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Pathology 2 - Block 2 - Part 1

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davidwurbel7's version from 2016-06-13 21:48

Myocarditis

Question Answer
Inflammation of myocardium associated with myocyte necrosis and degenerationMyocarditis
An important cause of dilated cardiomyopathy that can lead to systolic dysfunctionMyocarditis
This is the most of Pericarditis and MyocarditisCoxsackievirus B
Any patient who comes from South America and have findings suggestive of cardiomyopathy should lead to thinking about this diagnosisChaga’s Disease
Chaga’s Disease is caused by this organismTrypanosoma cruzi
Non infectious causes of this including acute RF, drugs (doxorubicin), and SLEMyocarditis
Endocardial biopsy is done if this is suspectedInfection
Endocardial biopsy done if infection is suspected. The biopsy shows focal myocyte necrosis and lymphocytic infiltrate which highly predictive of thisViral Myocarditis
Clinical findings include the possibility of being asymptomatic with complete recovery or may present with Fever, chest pain, arrhythmias, malaise, myalgias , sudden death. Most eventually develop CHFMyocarditis
The lab report for myocarditis will show thisElevated Troponins and CK-MB
A late complication of myocarditis is thisDilated Cardiomyopathy
Definitive treatment for myocarditis is thisCardiac Transplant
Group of non-inflammatory diseases that primarily involve the myocardium and produce myocardial dysfunction. Usually present with heart failure and arrhythmias. Treatment: cardiac transplantCardiomyopathy
A very large heart that has a globoid shape. The heart feels very flabby, and the myocardium was poorly contractileDilated Cardiomyopathy
The most common cardiomyopathyDilated Cardiomyopathy
Characterized by progressive four chamber dilation resulting in systolic dysfunction leading to hypocontraction resulting in CHFDilated Cardiomyopathy
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(Insert 14-22)
Question Answer
Obstruction of blood flow is below aortic valve - Anterior leaflet of MV is drawn against the asymmetrically hypertrophied septum as blood exits LV (systole) leading to a decreased CO (angina,syncope). Harsh ejection systolic murmur. Aberrant myofibers and conduction system in IVS - Conduction disturbances are responsible for sudden death. Decreased diastolic filling - Muscle thickening restricts filling leading to diastolic failure because decreased SVHypertrophic Cardiomyopathy
Clinical manifestations can be asymptomatic ( common, therefore screening in important- echocardiogram) or present with Angina, presyncope/syncope (due to left ventricular outflow obstrction), CHF, Arrhythmias. Sudden cardiac deathHypertrophic cardiomyopathy
Hypertrophic cardiomyopathy can be screened for by thisEchocardiogram
Patients with Hypertrophic cardiomyopathy must avoid theses factorsFactors that Increase Obstruction
Patients with Hypertrophic cardiomyopathy have improvement of symptoms with doing thisIncreasing Preload
Hypertrophic cardiomyopathy patient can be given these classes of drugs to improve symptomsBeta Blockers and Calcium Channel Blocker
This can be done in patients with Hypertrophic cardiomyopathy to prevent ventricular arrhythmiasImplantable Cardioverter-Defibrillator
Characterized by restricted ventricular filling leading to reduced SV and CORestrictive Cardiomyopathy
Infiltrates depositing in the myocardium can lead to thisRestrictive Cardiomyopathy
Restrictive Cardiomyopathy in which glucose is being deposited in the myocardium is associated with this conditionPompe's Disease
In Pompe's Disease, staining myocardium with this stain will show glucose depositsPAS
Restrictive Cardiomyopathy in which amyloid is being deposited in the myocardium is associated with this conditionAmyloidosis
In amyloidosis, staining myocardium with this stain will show amyloid depositsCongo Red
In chronic inflammatory condition, the amyloid that gets deposited comes from thisSAA
Restrictive Cardiomyopathy in which iron is being deposited in the myocardium is associated with this conditionHemochromatosis
In hemochromatosis, staining myocardium with this stain will show glucose depositsPrussian Blue
In a child, this is the most common cause of restrictive cardiomyopathy in which thick fibroelastic tissue in the endocardium. Need a heart transplantEndocardial Fibroelastosis
The most common cause worldwide of restrictive cardiomyopathy is thisTropical Endomyocardial Fibrosis
Deposition of iron in tissues of the body is dangerous due to thisIron Induced Hydroxyl Free Radicals
Condition is which a person absorbs 100% of the iron in their diet leading to accululation of iron in the bodyGenetic Hemochromatosis
Condition in which a person has too much iron in the body. Most of the time due to multiple transfusionsAcquired Hemochromatosis
Benign condition in which iron is deposited in macrophagesHemosiderosis
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Tumors of the Heart

