أسئلة المحاضرة الثامنة باثولوجي CVS (قبل التعديل)
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What is NOT a type of cardiomyopathy?

  • Hypertrophic
  • Dilated
  • Ischemic (correct)
  • Restrictive
  • Which symptom indicates pulmonary congestion in heart failure?

  • Dyspnea (correct)
  • Cold extremities
  • Rapid Weak pulse
  • Easy fatigability
  • What is a common complication of cardiomyopathy?

  • Heartburn
  • Stroke
  • Chronic fatigue syndrome
  • Sudden cardiac death (correct)
  • Which of the following is NOT a manifestation of reduced cardiac output?

    <p>Cough</p> Signup and view all the answers

    Which condition is an example of a genetic cause of cardiomyopathy?

    <p>Duchenne muscular dystrophy</p> Signup and view all the answers

    What cardiovascular manifestation is suggested by congested neck veins?

    <p>Systemic congestion</p> Signup and view all the answers

    What is a hallmark gross finding in dilated cardiomyopathy?

    <p>Globular heart shape</p> Signup and view all the answers

    Which type of muscle damage is primarily associated with cardiomyopathy?

    <p>Cardiac myocyte dysfunction</p> Signup and view all the answers

    What is a characteristic microscopic finding in cardiomyopathy?

    <p>Focal myocyte death</p> Signup and view all the answers

    Which statement correctly describes left ventricular hypertrophy in cardiomyopathy?

    <p>Is more commonly asymmetric than symmetric</p> Signup and view all the answers

    What factor predominantly leads to myocyte loss in Duchenne muscular dystrophy?

    <p>Tears in the sarcolemmal membrane</p> Signup and view all the answers

    Which condition causes infiltration of the myocardium by abnormal substances?

    <p>Restrictive cardiomyopathy</p> Signup and view all the answers

    What histological feature is commonly observed in hypertrophic cardiomyopathy?

    <p>Interstitial fibrosis</p> Signup and view all the answers

    What is primarily affected in diastolic dysfunction?

    <p>Filling of the ventricles</p> Signup and view all the answers

    Which of the following is NOT a cause of restrictive cardiomyopathy?

    <p>Coronary artery disease</p> Signup and view all the answers

    What is the structural change observed in myocytes under histological examination in cardiomyopathy?

    <p>Increased branching and hyperchromatic nuclei</p> Signup and view all the answers

    What is a primary characteristic of dilated cardiomyopathy?

    <p>Globular shape of the heart</p> Signup and view all the answers

    Which of the following is a manifestation of systemic congestion in cardiomyopathy?

    <p>Congested neck veins</p> Signup and view all the answers

    Which of the following symptoms is most indicative of reduced cardiac output?

    <p>Rapid weak pulse</p> Signup and view all the answers

    Which cause of cardiomyopathy is associated with the peripartum period?

    <p>Pregnancy-related factors</p> Signup and view all the answers

    Which of the following types of cardiomyopathy is characterized by arrhythmias as a prominent feature?

    <p>Arrhythmogenic right ventricular dysplasia</p> Signup and view all the answers

    What is the impact of toxins such as alcohol and cocaine on cardiomyopathy?

    <p>They contribute to myocyte death</p> Signup and view all the answers

    Which of the following is NOT considered a manifestation of pulmonary congestion?

    <p>Hypotension</p> Signup and view all the answers

    What distinct structural change is observed in the myocardium of dilated cardiomyopathy?

    <p>Endocardial thickening</p> Signup and view all the answers

    What is a characteristic feature of interstitial fibrosis in cardiomyopathy?

    <p>Fibrosis surrounds and isolates individual myocytes.</p> Signup and view all the answers

    Which microscopic change is indicative of hypertrophic cardiomyopathy?

    <p>Myocyte hypertrophy and disarray.</p> Signup and view all the answers

    What is a common gross finding in hypertrophic cardiomyopathy?

