CHEMICALS, COMPOUNDS, MOLECULES, AND ELEMENTS

Acetaldehyde

What metabolite of alcohol has a direct toxic effect on the myocardium, strongly associated with dilated cardiomyopathy (DCM)?

Carbon monoxide

What toxin is listed as an etiologic agent associated with heart muscle disease or cardiomyopathy?

Lithium

What element is listed as an etiologic agent associated with heart muscle disease or cardiomyopathy?

Hydrocarbons

What compound is listed as an etiologic agent associated with heart muscle disease or cardiomyopathy?

Arsenic

What element, often associated with carcinogen exposures in hepatic angiosarcoma (e.g., in Arsenal pesticide), is listed as an etiologic agent associated with heart muscle disease or cardiomyopathy?

Cobalt

What heavy metal has cardiotoxicity and has caused dilated cardiomyopathy (DCM) in the setting of inadvertent tainting (e.g., in beer production)?

Iron

What element's overload, which can result from hereditary hemochromatosis or multiple transfusions, causes dilated cardiomyopathy (DCM)?

Iron

What element's production of reactive oxygen species (ROS) may cause injury to metal-dependent enzyme systems in iron overload, leading to DCM?

Doxorubicin (Adriamycin) and Daunorubicin

What two Anthracyclines, which are conventional chemotherapeutic agents, cause toxic myocardial injury in a dose-dependent manner?

Hemosiderin

What iron-containing substance is present in hemosiderin-laden cells that stain blue with Perls’ Iron stain (Prussian Blue stain)?

Hemosiderin

What iron-containing substance is found in macrophages in the lungs ("heart failure cells"), serving as telltale signs of previous episodes of pulmonary edema in left-sided heart failure (LSHF)?

Lipofuscin pigment

What substance appears brown in normal H and E stain, similar to iron overload?

Norepinephrine

What chemical is released by adrenergic cardiac nerves of the autonomic nervous system to increase heart rate, myocardial contractility, and vascular resistance?

Catecholamines

What substance is synthesized from the adrenal medulla and is released to increase heart rate, myocardial contractility, and vascular resistance?

Catecholamines

What chemical's excess causes multifocal myocardial contraction band necrosis, leading to dilated cardiomyopathy (DCM) in individuals with tumors such as pheochromocytomas?

Aldosterone

What mineralocorticoid, produced in the zona glomerulosa of the adrenal cortex, is involved in the Renin-Angiotensin-Aldosterone System (RAAS)?

Sodium and water

What two substances' retention is augmented by aldosterone, increasing interstitial and intravascular volume, and ultimately increasing blood pressure?

Sodium

What element's excretion in the urine is known as natriuresis, a function of Atrial Natriuretic Peptide (ANP)?

Atrial Natriuretic Peptide (ANP)

What molecule counterbalances the Renin-Angiotensin-Aldosterone System (RAAS) through diuresis, natriuresis, and vascular smooth muscle relaxation?

ATP

What high-energy phosphate's inadequate production is a result of the cessation of aerobic metabolism following coronary arterial obstruction?

Lactic acid

What potentially noxious metabolite accumulates due to ischemia, following the cessation of aerobic metabolism?

Oxygen

What element's inadequate supply and inability to remove metabolites characterizes myocardial ischemia?

Reactive oxygen species (ROS)

What substance's iron-mediated production may cause injury in iron overload, leading to DCM?

Calcium

What ion's influx across plasma membranes causes contraction band necrosis in irreversibly injured myocytes in reperfused myocardium?

Collagen

What extracellular matrix (ECM) protein is synthesized by vascular smooth muscle cells (SMCs)?

Elastin

What extracellular matrix (ECM) protein is synthesized by vascular smooth muscle cells (SMCs)?

Proteoglycans

What extracellular matrix (ECM) protein is synthesized by vascular smooth muscle cells (SMCs)?

Collagen, elastin, and proteoglycans

What three components form the extracellular matrix (ECM) synthesized by SMCs in response to vascular injury or dysfunction?

