3/15 Flashcards
(18 cards)
In what position do patients with pericarditis sit in to relieve some of the pain? Does the pain associated with pericarditis get better or worse with inspiration?
seated and leaning forward
worse with inspiration
What are the classic ECG findings in pericarditis?
diffuse ST segment elevation and depression of the PR interval
What is the most common cause of viral pericarditis?
Coxsackievirus (picornavirus)
What are the signs of Marfan’s syndrome?
pectus excavatum, hyperextensible joints, tall stature and long extremities and digits; predisposes to aortic aneurysms and mitral valve prolapse
What is the histological characteristics of atrial myxomas? How do atrial myxomas present?
amorphous extracellular matrix
Present with symptoms f mitral valve obstruction, “plop” on auscultation or embolic strokes
What are the signs of Kawasaki’s disease?
CRASH and burn
Conjunctivitis
Rash (everywhere but also on palms and soles)
Adenopathy (lymphadenopathy usually cervical)
Strawberry tongue (oral mucositis)
Hands and feet are very red and swollen (erythema and edema)
Burn = fever
What is the pathognomonic histologic finding in rheumatic heart disease?
Aschoff bodies which are noncaseating granulomas with multinucleate giant cells. Aschoff bodies at high power show Anitschkow cells
What symptom is most concerning after administration of hydralazine?
Hydralazine is a potent arterial vasodilator used to treat refractory HTN but this decrease in after load will cause a reflexive tachycardia that can cause angina/ischemia in a patient with CAD. This is why you always have to give a beta blocker before hydralazine
What are the symptoms of digoxin toxicity?
increased parasympathetic tone (N/V, diarrhea), blurry yellow vision, arrhythmias, ECG abnormalities, and hyperkalemia
What is the best initial treatment for digoxin toxicity? What else can you do?
Slowly normalize the potassium levels. Other steps are cardiac pacing, anti-digoxin Fab fragments and magnesium
What diseases should you suspect if there is pathology of the right-sided valves?
carcinoid syndrome and IV drug use
What is the Fick principle?
The rate of oxygen utilization by the body is equal to the cardiac output times the difference between the oxygen content in the arterial blood and the venous blood
What does a VSD sound like on auscultation? What does an ASD sound like on auscultation?
VSD = holosystolic murmur best heard at the left sternal border ASD = fixed splitting of S2
What is the gold standard for diagnosing MI within the first 6 hours of onset of symptoms?
ECG changes including ST segment elevation, depression or Q waves
What is on the differential for concentric hypertrophy of the left ventricle?
Chronic systemic hypertension and aortic stenosis
What is seen on ECGs of patients with hyperkalemia? hypokalemia?
hyperkalemia - peaked T waves
hypokalemia - U waves
What physical manipulation can a patient with mitral valve prolapse do to accentuate the murmur?
Valsalva maneuver which increases intrathoracic pressure which decreases venous return to the heart which increases the intensity of the MVP murmur
What are the causes of dilated cardiomyopathy?
ABCCCD alcohol abuse Beriberi Coxsackie B myocarditis Cocaine use (chronic) Chagas' disease Doxorubicin toxicity
