Cardiovascular Path 1

Question 1

What is the blood supply of the heart valves?

Answer 1

Scanty blood supply: thin enough to be nourished by diffusion from the heart’s blood

Question 2

Most blood flow to the myocardium is during systole/diastole

Answer 2

Diastole

Question 3

Rapid shallow breathing associated with left heart failure is due to the activation of ________

Answer 3

J receptor in the interalveolar septum

Question 4

What molecules are specifically elevated in MI

Answer 4

• troponin

- CK-MB

Question 5

Cardiac hypertorphy leads to induction of genes coding for:

Answer 5

• actin, myosin → ↑ sarcomeres

Question 6

Pressure overload on the ventricles cause ___________ hypertrophy in which new sarcomeres are added __________ to existing sarcomeres

Answer 6

Concentric hypertrophy; in parallel (leads to ↑ wall thickness)

Question 7

In what conditions would you have sarcomeres added in parallel in the cardiac myocytes?

Answer 7

Pressure overload in the ventricles: HTN, aortic stenosis

Question 8

Eccentric hypertrophy of the cardiac myocytes occurs in ______________ in which sarcomeres are added _________

Answer 8

Volume overload; IN SERIES

Question 9

What conditions would you have sarcomeres being added in series?

Answer 9

Volume overload in the ventricles: aortic regurgitation

Question 10

Aortic stenosis is associated with __________ hypertrophy with/without wall thickening

Answer 10

Concentric; WITH wall thickening because sarcomeres are added in parallel

Question 11

__________ hypertrophy in the heart is NOT associated with increase in thickness of the walls

Answer 11

Eccentric

Question 12

High output failure is a ________ dysfunction and is due to __________

Answer 12

Systolic;

↑ tissue demands and the well functioning heart cant keep up

Question 13

What kind of conditions can lead to high output cardiac failure?

Answer 13

• diseases that ↑ tissue demands: anemia, hyperthyroidism, pregnancy

Question 14

Low output failure is HF with _______

Answer 14

↓ CO

Question 15

Intrinsic diseases of the lung parenchyma/vasculature can lead to ______ sided heart failure

Answer 15

right;

COPD, pulmonary HTN

Question 16

Patient has dyspnea, orthopnea and paroxysmal nocturnal dyspnea. What sided heart failure is most likely

Answer 16

Left

Question 17

Nutmeg liver is mostly due to _____ heart failure

Answer 17

Right

Question 18

What are the morphological features of the spleen due to right heart failure?

Answer 18

Congestion and enlargement of the spleen

Question 19

__________ has a protective role in coronary artery disease

Answer 19

Estrogen; ischemic heart disease is more common in males than females until menopause which then is equal between them

Question 20

Other than atherosclerosis, what are some less common causes of IHD?

Answer 20

• anemia/hypoxemia
• low systemic BP
• ↑ cardiac demand: exercise/hypertrophy
• vasculitis
• aortic dissection

Question 21

Most patients with IHD have ____________ lesions that cause __________ narrowing of the coronary arteries

Answer 21

Atherosclerotic; stable fixed narrowing

Question 22

What are some changes in morphology of the plaque when it becomes unstable (due to mechanical stresses)

Answer 22

• erosion
• ulceration
• fissuring / rupture
• hemorrhage