Question Answer
This tumor of the heart is more commonMetastatic Tumor
Cancer lung, breast, malignant melanoma are examples of these type of cancer that go to the heartMetastatic Tumor
The most common site of metastasis in the heart is herePericardium
Metastasis to the pericardium can lead to thisPericarditis and Effusion
An adult with a primary tumor of the heart most likely has thisCardiac Myxomas
A child with a primary tumor of the heart most likely has thisRhabdomyomas
Most cardiac myxomas are located here in the heartLeft Atrium
A cardiac myxoma can secret thisIL-6
Fever, maiase, anorexia are effects of the production of thisIL-6
Cardiac myxoma can possibly be seen using thisTransesophegeal Echocardiogram
The myxoid substance is composed of thisGlycosaminoglycan
A Cardiac Myxoma that is affixed to the wall of the atriumSessile Cardiac Myxomas
A Cardiac Myxomas that has a stalkPedunculated Cardiac Myxomas
A pedunculated cardiac myxoma that blocks of mitral valve orifice. Blocks diastolic filling of left ventricle, simulating mitral valve stenosisBall-Valve Effect
Auscultation may reveal a sound during diastole as the tumor hits the ventricleTumor Plop
This is the most common primary tumor of heart in infants and childrenCardiac Rhabdomyoma
Major association with tuberous sclerosisCardiac Rhabdomyoma
Cardiac Rhabdomyoma has a major association with this conditionTuberous Sclerosis
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Valvular Heart Disease Part 1

