Cardio III - Q2,3

Question 1

What is signifigant about an infected vegitation on a heart valve

Answer 1

Blood passing over valve can spread the infection throughout body via blood

Question 2

infectious endocarditis chiefly effects what?

Answer 2

valves and the ring around valves

Question 3

What is at increased risk from infectious endocarditis?

Answer 3

Damaged valves, fake valves, chordae tindinae lining of heart

Question 4

what is merantic endocarditis?

Answer 4

sterile non infectious endocarditis

Question 5

Where is merantic endocarditis often seen, presnetation

Answer 5

often seen in cancer, there are vegetations without infection due to a hypercoaguable state, can also show up in cancer.

Question 6

how would merantic endocarditis present

Answer 6

new onset of murmur or old murmur getting louder.

Question 7

how is infectious endocarditis tested for

Answer 7

blood culture, 3 tests within 24 hours.

Question 8

what would the CBC look like if there are bacteria?

Answer 8

increased neutrophils.

Question 9

why can old people not make fever as wel

Answer 9

they can make as many pyrogens.

Question 10

communiyt accured endocarditis is what bacteria

Answer 10

staph aureus 50-50%

Question 11

what is the bacteria associated with strep throat and thus Rheumatic fever?

Answer 11

strep pyogenes group a beta hemolytic\

Question 12

what bacteria is moslty assiciated with endocarditis

Answer 12

s. aureus

Question 13

what is probably the most common type of myocarditis

Answer 13

viral type, coxsackie virus

Question 14

on a slide what does viral myocarditis look like

Answer 14

Lymphocytic infiltrates

Question 15

What normaly causes pneumonic valve disease

Answer 15

congenital

Question 16

Symptoms of heart valve disease

Answer 16

SOB, palpitations, weakness, edema and chest discomfort

Question 17

is the symptom picture consistent with severity?

Answer 17

not really, could ave no symptoms and need immediate help, or have lots of symptoms and it be no big deal

Question 18

what is normaly used to diagnos a valvular disease

Answer 18

echocardiography

Question 19

when do you hear mitrial stenosis

Answer 19

S2

Question 20

When do you hear aortic stenosis

Answer 20

S1

Question 21

When do you hear mitrial regurg

Answer 21

S1

Question 22

When do you hear aortic regurg

Answer 22

S2

Question 23

what is a gegenerative calcified deposit that develops in the fibrous ring of mitral valve?

Answer 23

mitrial annular calcification

Question 24

myxomatous degeneration what?

Answer 24

the pathological weakening of connective tissue that is the most common cause mitral valve prolapse.

Question 25

how far back must mitral valve billow to be MVP

Answer 25

more than 2mm int left atrium above anular plane in a long axis view.

Question 26

What are the 5 diagnostic criteria for rheumatic fever

Answer 26

Carditis, poly arthritis, subcutaneous nodules and erythema marginatum.

Question 27

what are the 5 minor diagnostic criteria for RF

Answer 27

prolonged PR in EKG, elevated WBC, ESR, CRP

Question 28

Rheumatic fever follows what infections

Answer 28

Pharyngitis with a Group A beta-hemolytic strep, (strep pyogenes)

Question 29

what is the most importain cardiac related consequence of RHD

Answer 29

mitral stenosis

Question 30

on PE, how is carditis detected

Answer 30

new murmur and tachycardia out of proportion with fever

Question 31

dehisence

Answer 31

separation of prosthetic valve suture line from hear leadin to leak

Question 32

Polyarthritis the the most common non cardiac manifestion of whhat heart issue

Answer 32

Rheumatic fever

Question 33

what is polyarthritis

Answer 33

temporary migration inflammation of large joint, sarting in legs and migrating up.

Question 34

erythema marginatum

Answer 34

characteristic rash in 5-13% of those with acute rheumatic fever. Non purent macules, never on face

Question 35

how is pericarditis characterized? 5

Answer 35

Serous, fibrinous, hemorrhagic, purulent and casuous

Question 36

what is pericarditis

Answer 36

inflammation of pericardium.

