Jeef First Aid Cardio Part 6

Front 1

138. Turner syndrome heart defects?

Back 1

a. Coarc of aorta (preductal)

Front 2

139. Marfan’s Syndrome heart defects?

Back 2

a. Aortic insufficiency (late complication).

Front 3

140. Infant in diabetic mother heart defect?

Back 3

a. Transposition of great vessels.

Front 4

141. Signs of hyperlipidemia?

Back 4

1. Atheromas
2. Xanthomas -Plaques or nodules of lipid-laden histiocytes in skin- esp eyelids (xanthelasma).
3. Tendinous xanthoma- Lipid deposits in tendon, especially Achilles.
4. Corneal arcus- lipid deposits in cornea, nonspecific (arcus senilis).

Front 5

142. Monckeberg arteriosclerosis?

Back 5

a. Calcification in the MEDIA of the arteries, especially radial or ulnar.
b. Usually benign; “pipestem” arteries.
c. Does not obstruct blood flow; intima not involved.

Front 6

143. Arteriosclerosis?

Back 6

a. Hyaline thickening of small arteries in essential HTN or DM.
b. Hyperplastic “onion skinning” in malignant HTN.

Front 7

144. Atherosclerosis, what part of arteries and what type of arteries are affected?

Back 7

a. Fibrous plaques and atheromas form in INTIMA of arteries.
b. Disease of large and medium-sized muscular arteries.

Front 8

145. Progression of atherosclerosis?

Back 8

1. Endothelial cell dysfunction
2. Macrophage and LDL accumulation
3. Foam cell formation
4. Fatty streaks
5. Smooth muscle cell migration (involves PDGF and TGF-β)
6. Fibrous plaque
7. Complex atheroma.

Front 9

146. Most common locations in descending order of Atherosclerosis?

Back 9

1. Abdominal aorta
2. Coronary artery
3. Popliteal artery
4. Carotid artery

Front 10

147. Aortic dissection?

Back 10

a. Longitudinal intraluminal tear forming a false lumen.
b. Associated w/HTN or cystic medial necrosis (component of Marfan’s syndrome).

Front 11

148. Presentation of aortic dissection?

Back 11

a. Presents w/tearing chest pain radiating to back.
b. CXR shows mediastinal widening.
c. The false lumen occupies most of the descending aorta.
d. Can result in aortic rupture and death.

Front 12

149. Stable angina- cause and presentation on ECG?

Back 12

a. Mostly 2º to atherosclerosis.
b. ST depression on ECG (retrosternal chest pain w/exertion).

Front 13

150. Prinzmetal’s variant- cause and presentation on ECG?

Back 13

a. Occurs at rest 2º to coronary artery spasm.
b. ST ELEVATION on ECG.

Front 14

151. Unstable/crescendo angina- cause and presentation on ECG?

Back 14

a. Thrombosis but no necrosis.
b. ST depression on ECG (worsening chest pain at rest or with minimal exertion).

Front 15

152. Sudden cardiac death?

Back 15

a. Death from cardiac causes w/in 1 hr of onset of sx.
b. Most commonly due to a lethal arrhythmia (e.g., V-fib).

Front 16

153. Heart in first day of MI?

Back 16

a. Risk for arrhythmia.
b. No visible change by light microscopy in first 2-4 hrs.
c. Contraction bands visible after 12-24 hrs.
d. Early coagulative necrosis after 4 hrs!
e. Release of contents of necrotic cells into bloodstream and the beginning of neutrophil emigration.

Front 17

154. Morph of heart first day?

Back 17

a. Dark mottling
b. Pale w/tetrazolium stain.

Front 18

155. Heart in days 2-4 post MI?

Back 18

a. Risk for arrhythmia
b. Tissue surrounding heart shows acute inflammation
c. Dilated vessels (hyperemia)
d. Neutrophil emigration
e. Muscle shows extensive coagulative necrosis.

Front 19

156. Morph of heart in days 2-4?

Back 19

a. Hyperemia.

Front 20

157. Heart in days 5-10 post MI?

Back 20

a. Risk for free wall rupture, tamponade, papillary rupture, IV septal rupture!!!
i. Due to fact that macs have degraded important structural components.
b. Outer zone- Ingrowth of granulation tissue.

Front 21

158. Morph of heart in days 5-10?

Back 21

a. Hyperemic border
b. Central yellow-brown softening- maximally yellow and soft by 10 days.

Front 22

159. 7 weeks post MI?

Back 22

a. Risk for Ventricular aneurysm!!!!
b. Contracted scar complete.

Front 23

160. Morph of heart at 7 wks?

Back 23

a. Grey-white muscle tissue in area of infarct.
b. Recanalized artery.

Front 24

161. Gold standard for diagnosis of MI in first 6 hrs?

Back 24

a. ECG.

Front 25

162. ECG changes w/MI?

Back 25

a. ST elevation (transmural infarct)
b. ST depression (subendocardial infarct).
c. Pathologic Q waves (transmural infarct).

Front 26

163. When does cardiac troponin I rise?

Back 26

a. After 4 hrs.
b. Elevated for 7-10 days.
c. More specific than other protein markers.

Front 27

164. Use of CK-MB?

Back 27

a. Predominantly found in myocardium but can also be released from skeletal muscle.
b. Useful in diagnosing reinfarction on top of acute MI.

Front 28

165. AST?

Back 28

a. Rises w/MI.
b. Nonspecific and can be found in cardiac, liver, and skeletal muscle cells.

Front 29

166. Transmural infarcts?

Back 29

a. ↑ necrosis
b. Affects entire wall
c. ST elevation on ECG
d. Q waves

Front 30

167. Subendocardial infarcts?

Back 30

a. Due to ischaemic necrosis of <50% of ventricle wall.
b. Subendocardium especially vulnerable to ischaemia due to fewer collaterals and higher pressure.
c. ST depression on ECG.