Cardiac pathology – Pathoma Questions with Complete
Solutions
What is the time course for tronponin I after MI? Correct Ans-elevated in 4-6 hours; peaks
at 24 and stays high for 5-12 days
What cardiac marker is useful for detecting an MI a few days after an initial MI? Correct
Ans-CK-MB
What is the time course for CK-MB after MI? Correct Ans-elevated in 4-6 hours; peaks at 24
hours returns to normal in 2-3 days
What should be given with aspirin prior to PCI? Correct Ans-prasugrel
Following an acute MI, what 5 treatments need to be started? Correct Ans-ASA+heparin,
oxygen, nitrates, B-blocker, ACEI
What are 2 outcomes of fibrinolysis or angioplasty following MI? Correct Ans-contraction
band necrosis and reperfusion injury
Where does contraction band necrosis occur following acute tx of MI? Correct Ans-
reperfusion of irreversibly damaged myocytes causing influx of calcium producing contraction
and subsequent bands
, Cardiac pathology – Pathoma Questions with Complete
Solutions
Why would cardiac enzymes continue to rise following acute tx of MI (angio, PCI...)?
Correct Ans-reperfusion injury causing free radicals to form and damaging more myocytes
What are the steps of microscopic changes that occur following MI in myocytes? Correct
Ans-4-24 hours - coag necrosis; 1-3 days inflammation with neutrophils; 4-7 days -
macrophages inflammation; 1-3 weeks granulation tissue; >1 month fibrosis and scarring
What are the complications following MI in the first 4 hours? Correct Ans-cardiogenic
shock, CHF and arrhythmia-for the first 24 horus
What are the complications following MI in 1-3 days? 4-7 days? Correct Ans-fibrinous
pericarditis; then rupture of ventricular free wall, IV septum, or papillary muscle
What kind damage in MI must you have to get fibrinous pericarditis? Correct Ans-
transmural ischemia
Which coronary artery feeds the papillary muscle in the left ventrical? Correct Ans-RCA
What are the complications following MI months after MI? Correct Ans-aneurysm, mural
thrombosus and Dressler syndrome
Autoimmune pericarditis 6-8 weeks after MI Correct Ans-Dressler syndrome
, Cardiac pathology – Pathoma Questions with Complete
Solutions
What is sudden cardiac death caused by following MI? Correct Ans-ventricular arrhythmia
What is the most common cause of sudden cardiac death? Correct Ans-atherosclerosis
causing acute ischemia
What are causes of sudden cardiac death besides atherosclerosis? Correct Ans-mitral valve
prolapse, cardiomyopathy, cocaine use
Poor myocardial function with chronic ischemic damage with or without MI that progresses to
CHF? Correct Ans-chronic ischemic heart disease
What are 5 causes of left-sided heart failure? Correct Ans-ischemia, HTN, dilated
cardiomyopathy, MI, restrictive cardiomyopathy
Why does HTN cause left-sided HF? Correct Ans-causes hypertrophy of the LV wall which
thickens due to the pressure it has to pump against and the oxygen requirements of the
enlarged muscle increases and eventually leads to ischemic damage
What is the common complication of left-sided HF that casues sxs? Correct Ans-pulmonary
congestion
Solutions
What is the time course for tronponin I after MI? Correct Ans-elevated in 4-6 hours; peaks
at 24 and stays high for 5-12 days
What cardiac marker is useful for detecting an MI a few days after an initial MI? Correct
Ans-CK-MB
What is the time course for CK-MB after MI? Correct Ans-elevated in 4-6 hours; peaks at 24
hours returns to normal in 2-3 days
What should be given with aspirin prior to PCI? Correct Ans-prasugrel
Following an acute MI, what 5 treatments need to be started? Correct Ans-ASA+heparin,
oxygen, nitrates, B-blocker, ACEI
What are 2 outcomes of fibrinolysis or angioplasty following MI? Correct Ans-contraction
band necrosis and reperfusion injury
Where does contraction band necrosis occur following acute tx of MI? Correct Ans-
reperfusion of irreversibly damaged myocytes causing influx of calcium producing contraction
and subsequent bands
, Cardiac pathology – Pathoma Questions with Complete
Solutions
Why would cardiac enzymes continue to rise following acute tx of MI (angio, PCI...)?
Correct Ans-reperfusion injury causing free radicals to form and damaging more myocytes
What are the steps of microscopic changes that occur following MI in myocytes? Correct
Ans-4-24 hours - coag necrosis; 1-3 days inflammation with neutrophils; 4-7 days -
macrophages inflammation; 1-3 weeks granulation tissue; >1 month fibrosis and scarring
What are the complications following MI in the first 4 hours? Correct Ans-cardiogenic
shock, CHF and arrhythmia-for the first 24 horus
What are the complications following MI in 1-3 days? 4-7 days? Correct Ans-fibrinous
pericarditis; then rupture of ventricular free wall, IV septum, or papillary muscle
What kind damage in MI must you have to get fibrinous pericarditis? Correct Ans-
transmural ischemia
Which coronary artery feeds the papillary muscle in the left ventrical? Correct Ans-RCA
What are the complications following MI months after MI? Correct Ans-aneurysm, mural
thrombosus and Dressler syndrome
Autoimmune pericarditis 6-8 weeks after MI Correct Ans-Dressler syndrome
, Cardiac pathology – Pathoma Questions with Complete
Solutions
What is sudden cardiac death caused by following MI? Correct Ans-ventricular arrhythmia
What is the most common cause of sudden cardiac death? Correct Ans-atherosclerosis
causing acute ischemia
What are causes of sudden cardiac death besides atherosclerosis? Correct Ans-mitral valve
prolapse, cardiomyopathy, cocaine use
Poor myocardial function with chronic ischemic damage with or without MI that progresses to
CHF? Correct Ans-chronic ischemic heart disease
What are 5 causes of left-sided heart failure? Correct Ans-ischemia, HTN, dilated
cardiomyopathy, MI, restrictive cardiomyopathy
Why does HTN cause left-sided HF? Correct Ans-causes hypertrophy of the LV wall which
thickens due to the pressure it has to pump against and the oxygen requirements of the
enlarged muscle increases and eventually leads to ischemic damage
What is the common complication of left-sided HF that casues sxs? Correct Ans-pulmonary
congestion
