Shared Flashcard Set

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Valvular/Endocardial Heart Disease
Cardio Module
66
Medical
Graduate
08/21/2009

Additional Medical Flashcards

 


 

Cards

Term
How many cusps does the aortic valve have normally?
Definition
3
Term
What are the three histological layers  to the aortic and mitral valve?
Definition

fibrosa

spongiosus

ventricularis

Term
In the mitral valve versus the aortic valve, how does the spongiosus layer differ?
Definition
the spongiosus layer of the mitral valve near its base has muscle
Term

What is the spongiosus mainly composed of in the

 

a. aortic valve?

 

b. mitral valve?

Definition

a. glycoaminoglycans

 

b. glycoaminoglycans

muscle

Term
Where does the anterior leaflet of the mitral valve mostly connect to?
Definition
fibrous tissue
Term
Where does the posterior mitral valve mostly connect to?
Definition
fibrous ring
Term
What infection is acute rheumatic fever secondary to?
Definition
group A Beta hemolytic strep
Term
What is the most common age group to have acute rheumatic fever?
Definition
5-15
Term
What are the most common valves to be affected in Acute Rheumatic Fever in order?
Definition
mitral, aortic, tricuspid, pulmonary
Term
Are there bacteria present in the heart in acute rheumatic fever?
Definition
no it is immune mediated
Term
What criteria is used to diagnosis acute rheumatic fever and what are the major criteria (7)?
Definition

Jones Criteria

 

Fever

Migratory polyartheritis

Erythemia Marginatum

skin lesions

Aschoff bodies/anitschkow "myocyte"

subcutaneous nodules

chorea

Term
What type of sound will you hear with pancarditis?
Definition
friction rub
Term
What is true of the polyarthritis in acute rheumatic fever?
Definition
migratory
Term
What are two characteritics of the erythema marginatum in acute rheumatic fever?
Definition

non puritic

ring shaped

Term
What is true of the subcutaneous nodules in acute rheumatic fever?
Definition

they come in crops

transient

painless

Term
What is chorea? (st. vitus dance)
Definition
rapid upper extremity movements
Term
What is an Aschoff body?
Definition

inflamation surrounded by lymphocytes

granuloma

Term
Can you see Aschoff bodies in old rheumatic heart disease?
Definition
yes but they are most common in acute rheumatic fever
Term

What are Anitschkow cells?

 

What do they look like?

Definition

they are actually macrocytes that become catapillar like with linear chromatin

 

they look like myocytes

Term
What occurs to the chordae tendenae in rheumatic heart disease?
Definition
they thicken due to inflammatory cells and subsequently fuse
Term
What is a McCallen patch?
Definition

a jet lesion usually in the atrium on the posterior wall due to atrial regurgitation

 

some question whether it may actually just be due to the Rhuematic Fever

Term
How is the verrucae characterized in rheumatic fever endocarditis?  (where, how large, do they emboli)
Definition

at the line of closure

small

- non-embolitic

Term
What is true of the vascularity in chronic rheumatic heart disease?
Definition

neovascularity

 

There are vessels that remain

Term
What is the most obvious sign of a valve in the heart that indicateds rheumatic heart disease?
Definition
mitral stenosis
Term
What can the mitral stenosis of rheumatic heart disease lead to? 2
Definition

CHF (vascular pulmonary resistance)

arrhythmia

 