Question Answer
A multisystem immunologic disorder. Follows Group A Streptococcal (GAS) infection. Characterized by inflammatory reactions involving the Heart, joints, basal ganglia and other tissuesAcute Rheumatic Fever
Antibodies cross react with similar proteins in human tissue. The antibodies develop against thisGroup A Streptococcal M Proteins
Joints: Migratory asymmetric Polyarthritis, Obvious (the heart): Carditis, Nodules: Subcutaneous nodules, Erythema marginatum, Sydenham’s choreaJone’s Major Criteria for Acute Rheumatic Fever
Fever , Arthralgia, Leukocytosis, elevated ESR ,C-reactive protein (CRP) and antistreptolysin O (ASO titers). Previous rheumatic fever or rheumatic heart diseaseJone's Minor Criteria for Acute Rheumatic Fever
A patient must have 2 major or 1 major and 2 minor criteria to diagnose thisAcute Rheumatic Fever
The most common initial presentation of acute rheumatic fever is thisMigratory Asymmetric Polyarthritis
Inflammation can move from one joint to another and can appear on only one side. Occurs in large joints (Knees, hip, ankle). Joints are tender and swollen. No permanent joint damageMigratory Asymmetric Polyarthritis
A pancarditis. Inflammation of pericardium, myocardium and endocardiumCarditis
Fibrin deposits on pericardium. Pericardial friction rub and precordial chest painFibrinous Pericarditis
Endocardial involvement leads to the formation of vegetations along the line of closure of the affected valveVerrucae
Pathognomonic lesion of RF. Consists of Central area of fibrinoid necrosis surrounded by Aschoff cellsAschoff Body
These are reactive histiocytes. Fuse and form Aschoff multinucleated giant cellsAschoff Cells
Characterized by inflammation of valve surfaces. Leading to development of sterile verrucoid appearing vegetations (platelet and fibrin clots) along the line of closure of the valveEndocarditis
This valve is the most common valve affected by sterile verrucoid appearing vegetationsMitral Valve
This valve is the second most common valve affected by sterile verrucoid appearing vegetationsAortic Valve
This is a possible complication of sterile verrucoid appearing vegetations on the mitral valveMitral Regurgitation
This is a possible complication of sterile verrucoid appearing vegetations on the aortic valveAortic Regurgitation
This is not a usual complication of sterile verrucoid appearing vegetations on the mitral valve or aortic valveEmbolism
Over time with repeated acute attack of rheumatic fever, damage to the mitral and aortic valves may develop thisStenosis
acute RF, LSE, non-bacterial Thrombic Endocarditis, and Infective EndocarditisValvular Vegetations
The size of the valvular vegetations in acute RF and LSE are thisSmall
The size of the valvular vegetations in non-bacterial Thrombic Endocarditis, and Infective Endocarditis are thisLarge
The small valvular vegetations in acute RF and LSE have a very small chance to do thisEmbolize
The large valvular vegetations in non-bacterial Thrombic Endocarditis, and Infective Endocarditis have a greater chance to do thisEmbolize
Occur on extensor surface, painless. Fibrinoid necrosis surrounded by histiocytes. Histologically same as that seen in rheumatoid arthritisSubcutaneous Nodules
Circular ring of erythema with central clearingErythema Marginatum
Reversible rapid, involuntary movements affecting all muscles. This is a late manifestation of acute rheumatic feverSydenham’s Chorea
Sydenham’s Chorea is also called thisSt. Vitus Dance
The most common COD with acute rheumatic fever is thisHeart Failure Secondary to Myocarditis
Recurrent attacks of acute rheumatic fever can lead to thisChronic Rheumatic Heart Disease
Cumulative damage to the heart valves is after recurrent acute rheumatic feverChronic Rheumatic Heart Disease
Chronic Rheumatic Heart Disease can be prevented by prophylaxis administration of thisPenicillin G
Bacterial endocarditis, Mural thrombi, Congestive heart failure are complications of thisChronic Rheumatic Heart Disease
Congestive heart failure seen in Chronic Rheumatic Heart Disease is due to thisAortic stenosis
The dilation and hypertrophy of the left atrium can stretch the condition system of the atrium leading to this complicationAtrial Fibrillation
Atrial fibrillation in conjugation with an atrial mural thrombus can cause thisEmbolization
A mid-diastolic decrescendo murmur with opening snapMitral Stenosis
Dilation and hypertrophy of the left atrium can push on the esophagus causing mechanism obstruction leading toSolid Dysphagia
Narrowing of the mitral valve orifice causing volume overload in left atrium and lungsMitral Stenosis
The most common cause of mitral regurgitation is thisMitral Valve Prolapse
Mitral regurgitation due to left sided heart failure is due to thisStretching of the Mitral Valve Ring
Mitral regurgitation due to rupture of the posterior papillary muscle is due to thisOcclusion of the Right Coronary Artery
Clinical findings include pansystolic murmur with radiation into the axilla. Heard best at apex. Increases on expiration. S3 heart sound: volume overload in LV. Dyspnea and cough from LHFMitral Regurgitation
An increase in the presence of this in the mitral valve leaflet that can lead to mitral valve prolapseGlycosaminoglycan
The increase presence of this glycosaminoglycan in the mitral valve leaflet that can lead to mitral valve prolapseDermatan Sulfate
The term used for the increased presence of glycosaminoglycan in the mitral valve leafletMyxomatous Degeneration of the Mitral Valve
Valvular condition which is associated with Marfan and Ehlers Danlos syndromeMitral Valve Prolapse
The most common cause of aortic stenosiscalcified congenital bicuspid valve
A mid-systolic crescendo-decrescendo murmurAortic Stenosis
An increase in preload will cause the murmur due to this condition to become softerHypertrophic Cardiomyopathy
An increase in preload will cause the murmur due to this condition to become louderAortic Stenosis
Chronic aortic stenosis can show schistocytes in a peripheral blood smear can eventually lead to thisHemolytic Anemia
Clinical findings of this murmur include early diastolic murmur (decrescendo), bounding pulse (water hammer pulse), head nodding, pulsating uvulaAortic Regurgitation
Due to regurgitant stream hitting the anterior mitral valve leaflet. Presence of this murmur is a indication for replacement of valveAustin Flint Murmur
Pansystolic murmur that increase in intensity with inspiration. Pulsating liver - Blood regurgitates into venous system with systoleTricupsid Regurgitation
Due to metastasis of a carcinoid tumor from intestine to liver. Carcinoid tumors liberate serotonin and may produce carcinoid syndromeCarcinoid Heart Disease
Symptoms include Cutaneous flushing, Diarrhea, dermatitis and bronchoconstriction (wheeze). Cardiac manifestations due to serotonin. Serotonin is fibrogenic and causes fibrosis of tricuspid valve and pulmonary valves resulting in tricuspid valve regurgitation and pulmonary valve stenosis (TIPS)Carcinoid Heart Disease
This substance is fibrogenic in nature that is produced from a Carcinoid tumorSeratonin
Carcinoid Heart Disease is diagnosed by the presence of this in the urine5-HIAA
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