Unit 4 - Wk 1 Pathology/biochemistry

Front 1

General IHD

Back 1

Cardiac ischemia secondary to coronary artery disease; most common cause of death in US

Common in middle aged men and postmenopausal women

Front 2

Angina Pectoris

Back 2

Transient cardiac ischemia wo cell death resulting in substernal chest pain (stable angina, rinzmetal variant angina, unstable or crescendo angina)

Front 3

Stable Angina

Back 3

Most common; coronary atherosclerosis >75%; exertional chest pain

Front 4

Exertional or emotinal induced chest pain

Back 4

Stable Angina; due to atherosclerosis

Front 5

EKG of stable angina

Back 5

ST segment depression

Front 6

Episodic chest pain occuring at rest

Back 6

Prinzmetal variant angina; due to coronary artery vasospasm

Front 7

Increasing frequency, intensity and duration of episodes occuring at rest

Back 7

Unstable or crescendo angina

Front 8

Cause of unstable/crescendo angina

Back 8

Formation of nonocclusive thrombus in an area of coronary atherosclerosis

Front 9

EKG of unstable or crescendo angina

Back 9

ST segment depression

Front 10

Myocardial Infarction

Back 10

Localized area of cardiac muscle necrosis due to ischemia

coronary artery atheroscleorsis with plaque rupture and superimposed thrombus formation or coronary artery spasm

Front 11

General IHD

Back 11

Cardiac ischemia secondary to coronary artery disease; most common cause of death in US

Common in middle aged men and postmenopausal women

Front 12

Angina Pectoris

Back 12

Transient cardiac ischemia wo cell death resulting in substernal chest pain (stable angina, rinzmetal variant angina, unstable or crescendo angina)

Front 13

Stable Angina

Back 13

Most common; coronary atherosclerosis >75%; exertional chest pain

Front 14

Exertional or emotinal induced chest pain

Back 14

Stable Angina; due to atherosclerosis

Front 15

EKG of stable angina

Back 15

ST segment depression

Front 16

Episodic chest pain occuring at rest

Back 16

Prinzmetal variant angina; due to coronary artery vasospasm

Front 17

Increasing frequency, intensity and duration of episodes occuring at rest

Back 17

Unstable or crescendo angina

Front 18

Cause of unstable/crescendo angina

Back 18

Formation of nonocclusive thrombus in an area of coronary atherosclerosis

Front 19

EKG of unstable or crescendo angina

Back 19

ST segment depression

Front 20

Myocardial Infarction

Back 20

Localized area of cardiac muscle necrosis due to ischemia

coronary artery atheroscleorsis with plaque rupture and superimposed thrombus formation or coronary artery spasm

Front 21

Transmural Infarction

Back 21

Most common type of MI; ischemic necrosis of >50% of myocardial wall

Front 22

Sudden onset of severe "crushing" substernal chest pain radiating to left arm, jaw and neck

Back 22

Myocardial Infarction

Front 23

Feeling of impending doom

Back 23

Myocardial infarction

Front 24

Why are women protected from MI until postmenopausal years?

Back 24

Estrogen; hormonal replacement therapy does NOT protect against atherosclerosis and IHD

Front 25

Pathogenesis of subendocardial MI

Back 25

acute plaque change leading to mural thrombus/ emboli

Front 26

Pathogenesis of unstable angina

Back 26

acute plaque change leading to mural thrombus/ emboli

Front 27

Pathogenesis of Prinzmetal angina

Back 27

coronary vasospasm

Front 28

Pathogenesis of stable angina

Back 28

coronary atherosclerosis

Front 29

Pathogenesis of transmural MI

Back 29

: acute plaque change leading to occlusive thrombus

Front 30

Pathogenesis of sudden cardiac death

Back 30

lethal arrythmias due to acute plaque disruption

Front 31

At what level of the vessel does an atheroma develop?

