Card - Path (Part 5: Cardiac Infections, Tamponade, & Tumors) Flashcards Preview

FA - Cardiovascular > Card - Path (Part 5: Cardiac Infections, Tamponade, & Tumors) > Flashcards

Flashcards in Card - Path (Part 5: Cardiac Infections, Tamponade, & Tumors) Deck (52)
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1

What is the most common symptom associated with bacterial endocarditis? What are other symptoms associated with endocarditis? What is a way to remember them?

(1) Fever; (2) Roth's spots (round white spots on retina surrounded by hemorrhage) (3) Osler's nodes (tender raised lesions on finger or toe pads) (4) New murmur (5) Janeway lesions (small, painless, erythematous lesions on palm or sole) (6) Anemia (7) Splinter hemorrhages; bacteria FROM JANE = Fever, Roth's spots, Osler's nodes, Murmur, Janeway lesions, Anemia, Nail-bed hemorrhage, Emboli

2

What is necessary for diagnosis of bacterial endocarditis?

Multiple blood cultures

3

What pathogen causes acute endocarditis? Describe its virulence.

S. aureus (high virulence)

4

What pathogen causes subacute endocarditis? Describe its virulence.

Viridans streptococci (low virulence)

5

What is the onset like in acute versus subacute endocarditis?

Rapid onset in acute endocarditis; Gradual onset in subacute endocarditis

6

What is the major pathological finding in acute endocarditis?

Large vegetations on previously normal valves

7

What is the major pathological finding in subacute endocarditis?

Smaller vegetations on congenitally abnormal or diseased valves.

8

Of what kind of procedures is subacute endocarditis a sequela?

Sequala of dental procedures

9

What are nonbacterial causes of endocarditis? What kind of endocarditis is this called?

Endocarditis may also be nonbacterial secondary to malignancy, hypercoagulable state, or lupus; Marantic/thrombotic endocarditis

10

What pathogen is present in colon cancer?

S. bovis

11

What pathogen is present on prosthetic valves?

S. epidermidis

12

Which valve is most frequently involved in bacterial endocarditis?

Mitral valve

13

With what patient population is tricuspid valve endocarditis associated? What is a way to remember part of this?

Tricuspid valve endocarditis is associated with IV drug abuse; don't TRI DRUGS

14

With what pathogens is tricuspid valve endocarditis associated?

Associated with S. aureus, Pseudomonas, & Candida

15

What are complications of bacterial endocarditis?

(1) Chordae rupture (2) Glomerulonephritis (3) Suppurative pericarditis (4) Emboli

16

Again, what are the symptoms associated with bacterial endocarditis, and what is a way to remember them?

(1) Fever; (2) Roth's spots (round white spots on retina surrounded by hemorrhage) (3) Osler's nodes (tender raised lesions on finger or toe pads) (4) New murmur (5) Janeway lesions (small, painless, erythematous lesions on palm or sole) (6) Anemia (7) Splinter hemorrhages; bacteria FROM JANE = Fever, Roth's spots, Osler's nodes, Murmur, Janeway lesions, Anemia, Nail-bed hemorrhage, Emboli

17

Of what is rheumatic fever a consequence?

A consequence of pharyngeal infection with group A Beta-hemolytic strepotococci

18

What causes early deaths in rheumatic fever patients?

Myocarditis

19

What is a major late sequela of rheumatic fever?

Rheumatic heart disease

20

In rheumatic heart disease, what is the order of heart valves according to which are most affected? What is the general basis behind this order?

Mitral > Aortic >> Tricuspid; High pressure valves affected more

21

What is an early lesion in rheumatic fever? What is a late lesion in rheumatic fever?

Mitral valve regurgitation; Mitral stenosis

22

With what 3 histological/lab findings is rheumatic fever associated? Briefly describe histologic findings.

(1) Aschoff bodies (granuloma with giant cells) (2) Anitschkow's cells (enlarged macrophages with ovoid, wavy, rod-like nucleus) (3) Elevated ASO titers

23

What is the mechanism of rheumatic fever? How does it relate to the infecting bacteria?

Immune mediated (type II hypersensitivity); not a direct effect of bacteria. Antibodies to M protein

24

In rheumatic fever, what are antibodies made against, and how does this lead to disease?

Antibodies to M protein cross-react with self antigens

25

What are the 7 symptoms/signs associated with rheumatic fever? What is a way to remember this?

(1) Fever (2) Erythema marginatum (3) Valvular damage (vegetation and fibrosis) (4) ESR increased (5) Red-hot joints (migratory polyarthritis) (6) Subcutaneous nodules (7) St. Vitus' dance (Sydenham's chorea)

26

How does acute pericarditis commonly present?

Commonly presents with sharp pain, aggravated by inspiration, and relieved by sitting up & leaving forward

27

What are the cardiovascular findings associated with acute pericarditis presentation?

Present with friction rub. ECG changes include widespread ST-segment elevation and/or PR depression

28

What causes acute fibrinous pericarditis?

Dressler's syndrome, uremia, radiation

29

How does acute fibrinous pericarditis present?

Presents with loud friction rub

30

What causes acute serous pericarditis?

(1) Viral pericarditis (often resolves spontaneously) (2) Noninfectious inflammatory diseases (e.g., rheumatoid arthritis, SLE)