Term
How is the mitral valve lesion described secondary to acute rheumatic fever?
Definition
fish mouth
Term
What type of arrhythmia is common to develop in rheumatic heart disease?
Definition
A fib
Term
What is the extra heart sound heard in rheumatic heart disease?
Definition
opening snap
Term
How large are the verrucae in infectious endocarditis?  Do they form emboli?
Definition

variable size

+ thrombi

Term
Does endocarditis cause stenosis?
Definition
no
Term
What is another name for Nonbacterial thrombotic endocarditis?
Definition
marantic
Term
What are two medical conditions that would predispose someone to marantic endocarditis?
Definition

hypercoagulable state

cancer

Term
What type of valve does acute bacterial endocarditis general infect?
Definition
a valve with normal wear and tear
Term
Where and how large are the verraccous lesions in Libman-Sacks endocarditis?
Definition

they are on both sides of the valve and are

small

Term
What two diseases is libman-sacks endocarditis associated with?
Definition

SLE causes LSE

 

anti phospholipid antibody syndrome

Term
What are three causes of calcific aortic stenosis?
Definition

rheumatic fever

aging

bicuspid aortic valve

Term
How can calcific aortic stenosus be divided by cause?
Definition

senile

 

rheumatic etiolgy

Term
How can one differentiate calcific aortic stenosis caused by rheumatic origin versus senile (aged related)?
Definition

Senile has no mitral invovlement

The NODULES are at the BASE of the valve

no fusion of chordae

Term
What is the only definative treatment of calcific aortic stenosis?
Definition
valve replacement
Term

What ventricle will hypertrophy in calcific aortic stenosis?

 

What will happen to the A2 component of S2?

Definition

Left

 

A2 will soften

Term
What are two major complications of calcific aortic stenosis?
Definition

angina- b/c less flow to coronary arteries

 

sudden death

Term
What is the most common reason for valve replacement in adults?
Definition
aortic valve stenosis
Term
What gene is associated in bicuspid aortic disease?
Definition
NOTCH 1
Term
Where does the initial calcification occur in a bicuspid aortic valve and what does it cause?
Definition

in the raphe

 

causes stenosis

Term
What is true of the symptoms in both bicuspid aortic stenosis in younger patients and in Libman Sacks endocarditis?
Definition
both are asymptomatic
Term
What are four risk factors of calcific aortic stenosis?
Definition

male

smoker

high LDL

HTN

Term
What are the two mechanisms of forming calcific aortic stenosis?
Definition

dystrophic calcification

bone formation

Term
What type of crystals form in dystrophic calcification?
Definition
CaPO4
Term
Does the serum calcium become elevated in dystropic calcification?
Definition
NO
Term
What does myxomatous degeneration often lead to in the mitral valve?
Definition
mitral valve prolapse
Term
Which valve is myxomatous degeneration more common in?
Definition
mitral
Term
What gene is responsible for myxomatous degeneration?
Definition
FLNA
Term
What two genetic disorders are associated with Myxomatous degeneration?
Definition

Elhers  Danlos

 

Marfans

Term
Histologically, which layer of the mitral valve is affected in myxomatous degeneration?
Definition
spongiosus
Term
A mid diastolic snap would suggest what cardiac abnormality?
Definition
mitral prolapse
Term
Which valvular disease is associated with thinning elongation, and tearing of the chordae?
Definition
mitral valve prolapse
Term
Where does one develop thrombi in mitral valve prolapse, the atrial or ventricular side?
Definition
atrial
Term
What is true about the symptoms in mitral valve prolapse?
Definition
no symptoms
Term
Umbrella leaflets correspond to what valvular disease?
Definition
mitral prolapse
Term
What is carcinoid heart disease caused by?
Definition

GI tumor that secrets amines

 

they are usually degraded in the liver, but when it is not functioning they get to the right side of the heart cause damage and then get metabolized in the lung by MAO, so the left side not effected

Term
The lesions found and Carcinoid heart disease can be mimicked with what two drugs?
Definition
Fen phen and ergot
Term
What is the most common valve that carcinoid heart disease damages?
Definition
tricuspid
Term
What is the most common tumor of the heart?
Definition
Atrial Myxoma
Term
Why does atrial myxoma often cause thrombi?
Definition
b/c the tumor is floating around in the atrium and its pudunculated form allows easy sluffing off
Term
What valvular diseases can Ergot and Fen phen cause?
Definition

 

mitral stenosis

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