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Flashcards in 2/23 Deck (95)
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1

Dyspnea on exertion
-why?

Failure or CO to inc. during exercise.
-dyspnea = SOB

2

Culture negative causes of endocarditis:

HACEK organisms:
Hemophilus
Actinobacillus
Cardiobacterium
Eikenella
Kingella

3

2 most common culture neg. causes of endocarditis.

Coxiella burnetti
Bartonella

4

Tricuspid valve endocarditis:
-which bugs besides S. aureus?

Pseudomonas, and Candida.
*S. aureus most common

5

rheumatic fever.
-consequence of what?

-Group A strep pharyngitis!

6

Whats an Aschoff body?

-granuloma found in rheumatic fever.

7

What are Anitschkow cells?

-enlarged macrophages with ovoid, wavy, rod-like
nucleus.
-found in rheumatic fever.
-"caterpillar macrophages"

8

Fusion of aortic/mitral commissures.
-found in which disease?

-rheumatic heart diseaes (late sequela of rheumatic fever).

9

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)

10

rheumatic fever: what are the early deaths due to?

myocarditis

11

SLE pericarditis: whats the fluid like?

serous, clear/yellow, protein rich w/few inflammatory cells.

12

Post MI pericarditis: whats the fluid like?

fibrinous, low protein count.

13

Acute pericarditis: more or less pain when leaning forward? During inspiration?

-less pain leaning forward
-more pain on inspiration

14

Causes of fibrinous pericarditis:

-Dressler syndrome
-uremia (etiology is poorly understood)
-radiation

*Presents with loud friction rub.

15

Causes of serous pericarditis:

-viral pericarditis (often resolves spontaneously)
-noninfectious inflammatory diseases (e.g., rheumatoid arthritis, SLE).

16

Causes of Suppurative/purulent pericarditis:

-bacterial infections (e.g., Pneumococcus, Streptococcus).

*Rare now with antibiotics.

17

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).

18

Pulses paradoxus seen in which diseases?

-cardiac tamponade
-asthma
-obstructive sleep apnea
-pericarditis
-croup.

19

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.

20

Tree bark appearance of syphillitic aorta due to what?

-irregular wrinkling of the tunica intima of the aorta.

21

Rhabdomyoma
-most common primary cardiac tumor in who?
-associated w/what disease?
-where does it usually arise?

-children
-tuberous sclerosis
-ventricle

22

Pyogenic granuloma

-Polypoid capillary hemangioma that can ulcerate and bleed.
-Associated with trauma and pregnancy.

23

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.

24

Angiosarcoma: associated w/what risk factors?

-sun exposed areas
-radiation
-arsenic
-PVC (liver)
-chronic lymphedema (skin)

25

Will kaposi sarcoma blanch?

-no

26

Does a negative biopsy exclude Temporal arteritis?

-no.
-lesions are segmental.

27

Two most common signs of Temporal arteritis?
-what can it lead to?

-Unilateral headache, jaw claudication
-irreversible blindness due to ophthalmic art. occlusion.

28

Temporal arteritis
-associated w/what disorder?

-polymyalgia rheumatica

29

Takayasu arteritis Sxs:

-“Pulseless disease” (weak upper extremity pulses)
-fever
-night sweats
-arthritis
-myalgias
-skin nodules
-ocular disturbances.

30

Temporal & Takayasu arteritis:
-what type of inflammation?
-inc or dec. ESR?

-granulomatous
-inc. ESR