Question 37

what can cause pericarditis?

Answer 37

idiopathic, infection, inflmmation post MI, autoimmune, trauma

Question 38

Pain of pericarditis is made worse how?

Answer 38

deep breathing, torso movement and can be replicated by pressing sternum

Question 39

what is the sound of pericarditis?

Answer 39

pericardial friction rub, velcro

Question 40

what is dresslers syndrome?

Answer 40

autoimmune response to pericarditis weeks after MI ****

Question 41

what do we suspect is the cause for idiopathic pericarditis

Answer 41

virual, but down't know why because biopsy is too invasive and would be required.

Question 42

what would the pericardial fluid look like if their was in infection

Answer 42

Exudative, more proteins, cloudy, more fibrin, neutraphils and proteins

Question 43

what happens to heart when BUN goes up

Answer 43

fluid will collect around heart, so renal failure can cause uremia that can cause pericartitis.

Question 44

what is the two main causes of autoimmue pericarditis

Answer 44

RA or Lupis are number 1

Question 45

What is hemorragic pericardits

Answer 45

when there is blood between the layers, often caused by trauma or cancer, TB.

Question 46

what is probably the most common non trauma caused hemorragic pericarditis

Answer 46

Turburculosis,

Question 47

what often seeds pericardium

Answer 47

tumors that metastizise the heart from other areas.

Question 48

what does caseous pericardium probably mean

Answer 48

tB, caseous granuloma fibrous walling off.

Question 49

what can cause serous pericarditis

Answer 49

not ususally infectious , uremia, RA or SLE, this is when there is extra serous fluicd is collecting

Question 50

when does fibrounous pericarditis happen

Answer 50

Post MI, trauma, surgury etc

Question 51

what does fibrounous pericarditis look like

Answer 51

bread and butter presentation.

Question 52

what happens to pulse when blood pressure drops?

Answer 52

pulse will go up.

Question 53

what is often the resolution of purulent pericarditis that has exudative pus and fibrin filled pericardial fluid

Answer 53

scarring and constrictive pericarditis potential.

Question 54

what would cause purulent pericarditis?

Answer 54

from adjacent infection (TB) septic embolism, septisemai, and after heart procedures

Question 55

what is the most likely cause of calcification of pericardial sack on a CXR

Answer 55

tB, caseous granuloma fibrous walling off.

Question 56

how do tumors move around

Answer 56

metastasize through blood and lymph

Question 57

what is the most common malignancy found in heart

Answer 57

metastatic tumors (malignancy only makes up 30% of heart tumors)

Question 58

what is the most common heart tumor

Answer 58

atrial myxoma which is benign,

Question 59

what % of primary heart tumors are benign

Answer 59

70% are benign, 30% are malignant, (most malignancies in heart have metastasized from somewhere else.

Question 60

what is an atrial myoxoma

Answer 60

benign masses attached to the atrial wall mostly

Question 61

studies for atrial myoxoma

Answer 61

echo then MRI c

Question 62

atrial myoxoma may cause what

Answer 62

ball valve effect

Question 63

can atrial myoxoma tmetastasize

Answer 63

yes although its rare, it can embolize

Question 64

cellular fetures of atrial myxoma

Answer 64

hypocellular mass, elongated cell shape, multinucleated,eosinophilic cytoplasm. Or without normal cardic muscle cells,\

Question 65

what is the most common tumor in the pediatric population

Answer 65

Cardiac rhabdomyoma

Question 66

what is cardiac rhabdomyoma related to

Answer 66

arrhythmias and chamber obstructions althugh it benign.

Question 67

histology of cardiac dhabdomyoma

Answer 67

cells are clear, round and enlarged.

Question 68

what most commonly metastasizes to the heart

Answer 68

melanoma, there is lots of melanin

Question 69

what follows melanoma for most common to metastasize to heart

Answer 69

lung and breast.