various stresses (3) role of immune mediated damage
What are the 5 types of myocarditis?suppurative, necrotizing, hemorrhagic, lymphocytic, eosinophilic
what are some viral etiologies for myocarditis? (one highlighted is the one he had in red)**canine parvovirus**, encephalomyocarditis virus, foot and mouth disease, pseudorabies, canine distemper, cytomegalovirus, Newcastle disease, avian encephalomyelitis, Eastern and Western equine encephalomyelitis
what are some bacterial etiologies for myocarditis? (one highlighted is the one he had in red) (mycotic? not highlighted but just to know)**blackleg**(clostridium), listeriosis, Tyzzer's disease, Actinobacillus equuli, necrobacillosis, tuberculosis, Corynebacterium kutscheri, Staphylococcus sp., Pseudomonas aeruginosa, Diplococcus pneumonia, caseous lymphadenitis (Mycotic: histoplasmosis)
what are the protozoan etiologies for myocarditis? (ones highlighted are ones in red which we should know) (parasitic ones? not red but just to know)** toxoplasmosis, sarcocystosis, encephalitozoonosis**, trypanosomiasis (Chagas' disease), theileriasis (East Coast Fever).... (parasitic ones are cysticercosis, trichinosis)
what is the dz which is an IDIOPATHIC cause of myocarditis?*eosinophilic myocarditis
the three possible expected outcomes of myocarditis?(1) complete resolution (2) residual scars (3) Progressive myocardial damage with acute or chronic cardiac failure

Myocardial Dilatation and Hypertrophy

Question Answer
when does hypertrophy usually happen?intrinsic response to heart failure
what are the two types of hypertrophy?(pic on slide 157) (1) Eccentric- (The wall thickness normally increases in proportion to the increase in chamber radius) (2) concentric- (the chamber radius may not change; however, the wall thickness greatly increases)
why does eccentric hypertrophy occur? examples?occurs because of increased blood volume such as in hypervolemia, valvular insufficiency, septal defects, polycythemia
explain how eccentric hypertrophy occurs (cellularly), and how it looks as a resultchamber dilation occurs as new sarcomeres are added in-series to existing sarcomeres
what does concentric hypertrophy occur? examples?occurs because of increased blood pressure such as in valvular stenosis, vascular disease, pulmonary disease, hyperthyroidism in cats, hypertension in cats and dogs
which type of hypertrophy does hyperthyroidism in cats cause?concentric (wall thickening) one
explain how concentric hypertrophy occurs (cellularly), and how it looks as a resultwall thickness greatly increases as new sarcomeres are added in-parallel to existing sarcomeres
what are some underlying features of cardiac hypertrophy?increase in cardiomyocyte size, enhanced protein synthesis, higher organization of the sarcomere
uhhhhh what's a sarcomere again?the basic unit of a muscle. (the thing with the bands, like I band, A band..) basically the muscle fiber is made of myofibrils bundled together, and each myofibril is composed of strings of sarcomeres (which have the various bands in them) (see slide 156 for a pic)
what's the pathogenesis of cardiac hypertrophy in a healthy myocardium?stretching of fibers from increased work load →fiber hypertrophy if healthy myocardium
what are the three stages of hypertrophy?initiation, stable hyperfunction, deterioration of function
what limitations does hypertrophy impose on the heart? (4)(1) blood supply (2) mechanical effect of increased muscle mass on function of adjacent areas of the heart (3) loss of compliance of myocardium (4) lack of adequate energy production (because of an increased myofibril to mitochondria ratio)
what is the gross appearance of eccentric hypertrophy?large chamber with thinned or normal thickness walls, rounded shape to heart, double apex
what is the gross appearance of concentric hypertrophy?small chamber with thick walls
how does hypertrophy look histologically?fibers are thick and have large nuclei
what is a specific disease example of hypertrophy in cattle?"brisket disease ", "high altitude disease" (result of pulmonary arterial hypertension induced by pulmonary hypoxia occurring at high altitude.)
what is a specific disease example of hypertrophy in dogs?dirofilariasis (infection by parasites in the Dirofilaria genus-- ie heartworms)
what is a specific disease example of hypertrophy in cats?hyperthyroidism
explain how "brisket disease "/"high altitude disease" in cattle causes hypertrophy (and other problems)hypoxic conditions over 7000 feet result in pulmonary hypertension--> right heart failure with subcutaneous edema of the brisket--> RV hypertrophy--> chronic passive congestion of the liver ("nutmeg liver“).
explain how dirofilariasis in dogs causes hypertrophythe parasites cause pulmonary vascular lesions (arteritis)--> produces pulmonary hypertension --> RV hypertrophy--> R heart failure
explain how hyperthyroidism in cats causes hypertrophycan happen in functional thyroidal adenomatous hyperplasia or functional adenomas. The hormones cause prominent myocardial hypertrophy (LV)

