2/23 Flashcards
Dyspnea on exertion
-why?
Failure or CO to inc. during exercise.
-dyspnea = SOB
Culture negative causes of endocarditis:
HACEK organisms: Hemophilus Actinobacillus Cardiobacterium Eikenella Kingella
2 most common culture neg. causes of endocarditis.
Coxiella burnetti
Bartonella
Tricuspid valve endocarditis:
-which bugs besides S. aureus?
Pseudomonas, and Candida.
*S. aureus most common
rheumatic fever.
-consequence of what?
-Group A strep pharyngitis!
Whats an Aschoff body?
-granuloma found in rheumatic fever.
What are Anitschkow cells?
-enlarged macrophages with ovoid, wavy, rod-like
nucleus.
-found in rheumatic fever.
-“caterpillar macrophages”
Fusion of aortic/mitral commissures.
-found in which disease?
-rheumatic heart diseaes (late sequela of rheumatic fever).
Rheumatic fever Sxs:
FEVERSS Fever Erythema marginatum Valvular damage (vegetation and fibrosis) ESR Red-hot joints (migratory polyarthritis) Subcutaneous nodules St. Vitus’ dance (Sydenham chorea)
rheumatic fever: what are the early deaths due to?
myocarditis
SLE pericarditis: whats the fluid like?
serous, clear/yellow, protein rich w/few inflammatory cells.
Post MI pericarditis: whats the fluid like?
fibrinous, low protein count.
Acute pericarditis: more or less pain when leaning forward? During inspiration?
- less pain leaning forward
- more pain on inspiration
Causes of fibrinous pericarditis:
- Dressler syndrome
- uremia (etiology is poorly understood)
- radiation
*Presents with loud friction rub.
Causes of serous pericarditis:
- viral pericarditis (often resolves spontaneously)
- noninfectious inflammatory diseases (e.g., rheumatoid arthritis, SLE).
Causes of Suppurative/purulent pericarditis:
- bacterial infections (e.g., Pneumococcus, Streptococcus).
* Rare now with antibiotics.
ECG of cardiac tamponade?
- low-voltage QRS
- electrical alternans (due to “swinging” movement of heart in large effusion - beat to beat alterations of QRS height).
Pulses paradoxus seen in which diseases?
- cardiac tamponade
- asthma
- obstructive sleep apnea
- pericarditis
- croup.
What causes pulsus paradoxus?
- when you breath in the right ventricle filled more so expands into pericardial space & also into LV space. LV usually displaces but now it can’t due to constriction of cardiac tamponade.
- so LV is constricted, fills less. Less volume means less pressure (frank starling) so you get a drop in systolic BP on inspiration.
Tree bark appearance of syphillitic aorta due to what?
-irregular wrinkling of the tunica intima of the aorta.
Rhabdomyoma
- most common primary cardiac tumor in who?
- associated w/what disease?
- where does it usually arise?
- children
- tuberous sclerosis
- ventricle
Pyogenic granuloma
- Polypoid capillary hemangioma that can ulcerate and bleed.
- Associated with trauma and pregnancy.
Glomus tumor
- Benign, painful, red-blue tumor under fingernails.
- Arises from modified smooth muscle cells of glomus body.
- glomus body = modified smooth muscle cells invovled in temp. regulation.
Angiosarcoma: associated w/what risk factors?
- sun exposed areas
- radiation
- arsenic
- PVC (liver)
- chronic lymphedema (skin)