Cardiac Path

Front 1

_____ is the multi-system derangement that occurs when the heart is no longer able to eject blood delivered to it by the venous system.

Back 1

Congestive Heart Failure

Front 2

______ of congestive heart failure(CHF) is the inadequate cardiac ouput.

Back 2

forward failure

Front 3

____ of CHF is the increased congestion of the venous circulation.

Back 3

backwards failure

Front 4

____ will increase heart rate and contractility.

Back 4

catecholamines

Front 5

_______ is ventricular wall thickening without an increase in chamber size.

Back 5

Concentric hypertrophy

Front 6

Eccentric hypertrophy is an _____ in thickness and an increase in _____.

Back 6

ventricular wall thickness and chamber size.

Front 7

_____ is a dilated ventricle that is able to maintain CO at a level that meets the needs of the body.

Back 7

Compensated heart failure

Front 8

_____ is a failing myocardium that is no longer able to maintain a CO that meets the needs of the body.

Back 8

decompensated heart failure

Front 9

Name 4 causes of Left-sided heart failure.

Back 9

1-systemic hypertension
2-ischemic heart disease
3-mitral or aortic valve disease
4-primary diseases of the myocardium

Front 10

you will see ____, ___, and ____ in left sided heart failure.

Back 10

pulmonary congestion, pumonary edema, and small alveolar space hamorrhage

Front 11

Name 3 common causes of Right sided heart failure.

Back 11

1-Left-sided heart failure
2-Pulmonary disease
3-congenital abnormalities

Front 12

In right sided heart failure ou will see ____, ___, ____, _____, and ____.

Back 12

1- congestion of abdominal viscera
2- soft tissue edema
3-pleural effusions
4-pericardial effusions
5-ascites

Front 13

If you see a "nutmeg" liver, you can guess this patient has ___?

Back 13

right sided heart failure

Front 14

A patient presents with elevated troponin I and CK-MB. You can predict he has probably had a ______?

Back 14

Myocardial Infarction

Front 15

______ is caused by the narrowing of the lumina of the coronary artery by atherosclerosis.

Back 15

Ischemic Heart Disease

Front 16

Name 4 things that could be the result of ischemis heart disease.

Back 16

1- angina pectoris
2- acute myocardial infarction
3- sudden cardiac death
4-chronic ischemic heart disease with congestive heart failure

Front 17

What are 4 risk factors for ischemic heart disease?

Back 17

1- HTN
2- diabetes mellitus
3-smoking
4-high levels of LDL cholesterol

Front 18

____ is defined as 75% or greater reduction in the lumen of one or more coronary arteries.

Back 18

critical stenosis

Front 19

Coronary artery vasospasm causes _____.

Back 19

temporary ischemia

Front 20

Angina Pectoris is defined as _____ chest pain caused by transient, _____ myocardial ischemia.

Back 20

intermittent, reversible

Front 21

A fixed, critical stenosis causes _______.

Back 21

typical or stable angina.

Front 22

Variant angina is caused by coronary artery ______.

Back 22

spasm

Front 23

____ is another name for variant angina.

Back 23

Prinzmetal

Front 24

Unstable angina pectoris is caused by an ____. This is also known as Preinfarction angina.

Back 24

acute plaque change

Front 25

_____ is defined as the development of an area of myocardial necrosis caused by local ischemia.

Back 25

MI

Front 26

Most MIs are caused by _____.

Back 26

coronary artery thrombosis

Front 27

Most MIs originate in the ____.

Back 27

subendocardium

Front 28

T or F: transmural infarcts involve most of the ventricular wall thickness.

Back 28

True

Front 29

____ involve the inner one third of the myocardium

Back 29

Subendocardial infarcts

Front 30

_____ is the seral marker that rises after a MI and remains elevated for days.

Back 30

troponin I

Front 31

Name 6 MI complications.

Back 31

1-papillary muscle dysfunction
2-external rupture of infarct
3-mural thrombosis
4-acute periarditis
5-ventricular aneurysm
6-cardiac arrhythmias

Front 32

Chronic ischemic heart disease is a consequence of ____ ischemic myocardial injury.

