REVIEW 2 (cardiac)

Question 1

Are cardiac tumors usually benign or malignant?

Answer 1

They are usually benign and are pedunculated, (they have a stalk for easy remova)

Question 2

What are the 3 types of cardiac tumors?

Answer 2

1. Cardiac Myxomas (Adults)
2. Rhabdomyomas (Kids)
3. Metastatic Tumors

Question 3

What is the most common primary cardiac tumor (35-50%)?

Answer 3

Cardiac Myxomas

Question 4

Which primary cardiac tumor?

Most arise from the left atrium (75%), although they can occur in any chamber of the heart or on a valve.

Answer 4

Cardiac Myxomas

Question 5

Which primary cardiac tumor?

• glistening, gelatinous, polypoid mass, usually 5-6 cms, with a short stalk
• Sometimes the tumor is sufficiently mobile as to obstruct the mitral valve orifice.

Answer 5

Cardiac myxoma

Question 6

> 1/2 of the patients with cardiac myxomas of the left atrium have clinical evidence of __________

Answer 6

mitral valve dysfunction

Question 7

1/3 of these pts with a cardiac myxoma of the left atrium or left ventricle die of what?

Answer 7

embolization of the tumor to the brain

Question 8

Is surgical removal of cardiac myxomas usually successful?

Answer 8

Yes. surgical removal is successful in most cases

Question 9

What is the most common primary cardiac tumor in infants and children and forms nodular masses in the myocardium.

Answer 9

Rhabdomyomas

Question 10

Which primary cardiac tumor?

• Almost all are multiple
• involve both the left and right ventricles, and in 1/3 of cases, the atria as well.
• In 1/2 of cases, the tumor mass projects into the cardiac chamber.

Answer 10

Rhabdomyoma

Question 11

Which primary cardiac tumor?

Grossly they are pale gray masses, up to several centimeters

Answer 11

Rhabdomyomas

Question 12

What is the most feared complication of an aneurysm no matter the location?

Answer 12

-Rupture and death by exsanguination

-the jet of blood may also dissect through the wall of the aorta and form a periarterial second lumen called a Dissecting Aneurysm (this may also be from the root of the aorta)

Question 13

What comes first in the pathogenesis of atherosclerosis:

Fatty streak

Atheroma

Plaque

Malignant plaque

Answer 13

1st- Fatty Streaks

2nd- Atheromas

3rd- Plaques

4th- Malignant plaques

Question 14

The following is major or minor criteria for “Jones Criteria”? What is this used to dx?

1. Pancarditis
2. Polyarthritis
3. Sydenhams Chorea
4. Subcutaneous Nodules
5. Erythema Marginatum

Answer 14

Major Criteria

Used to dx RHD

Clinical dx made when 2 major OR 1 major + 2 minor criteria are fulfilled

Question 15

Major or minor “Jones Criteria? Used to dx what?

1. h/o Rheumatic Fever
2. Fever
3. Arthragias
4. EKG signs of heart damage
5. Evidence of prior Strept infection (ASO titers, C-reactive protein, increased sed. rate)

Answer 15

Minor criteria

Used to dx RHD

*Clinical dx made when 2 major OR 1 major + 2 minor criteria are fulfilled

Question 16

When is a clinical diagnosis of RHD made?

(how many major or minor criteria)

Answer 16

clinical dx made when:

2 major criteria

OR

1 major + 2 minor criteria are fulfilled

Question 17

The following describes what histologic finding:

• Aggregates of lymphocytes and macrophages around a central zone of fibrinoid necrosis
• w/ time it assumes a granulomatous appearance and eventually is replaced by a scar

Answer 17

Aschoff Bodies

Seen in the myocardium of acute rheumatic myocarditis

Question 19

What condition are Aschoff bodies seen in?

Answer 19

Acute Rheumatic Myocarditis

Question 20

90% of the time, ______ (L or R) sided heart valves are involved in both RHD and Infective Endocarditis

Answer 20

Left sided heart valves

Question 21

What is the only way you get right sided heart vegitation

Answer 21

??

Question 22

What is Acute Bacterial Endocarditis (ABE) usually due to?

Answer 22

highly vurulent organisms like Staph auereus or the Gram negatives

Question 23

What is Subacute Bacterial Endocarditis (SBE) usually due to?

Answer 23

Organisms of less virulence

Streptococcus viridans

Question 24

Which organism is responsible for the most cases of Prosthetic Valve Endocarditis?

Answer 24

Staph epidermidis (majority)

other groups- Enterococci, Gram neg bacteria and fungi

Question 25

What is the main organism associated with Endocarditis in IVDA’s?

Answer 25

St. aureus (50-60% of cases)

followed by Strept. species and candida (or any skin commensal)

Question 26

RHD- what is responsible for the majority of deaths in the acute phase due to conduction system fibrosis?

Answer 26

Myocarditis

Question 27

RHD:

The _______ is responsible for the most deaths after the acute phase

Answer 27

Endocarditis

Question 28

Which cardiomyopathy is the largest?

Answer 28

Hypertrophic

Question 29

Which cardiomyopathy is the most common?

Answer 29

Dilated CM