Cardiomyopathies/Neoplastic disease

Question Answer
how do you usually dx a cardiomyopathy?diagnosis by exclusion
what is a cardiomyopathy?progressive myocardial failure of undetermined cause
what is happening at a cellular level in a cardiomyopathy?alterations in myocyte sarcomeric proteins
what are the types of cardiomyopathies that CATS get?(1) dilated (congestive) type (2) hypertrophic type (3) restrictive type
CATS--> DILATED (congestive) type of cardiomyopathy looks like what, and WHY does it happen?the chambers are dilated, this is because of a taurine deficiency
CATS--> HYPERTROPHIC type of cardiomyopathy looks like what, and WHY does it happen?the LV is thickened, it appears to be heritable (persian, maine coon)
CATS--> RESTRICTIVE type of cardiomyopathy looks like what, and WHY does it happen?you will see excessive moderator bands (muscular band of heart tissue found in the right ventricle of the heart) or LV endocardial fibrosis (didnt list a cause)
what are lesions you'd see with all three types (dilated, hypertrophic, restrictive) of cardiomyopathies in cats? (5 things)you'd also see pulmonary congestion and edema, ascites, hydrothorax, hepatic congestion, and thromboemboli in aorta, atria, kidney
which type of dog is prone to Idiopathic cardiomyopathies, and WHICH TYPE?LARGE breed dogs are prone to the Dilated/congestive type of cardiomyopathy
how does dilated (congestive) myopathy present in the dog?dilated ventricles, multifocal subendocardial necrosis, extracardiac lesions of congestive failure
what are the two kinds of cardiomyopathies that dogs can get?dilated/congestive type (most commonly), or (Arrhythmogenic right ventricular cardiomyopathy<---didnt seem to care about)
what are some situations where cardiomyopathies can be secondary?hereditary, nutritional deficiency, toxic, endocrine disorders, physical injury and shock, Infections, neoplastic infiltration, systemic hypertension
what is the heart base tumor he mentions? where does it usually arise from? WHO does it usually affect? what consequence is there to this existing?CHEMODECTOMAS! usually arise from the aortic body and is important in dogs. they can produce an obstruction at the base of the heart
Malignant lymphoma--> which parts of the heart does this most often effect? WHO does this usually happen in? what consequence is there to this existing?might involve the pericardium and myocardium. most frequent in CATTLE. may produce cardiac failure
hemangiosarcoma--> WHO does this most often affect? WHERE is it usually located? what should you know about the primary tumor?usually in DOGS in the RA. +/- the primary tumor is in the SPLEEN
(most common cardiac dzs in the dog? - 6)Valvular endocardiosis, Congenital heart disease, Dilated cardiomyopathy, Hemorrhagic pericardial effusion, Cardiac neoplasia, Dirofilariasis
(most common cardiac dzs in the cat? -4)Hypertrophic cardiomyopathy, Dilated cardiomyopathy, Hyperthyroidism-associated hypertrophy, Congenital heart disease
(most common cardiac dzs in the rumi? -6)White muscle disease (selenium-vitamin E deficiency), Cardiotoxicity (ionophores, gossypol, Cassia occidentalis, Karwinskia humboldtiana), Brisket disease (high altitude disease), Pericarditis, Endocarditis, Malignant lymphoma
(most common cardiac dzs in the swine? -3)Mulberry heart disease (selenium-vitamin E deficiency), pericarditis, endocarditis
(most common cardiac dzs in the horse? -9)Congenital CV disease (VSD), Fibrinous pericarditis, Toxic cardiomyopathy (ionophores, white snakeroot), Endocardial fibrosis and calcification, Valvular endocardiosis, Endocarditis, Aortic rupture, Verminous endarteritis, Aorto-iliac thrombosis

Blood vessels-- arteries, veins, lymphatics Intro / Ruptures/Aneurysms / hypertrophy and hyperplasia / Atherosclerosis / Arteriosclerosis/Medial Calcification