Back 32

long term

Front 33

HTN heart disease causes left ventricular ____.

Back 33

hypertrophy

Front 34

______ is a disease of right sided heart chambers caused by pulmonary HTN in an individual with a history of HTN and all other causes of ventricular hypertrophy have been ruled out.

Back 34

cor pulmonale

Front 35

cor pulmonale is a disease of ____ side heart chambers.

Back 35

right

Front 36

Acute cor pulmonale is caused by pulmonary ____.

Back 36

embolism

Front 37

chronic cor pulmonale is most commonly caused by ____.

Back 37

chronic obstructive lung disease

Front 38

Deformed valves are more susceptible to ___?

Back 38

infection

Front 39

Deformed valves may impose a major hemodynamic burden on the cardiac chambers by causing ____ or ____.

Back 39

stenosis, incompetence (regurgitation)

Front 40

_______ is an acute immunologically mediated, multisystem inflammatory disease that follows group A strept pharyngitis after an interval of a few weeks.

Back 40

Rheumatic fever

Front 41

What is the peak incidence age for rheumatic fever?

Back 41

5-15 years old

Front 42

inflammatory infiltrates may occur in a ______ range of sites including the heart.

Back 42

wide

Front 43

What will you see histologyically in rheumetic carditis?

Back 43

Aschoff bodies.

Front 44

Desribe an aschoff body.

Back 44

it is a central focus of fibrinoid necrosis surrounded by a chronic mononuclear inflammatory infiltrate and occasional macrophage.

Front 45

T or F: you will see inflammatory changes in all three layers of the heart during acute rheumatic carditis.

Back 45

True, in the pericardium, myocardium and endocardium

Front 46

In verrucous endocarditis you wil see a(n) _______ deformity of one or more valves.

Back 46

irreversible

Front 47

What valve is most often affected during Rheumatic endocarditis?

Back 47

Mitral valve

Front 48

What is the most common cause of aortic stenosis?

Back 48

calcific aortic stenosis

Front 49

Is calcific aortic stenosis of normal valves part of the aging process?

Back 49

yes

Front 50

Desribe calcific aortic stenosis.

Back 50

it is irregular Ca deposits behind the valve cusps.

Front 51

What is the most frequent valvular lesion?

Back 51

Mitral valve prolapse

Front 52

T or F: Mitral valve prolapse occurs more frequently in young women.

Back 52

true

Front 53

In _______ you will hear systolic murmur with a midsystolic click.

Back 53

mitral valve prolapse

Front 54

Mitral valve prolapse can predispose you to _____.

Back 54

infective endocarditis

Front 55

Nonbacterial thrombotic endocarditis is the deposition of _____ small masses of ___, ___, and other blood.

Back 55

Sterile, fibrin, platelets

Front 56

Can nonbacterial thrombotic endocarditis embolize?

Back 56

yes it can

Front 57

_______ is sterile vegetations that develop on cardiac valves of patients with systemic lupus erythematosus.

Back 57

Libman-Sacks endocarditis

Front 58

Infective endocarditis os a bacterial or fungal infection of the _______, particularly the _____- surfaces.

Back 58

endocardium, valvular (mitral)

Front 59

What are the vegetations comprised of in infective endocarditis?

Back 59

soft, friable vegetation of inflammatory cells and bacteria

Front 60

What are 3 risk factors for infective enocarditis?

Back 60

1- preexisting cardiac abnormalities (ie. alpha-hemolytic strep)
2- prosthetic heart valve
3- IV drug abuse

Front 61

What are 2 complications of infective endocarditis?

Back 61

1-distal embolization
2- Ring abscesses

Front 62

Prosthetic valves are susceptible to mechanical deterioration and leaks. What are 3 other complications with these valves?

Back 62

1- thrombi
2- infective endocarditis
3- hemolysis

Front 63

______ is inflammation of the myocardium.

Back 63

myocarditis

Front 64

T or F: infection can cause myocarditis.