    <p>Asymmetric left ventricular hypertrophy.</p> Signup and view all the answers

    What contributes to the diastolic dysfunction seen in cardiomyopathy?

    <p>Stiffness of the myocardium.</p> Signup and view all the answers

    Which condition is associated with the infiltration of the myocardium by amyloid?

    <p>Amyloidosis.</p> Signup and view all the answers

    What is a defining characteristic of myocytes in conditions leading to myocardial fibrosis?

    <p>Hyperchromatic and enlarged nuclei.</p> Signup and view all the answers

    Which factor primarily leads to tears in the sarcolemmal membrane in Duchenne muscular dystrophy?

    <p>Mutant dystrophin leading to membrane tension.</p> Signup and view all the answers

    What is observed microscopically in restrictive cardiomyopathy?

    <p>Nonspecific changes including focal or diffuse perimyocytic fibrosis.</p> Signup and view all the answers

    Study Notes

    Cardiomyopathy

    • A group of diseases characterized by dysfunction of the myocardium.
    • Types of cardiomyopathy:
      • Dilated
      • Hypertrophic
      • Restrictive
      • Arrhythmogenic Right ventricular dysplasia
    • Clinical Picture:
      • Reduced Cardiac Output:
        • Easy fatigability
        • Cold extremities
        • Recurrent syncopal attacks
        • Rapid Weak pulse
        • Hypotension
      • Pulmonary Congestion:
        • Dyspnea
        • Orthopnea
        • Cough
        • Pulmonary edema
      • Systemic Congestion:
        • Congested neck veins
        • Hepatomegaly and splenomegaly (HSM)
        • Malabsorption, anorexia, nausea, vomiting
        • Insomnia
        • Edema
    • Complications:
      • Arrhythmia
      • Sudden cardiac death in young age

    Dilated Cardiomyopathy

    • Definition: Damage and wasting of the cardiac myocytes.
    • Causes:
      • Genetic: Muscular dystrophy (Duchenne and Becker)
      • Toxins: Alcohol and cocaine
      • Infections: Viral as Coxsackie
      • Peripartum: Mostly in 3rd trimester.
    • Grossly:
      • The heart assumes a globular shape with pronounced ventricular chamber dilatation, diffuse endocardial thickening and atrial enlargement, often with thrombi in the appendages.
    • Microscopically:
      • Increase in myocyte nuclear size
      • Myofibrillary loss within myocyte
      • Focal myocyte death
      • Interstitial fibrosis
    • Duchenne Muscular Dystrophy:
      • Mutant Dystrophin
      • Sarcolemmal membrane tension during contraction → Tears in sarcolemmal membrane & Myocyte loss

    Hypertrophic Cardiomyopathy

    • Definition: Thickening of the ventricular wall.
    • Clinical Picture:
      • There is diastolic dysfunction (defective filling)
      • Obstruction to the blood outflow
      • Myocyte hypertrophy and dissarray → arrhythmia
      • Most common cause of sudden cardiac death in young age.
    • Grossly:
      • Main gross findings include left ventricular hypertrophy; asymmetric hypertrophy is more common than symmetric.
      • There may also be subaortic mitral valve fibrosis.
    • Microscopically:
      • Hallmarks of histological diagnosis:
        • Myocyte hypertrophy
        • Fibrosis
        • Disarray
      • Cells are abnormally branched with hyperchromatic and enlarged nuclei.
      • Fibrosis is present interstitially between myocytes, around capillaries in a perivascular pattern or forms scar / replacement tissue after myocyte death.