Question Answer
when the vessels respond to injury, there is a complex interaction among what two things?Complex interaction among the cellular and non-cellular elements of the vessel wall and the cellular and non-cellular elements of the blood
what are the two major post-mortem changes you will see in the vessels?(1) Imbibition of blood- red staining of the intima by Hb (2) clotting-- can have "currant jelly" or "chicken fat" types (May be absent if death from hypoxia)
when might clotting be abset in vessels post-mortem?May be absent if death from hypoxia
what is a congenital anomaly of the vessels?Lymphatic hypoplasia
Lymphatic hypoplasia--> what does this congenital problem cause? who is it hereditary in? what is it called in dogs?Produces anasarca (generalized edema), it is hereditary in Ayrshire cattle, and in dogs it is called hereditary lymphedema
Where do HORSES usually get a rupture of a vessel? Why does this happen/what happens once there is a rupture?usually rupture of the AORTA! (also carotid but that's a diff card) usually intrapericardial hemorrhage associated with exertion
where do TURKEYS (esp MALES) usually get a rupture of a vessel? which type of rupture is it, and what is the result of this?usually rupture of the aorta! They are often the dissecting type--> rupture--> exsanguination
who usually gets a rupture of the CAROTID artery, and why? what is a common clinical sign?HORSES, it is usually secondary to gutteral pouch mycosis--> epitaxis
who is prone to get a rupture of the thoracic duct? (lymph vessel). what condition does this cause?CAT AND DOG, results in chylothorax....cause usually not determined
what causes hypertrophy of the vessels?increased volume and pressure load
what are some examples of increased volume and pressure load of vessels caused hypertrophy? (8)(1) uterine arteries in pregnancy (2) pulmonary vessels in cardiac shunts (3) "high altitude disease" (4) Aelurostrongylus sp (Cat nematode) (5) Toxocara sp. (round worms) (6) dirofilariasisin cats (7) ergot and fescue toxicosis (8) idiopathic in cats
how do the lesions of hypertrophy of vessels appear?thick walls, medial hyperplasia
Big cause in cattle and big cause in dogs of vessel hyperplasia? (in red)cattle=Brisket dz. Dog= dirofilariasis
what is an Aneurysm, what is it a type of?type of dilation- it is a thin outpouching of arterial wall, subject to rupture
what are three things that can cause an aneurysm?(1) Cu deficiency (2) lathyrism (sweet pea toxicosis) (3) in HORSES, strongylosis (equine intestinal threatworm)
(what are Varicosities?)(vericose veins) elongation and dilation of veins
what is Arteriosclerosis?“hardening of arteries”
what is Atherosclerosis?Atherosclerosis is a specific type of arteriosclerosis, Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on your artery walls (plaques), which can restrict blood flow
what are two causes of Atherosclerosis?(1) hypercholesterolemia (2) hypothyroidism
explain the pathogenesis of ATHEROsclerosishigh dietary cholesterol and saturated fat intake--> high level of serum LDL--> increased permeability of endothelium--> entry of lipids into wall to form lesions
4 charateristic lesions of ATHEROsclerosis? (1) fatty streaks on intima early (2) later, thick rough plaques on intima and adhered thrombi (3) accumulation of "foam cells" in intima and media (4) fibrosis
what are foam cells? when do you see them?Foam cells are fat-laden macrophages seen in atherosclerosis. They are an indication of plaque build-up, or atherosclerosis
what are the sequelae of atherosclerosis?thrombosis --> infarction (heart, brain, kidney)--> tissue ischemia
how does vitamin D poisoning appear in the vessels?vitamin D poisoning causes medial calcification
poisoning by plants containing 1,25 (OH)2 cholecalciferol causes?medial calcification
Hyperparathyroidism causes what vessel pathology?medial calcification
how does Mg poisoning affect the vessels?causes medial calcificiation
how does cachexia (Johne's disease) affect the vessels?causes medial calcificiation
Medial calcification can be caused by? (5)(1) vitamin D poisoning (2) poisoning by plants containing 1,25 (OH)2 cholecalciferol (3) Hyperparathyroidism (4) Mg poisoning (5) cachexia (Johne'sdisease)
Degeneration and necrosis of vessels--> Medial necrosis and hemorrhage: WHERE does this occur, in WHO, and what induces it?occurs in the muscular arteries of DOGS, induced by vasoactive drugs
how can you dx Fibrinoid necrosis histologically?seen histologically as for hyaline degeneration but stains positive by PAS and fibrin stain
in what dz processes does fibrinoid necrosis occur?occurs in "mulberry heart disease", edema disease, cerebrospinal angiopathy in swine, organic mercury toxicity