Back 64

true

Front 65

What are 5 immune-mediated rxns that can cause myocarditis.

Back 65

1- postviral
2- poststreptococcal
3- SLE
4- drugs
5- Treatment rejection

Front 66

Can giant cell myocarditis cause myocarditis? Can sarcoid?

Back 66

yes, yes (WTF is sarcoid???)

Front 67

____ is a primary abnormality of myocardium.

Back 67

cardiomyopathies

Front 68

____ is the most common cardiomyopathy and is a progressive cardiac hypertrophy, dilation and mainly: contractile dysfunction.

Back 68

Dilated cardiomyopathy

Front 69

In dilated cardiomyopathy you will experience ______.

Back 69

contractile dysfunction

Front 70

______ is the hypertrophy of the ventricular wall, particularly the septum.

Back 70

hypertrophic cardiomyopathy

Front 71

What is charcteristic of hypertrophic cardiomyopathy?

Back 71

abnormal diastolic filling and left venricular outflow obstruction.

Front 72

What heart problem do young athletes sometime die of?

Back 72

hypertrophic cardiomyopathy

Front 73

________ is an infiltrate process within the myocardium that results in a decrease in ventricular compliance.

Back 73

Restrictive cardiomyopathy

Front 74

In restrictive cardiomyopathy you will see ________ diastolic filling and _______.

Back 74

impaired, contractile dysfunction

Front 75

The pressure on the left side of the heart is ____ than the pressure on the right.

Back 75

greater

Front 76

A hole in the heart will cause a ____ to ____ shunt.

Back 76

left to right, due to the pressure gradient.

Front 77

What are 3 examples of left to right shunts.

Back 77

1- ASD (atrial septal defect
2-VSD (ventricular septal defect)
3-PDA (Peyton ductus arteriosis)

Front 78

Name 2 right to left shunts.

Back 78

1-tetralogy of fallot (WTF?)
2- transposition of the great arteries.

Front 79

Shunts are a form of ____.

Back 79

congenital heart disease

Front 80

T or F; Infants will do just fine at birth if they have a small left to right shunt.

Back 80

true

Front 81

Infants with small left to right shunts in their heart will experience _____ and _____ when they get older.

Back 81

HTN and right ventricle hypertrophy

Front 82

Late cyanosis secondary to pulmonary HTN is a result of ____.

Back 82

left to right shunts

Front 83

cyanosis at birth is seen with _____.

Back 83

RIght to left shunts

Front 84

T or F: cyanosis at birth is not compatible with life.

Back 84

true

Front 85

Name the 4 components of the tetralogy of fallot.

Back 85

1- VSD(ventricular septal defect)
2- a dextraposed aortic root that overrides the VSD
3- right ventricular outflow obstruction
4-right ventricular hypertrophy

Front 86

Coarctation of the aorta is an ______ lesion.

Back 86

obstruction

Front 87

____ is inflammation os the pericardium.

Back 87

pericarditis

Front 88

describe 2 forms of pericarditis.

Back 88

1- primary-viruses
2- secondary- acute MI, cardiac surgery, uremia, acute rheumatic fever

Front 89

What is a pericardial effusion?

Back 89

fluid accumulation

Front 90

What causes pericardial effusions? (3)

Back 90

1- serous(heart failure)
2- serosanguinous(blunt chest trauma)
3-chylous( lymphatic obstruction)

Front 91

______ is pure blood in the pericardial sac.

Back 91

hemopericardium, this leads to cardiac tamponade(heart cant expand anymore)

Front 92

What are 2 cardiac tumors (primary neoplasms).

Back 92

1- myxomas
2- cardiac rhabdomyomas

Front 93

myxomas arise in the ___ atrium.

Back 93

left

Front 94

Cardiac rhabdomyomas are typically seen in _____ and ____.

Back 94

infancy and childhood

Front 95

Metastatic cardiac tumors typically come from ___ and ____.

Back 95

lung and breast