    Restrictive Cardiomyopathy

    • Definition: Stiffness of the myocardium with resistance to stretch.
    • Clinical Picture:
      • There is diastolic dysfunction (defective filling).
      • Defective filling during diastole.
    • Causes:
      • Infiltration of myocardium by any abnormal substance:
        • Amyloid (congo-red positive)
        • Sarcoidosis
        • Gaucher disease
        • Hemochromatosis (Prussian blue)
      • Fibrosis of myocardium (toxins, irradiation, carcinoid syndrome, Loffler’s syndrome)
    • Grossly:
      • Ventricular cavity is normal.
      • Ventricular wall is abnormal, with a rubbery texture.
      • Thickening of the endocardium may be observed.
    • Microscopically:
      • Microscopic changes are nonspecific and include myocyte hypertrophy, focal or diffuse perimyocytic fibrosis and focal myofiber disarray.

    Cardiomyopathy

    • A group of diseases characterized by dysfunction of the myocardium.
    • Types include:
      • Dilated
      • Hypertrophic
      • Restrictive
      • Arrhythmogenic Right ventricular dysplasia
    • Manifestations of Heart Failure:
      • Reduced cardiac output
        • Easy fatigability
        • Cold extremities
        • Recurrent syncopal attacks
        • Rapid weak pulse
        • Hypotension
      • Pulmonary congestion
        • Dyspnea
        • Orthopnea
        • Cough
        • Pulmonary edema
      • Systemic congestion
        • Congested neck veins
        • Hepatosplenomegaly (HSM)
        • Malabsorption, anorexia, nausea, vomiting
        • Insomnia
        • Edema
    • Complications:
      • Arrhythmia
      • Sudden cardiac death in young age

    Dilated Cardiomyopathy (DCM)

    • Damage and wasting of the cardiac myocytes.
    • Thinning of the myocardium and dilatation of the left ventricular cavity.
    • Causes:
      • Genetic: Muscular dystrophy (Duchenne and Becker)
      • Toxins: Alcohol and cocaine
      • Infections: Viral, such as Coxsackie
      • Peripartum: Mostly in the 3rd trimester
    • Gross appearance:
      • Heart assumes a globular shape
      • Pronounced ventricular chamber dilatation
      • Diffuse endocardial thickening and atrial enlargement
      • Often with thrombi in the appendages
    • Microscopic appearance:
      • Increase in myocyte nuclear size
      • Myofibrillary loss within myocyte
      • Focal myocyte death
      • Interstitial fibrosis

    Duchenne Muscular Dystrophy (DMD)

    • Mutant Dystrophin
    • Sarcolemmal membrane tension during contraction → Tears in sarcolemmal membrane & myocyte loss

    Hypertrophic Cardiomyopathy (HCM)

    • Thickening of the ventricular wall.
    • Diastolic dysfunction (defective filling).
    • Obstruction to the blood outflow
    • Myocyte hypertrophy and dissarray → arrhythmia
    • Most common cause of sudden cardiac death in young age.
    • Gross appearance:
      • Left ventricular hypertrophy
      • Asymmetric hypertrophy is more common than symmetric
      • Subaortic mitral valve fibrosis
    • Microscopic appearance:
      • Myocyte hypertrophy
      • Fibrosis
      • Disarray
      • Cells are abnormally branched with hyperchromatic and enlarged nuclei
      • Fibrosis is present interstitially between myocytes, around capillaries in a perivascular pattern or forms scar/replacement tissue after myocyte death.

    Restrictive Cardiomyopathy (RCM)

    • Diastolic dysfunction (defective filling).
    • Stiffness of the myocardium with resistance to stretch.
    • Causes:
      • Infiltration of myocardium by any abnormal substance:
        • Amyloid (congo-red positive)
        • Sarcoidosis
        • Gaucher disease
        • Hemochromatosis (Prussian blue)
      • Fibrosis of myocardium (toxins, irradiation, carcinoid syndrome, Loffler’s syndrome
    • Gross appearance:
      • Ventricular cavity is normal.
      • Ventricular wall is abnormal, with a rubbery texture.
      • Thickening of the endocardium may be observed.
    • Microscopic appearance:
      • Nonspecific changes including myocyte hypertrophy, focal or diffuse perimyocytic fibrosis and focal myofiber disarray.

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