Back 31

Intima; fatty core surrounded by smooth muscle

Front 32

Mural Thrombus

Back 32

Occludes lumen but not complete occlusion

Front 33

Transmural Infarct

Back 33

Occlusive thrombus

Front 34

Lumen occlusion >75%

Back 34

Ischemia precipitated by exercise

Front 35

Lumen occlusion >90%

Back 35

inadequate coronary blood flow even at rest

Front 36

ischemic chest discomfort (pressure, crushing, squeezing, radiation to jaw/shoulders) occurs at rest with minimal exertoin

Back 36

acute coronary syndrome

Front 37

Ischemic chest discomfort that occurs predictably and reproducibly at a certain level of exertion and is relieved with rest

Back 37

chronic stable angina

plaque hasn't ruptured and there's still blood flow but gives you symptoms when demand exceeds supply

Front 38

Ischemic chest discomfort progressive over years

Back 38

Left ventricular outflow obstruction

due to aortic stenosis, hypertrophic cardiomyopathy with subaortic stenosis

Front 39

Why do myoglobin levels drop so rapidly? (return to baseline within 24 hrs)

Back 39

Clearance by kidney; these levels are also elevated in someone with kidney failure

Front 40

Which marker is the most specific for MI or heart damage?

Back 40

Troponin I and T

Front 41

where does troponin come from?

Back 41

regulate sinteraction of myosin with actin in response to calcium binding

Front 42

What is the function of creatine kinase?

Back 42

Produce ATP that can be accesed by cardiac and skeletal muscle

MB is the primary form seem in the heart

Front 43

When can infarcted tissue still be saved?

Back 43

until 30 minutes after onset

Front 44

Pale vs Red Infarct

Back 44

Front 45

How long since infarct

Back 45

7-28 days; central pallor with red border

Front 46

How long since infarct

Back 46

Center is tan with surrounding hyperemia

Front 47

Back 47

white appearance indicates scarring (months)

Front 48

Back 48

1-2 Days; Coagulation necrosis with loss of nuclei and striations; brisk interstitial infiltrate of neutrophils

Front 49

Back 49

3-4 days; extensive acute inflammatory cell infiltrate and myocardial fibers are so necrotic that their outlines are barely visible

Front 50

Back 50

Intermediate MI of 1-2 weeks; remaining myocardial fibers at top; many macrophages along with capillaries and collagen deposition

Front 51

Back 51

Remote infarct; blood vessels with rbc; acute inflammation occuring

Front 52

What artery supplies the septal leads (V1/2)

Back 52

LAD

Front 53

Which artery is monitored by inferior leads (II, III, aVF)

Back 53

Right coronary

Front 54

Which artery is monitored by lateral leads? (I, aVL, V5, V6)

Back 54

Right circumflex artery

Front 55

Which artery is monitored by anterior leads (V2, V3, V4)

Back 55

LAD

Front 56

Aortic Dissection

Back 56

Blood splays apart the laminar planes of the media to form a blood filled channel within the aortic wall

Front 57

Back 57

A) Cystic medial degeneration; marfan sndrome showing marked elastin fragmentation and areas devoid of elastin
B) normal media for comparison

Front 58

Acute pericarditis

Back 58

Acute inflammation of the pericardium; can be immunological mediated, infectoius or infarction

Front 59

Acute fibrinous/serofibrinous pericarditis

Back 59

most frequent type of pericarditis; serouf fluid mixed with a fibrinous exudate

Front 60

Acute purulent or Suppurative Pericarditis

Back 60

Invasion of the pericardial space by microbes; frequently produces constrictive pericarditis secondary to intense inflammatory response

Front 61

Acute hemorrhagic pericarditis

Back 61

The exudate is composed of blood mixed with fibrinous or suppurative effusion

Front 62

Causeous Pericarditis

Back 62

Caused by TB; sometimes fungal infection

Front 63

MI Pathogenesis

Back 63