Acid mucopolysaccharide

What substance forms the abundant ground substance in which stellate or globular myxoma cells are embedded?

Elastic fibers

What component, along with myxoid connective tissue and mucopolysaccharide matrix, forms the core of hair-like projections in papillary fibroelastomas?

Lipids

What substance's accumulation, along with intimal thickening, is a key process in atherosclerotic plaque formation?

Cholesterol and cholesterol esters

What two components form the soft, yellow, grumous core of lipid in an atherosclerotic plaque?

Cholesterol

What substance is engulfed by macrophages, forming lipid-filled foam cells in fatty streaks?

C-reactive protein (CRP)

What circulating marker of inflammation is secreted from cells within the atherosclerotic intima, predicting the risk of MI and stroke, and increasing the adhesiveness of endothelium for leukocytes?

Homocysteine

What chemical's elevated serum levels have a strong relationship with coronary artery disease, peripheral vascular disease, stroke, and venous thrombosis?

Vitamin B9 (folate) and Vitamin B12 (cobalamin)

What two vitamins' low intake can cause elevated homocysteine levels?

Lipoprotein (a)

What altered form of low-density lipoprotein is associated with coronary and cerebrovascular disease risk, independent of total cholesterol or LDL levels?

Cholesterol

What specific lipid's high levels (hypercholesterolemia) are an important cause of endothelial dysfunction and a factor in atherosclerosis pathogenesis?

Thromboxane A
2
​
, ADP, and serotonin

What three chemicals are released by activated platelets upon exposure to subendothelial collagen and necrotic plaque contents?

Fibrin

What substance, along with inflammatory cells, bacteria or other organisms, composes the destructive vegetations (verrucae) that are a hallmark of infective endocarditis (IE)?

Fibrin and mucinous content

What two components form the bland thrombi loosely attached to the underlying valve or cusp in Nonbacterial Thrombotic Endocarditis (NBTE)?

Fibrin

What substance, along with mucinous content, composes the non-infective (bland) thrombi in NBTE?

Mucin

What tumor-derived substance or tissue factor is associated with the procoagulant effects of mucinous adenocarcinomas, linked to NBTE?

Fibrinoid

What type of necrosis is seen in the cusps or along the tendinous cords of the left-sided valves in acute rheumatic carditis?

Amyloid

What protein substance's deposition in the heart can cause diastolic dysfunction, encountered in restrictive cardiomyopathy (RCM)?

Amyloid proteins

What proteins are typically alpha-helices but form insoluble beta-pleated sheets when deposited into organs in amyloidosis?

Transthyretin

What protein are deposits in senile cardiac amyloidosis largely composed of, which accelerates amyloid deposition?

Reticulum fibers

What component, along with collagenous and elastic fibers, is found in the normal atrial septum?

Radiopaque dye

What substance is used in Lymphangiography to visualize the lymphatics' potential risk of lymphatic drainage?

Radiolabeled albumin or dextran

What two substances are used in Lymphoscintigraphy to visualize lymphatics?

Water

What compound is added to a drop of blood on a slide in the wet smear method to de-hemoglobinize red cells for easier viewing of microfilariae?

Alpha-helices

What is the typical form of amyloid proteins before extracellular accumulation and deposition?

Beta-pleated sheets

What structure is formed by extracellular accumulation of protein fibrils in amyloidosis?

Neutrophils

What type of white blood cells (WBCs) are abundant in pus, which can fill the pericardial space in purulent pericarditis?

Red cells

What cells are abundant in hemopericardium, blood mixed with fibrinous or suppurative effusion, or hemorrhagic pericarditis?

Lymphocytes

What type of cells are seen in the mild inflammatory infiltrate in the epipericardial fat in serous pericarditis?

Lymphocytes (primarily T-cells) and Plasma cells

What two types of white blood cells are found in Aschoff bodies in rheumatic fever (RF), along with Anitschkow cells?

Streptolysin O and DNase B

What two streptococcal enzymes are targeted by antibodies seen in the serum of a patient with rheumatic fever (RF)?

Calcinosis

What general condition is associated with valvular degeneration due to the presence of calcium deposits in the heart valves?

Calcium salts/deposits

What substance's presence causes aortic stenosis in anatomically normal or congenitally bicuspid aortic valves?

Calcium deposits

What substance develops in the peripheral fibrous ring (annulus) of the mitral valve in Mitral Annular Calcification?

Elastin

What gene deletion on chromosome 7 causes supravalvular aortic stenosis as a component of a multiorgan developmental disorder?

Cytokines

What inflammatory molecules are released by viruses/pathogens that cause myocardial dysfunction (out of proportion to actual myocyte damage) in myocarditis?

Neutrophils

What immune cells are abundant in the mixed inflammatory infiltrate along with trypanosomes, lymphocytes, macrophages, and occasional eosinophils in Chagas disease myocarditis?

Neutrophils

What specific inflammatory cells are present in abundance in purulent pericarditis, forming frank pus?

Lymphocytes, macrophages, and a high proportion of eosinophils

What three types of cells compose the interstitial infiltrates, principally perivascular, in Hypersensitivity Myocarditis?

Lymphocytes, eosinophils, plasma cells, and macrophages

What four types of cells are interspersed with multinucleated giant cells in the widespread inflammatory cellular infiltrate of Giant Cell Myocarditis?

Albendazole

What drug is donated by GlaxoSmithKline (GSK) for the elimination of Lymphatic Filariasis (LF)?

Diethylcarbamazine (DEC)

What drug is donated by Eisai Pharmaceuticals of Japan for the elimination of LF?

Ivermectin

What drug is donated by Merck and Company for the elimination of LF?

Giemsa or Wright stain

What two stains are used for thick blood film to speciate and determine the morphology of microfilariae?

Prostaglandin E2

What substance's declining local levels, along with increased arterial oxygenation and decreased pulmonary vascular resistance, causes the ductus arteriosus to constrict and functionally close after birth?

Prostaglandin E

What drug is administered to maintain ductal patency in PDA with other congenital malformations (e.g., obstructed pulmonary or systemic outflow tracts)?

Tissue Factor

What substance procoagulant is produced by endothelium, and is also associated with the systemic hypercoagulable state seen in Nonbacterial Thrombotic Endocarditis (NBTE)?

Gamma globulins (Immunoglobulin)

What drug is administered intravenously in the treatment of Kawasaki disease?

Aspirin

What drug, along with IV immunoglobulin, is used in the treatment of Kawasaki disease?

Neutrophils, eosinophils, and mononuclear cells

What three types of cells compose the acute phase transmural inflammation in Polyarteritis Nodosa (PAN)?

Tumor Necrosis Factor (TNF)

What proinflammatory cytokine is produced by activated T-cells and drives the pathogenesis of Giant Cell Arteritis?

Arsenic, Thorotrast, and Polyvinyl Chloride

What three carcinogen exposures are associated with Hepatic Angiosarcoma?

beta1 integrin

What substance on white blood cells is the ligand for VCAM-1?

beta2 integrins (LFA-1 and Mac-1)

What substances on white blood cells are the ligands for ICAM-1?

CD31

What endothelial cell marker is used in immunohistochemical staining to prove the endothelial nature of angiosarcoma tumor cells?

Ivermectin, Diethylcarbamazine, and Albendazole

What three drugs are indicated for the treatment and elimination of Lymphatic Filariasis (LF)?

DEC and Albendazole

What two drugs are the recommended single-dose, once yearly regimen for Mass Drug Administration (MDA) to interrupt LF transmission?

Ivermectin and Albendazole

What two drugs are the recommended single-dose, once yearly regimen used in Africa for MDA to interrupt LF transmission?

Ivermectin, DEC, and Albendazole (IDA)

What three-drug regimen is used in select areas in the Philippines when the double-drug combination for MDA is not successful?