Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiology (inpatient) > endocarditis, pericarditis, Rheumatic fever > Flashcards

endocarditis, pericarditis, Rheumatic fever Flashcards

1
Q

Native Valve endocarditis

A

Strep. viridans, staph aureus, entercocci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

IV drug users endocarditis

A

S. aureus, tricupsid valve most affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Prosthetic valve endocarditis

A

S. aureus, gram (-), fungi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

osler nodes

A

painful, violascous red lesions of fingers, toes, feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

janeway

A

painless red lesion of palms and soles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Roth spots

A

exudative lesions of retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how do dx endocarditis

A

3 blood cultures 1 hr apart, echo, TEE (helpful to see what valves are involved), Duke Criteria

presence of vegetation is diagnositc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Duke Criteria major criteria

A

two + blood cultures of a typical causative microorganism, echo evidence showing a new valvular regurge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Duke Criteria minor criteria

A

predisposing factor, fever higher than 100.4, vascular phenomena (embolic dz, pulm infarction), immunologic phenomena, positive blood culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

tx of endocarditis

A

gentamicin + ceftriaxone or vanco

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Rheumatic Heart Disease

A

immune response 2-3 wks after B hemolytic strep throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

most affected valve of RHD?

A

mitral, then aortic (2/3 may have chronic valvular change)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

typical lesion of RHD?

A

perivascular granuloma w/ vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Jones Criteria Major?

A

carditis, erythema marginatum, subcutaneous nodules, chorea, polyarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Jones Criteria Minor?

A

fever, polyarthralgias, reversible prolongation of PR interval, rapid ESR, C-reactive protien

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

RHD tx?

A

bed rest, salicylates (ASA), IM PCN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

RHD tx for PCN alergic

A

erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are some ways pelple can get endocarditis?

A

direct intravascular contaminations from bacteremia- dental, upper respiratory, urologic, and lower GI porcedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are some clinical features of endocarditis?

A

fever (can be absent in the elderly), nonspecific sx (cough, dyspnea, arthralgias, back or flank pain, GI complaints)

-pallor and splenomegaly, strokes and emboli may occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what do almost 90% of endocarditis pts have ?

A

stable murmur, but this may be absent in right-sided infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

when is antibiotic prophylaxis recommended w/ invasive dental work or surgical procedures?

A

pt with prosthetic valves, previous IE, some congenital heart conditions, some acquireed valve diorsder, hypertrophic cardiomyopathy and cardiac trasnplant recipeitns w/ vavulopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the antibiotic prophylaxis drug of choice?

A

amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are some pericardial disorders?

A

acute pericarditis, perciardial effusion, or pericardial tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the most common cause of acute pericarditis?

A

idiopathic or due to viral infxn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are some other causes of acute pericarditis?

A

bacterial infxn,autoimmune or conncective tissue dz, neoplams, radiation theraphy, chemo, drug toxicity, cardiac surrgery, or myxedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what population is percarditis most common?

A

men and those younger than 50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what can a pericardial effusion be secondary to?

A

pericarditis, uremia, or cardiac trauma

28
Q

what is cardiac tamponade?

A

when fluid compromises cardiac filling and impairs cardiac ouput

29
Q

what is the primary presenting sx of acute pericarditis?

A

sharp, pleuritic substernal radiating chest pain often relieved by sitting upright and leaning forward

30
Q

what is characteristic of PC?

A

cardiac friction rub

31
Q

how do constrictive pericarditis pts present?

A

slowly progressive dyspnea, fatigue, weakness, accompanied by edema, hepatomeglay, and ascites

32
Q

how do pericardial effusions present?

A

+/- pain, cough dyspnea

33
Q

how does cardiac tamponade present?

A

tachycardia, tachypnea, narrow pulse pressure, JVD. pulses paradoxus

34
Q

what is pulses paradoxus?

A

an abnormally large decrease in stroke volume, systolic blood pressure and pulse wave amplitude during inspiration. The normal fall in pressure is less than 10 mmHg. When the drop is more than 10 mmHg, it is referred to as pulsus paradoxus. Pulsus paradoxus is not related to pulse rate or heart rate and it is not a paradoxical rise in systolic pressure.

etect beats on cardiac auscultation during inspiration that cannot be palpated at the radial pulse.[1] It results from an accentuated decrease of the blood pressure, which leads to the (radial) pulse not being palpable and may be accompanied by an increase in the jugular venous pressure height (Kussmaul’s sign). As is usual with inspiration, the heart rate is slightly increased,[2] due to decreased left ventricular output.

35
Q

dx studies for pericarditis

A

CBC

cXR or echo- extent of effusion or pericardial clcification

36
Q

what would an EKG show in pericarditis?

A

diffuse ST-segment elevation

37
Q

what would an EKG show in effusion?

A

nonspecific T-wave changes and low WRS

38
Q

what is electrical alternans?

A

onsecutive, normally-conducted QRS complexes alternate in height.
the heart swings backwards and forwards within a large fluid-filled pericardium

massive pericardial effusions

39
Q

tx of pericarditis?

A

if pt is in hemodynamic compromise, do a pericardiaocentesis

may need a pericardial window

40
Q

inflammatory percarditis tx?

A

NSAIS or steroids

41
Q

constrictive pericarditis?

A

pericardectomy

42
Q

aortic aneurysm

A

weakness and subsequent dilation of vessel wall: genetic defect or atherosclerotic

43
Q

what ist he most common cause of aortic aneurysms?

A

artherosclerosis

but other causes include:

  • syphilis
  • GCA
  • vasculitis
  • trauma
  • Marfan
  • Ehlers-Danlos
44
Q

who is most likely to have AA?

A

elderly males

45
Q

what is the classic patient presentation of AA

A

elderly male smoker w/ CAD, ephysema, and renal impairment

46
Q

what ere ist he most common place for AA?

A

abdominal (90%)

thoracic (105)

47
Q

s/sx of A AA

A

asx

pulsating abdominal mass, sometimes accompanied by abdmonal or back pain

48
Q

what is also present in 25% of pts with AA

A

renal or lower extremity occlusive dz

49
Q

what are sx of thoracic AA?

A

asx

substernal, back, or neck pain, dyspnea, stridor, cough

-hoarseness, sx of superior vena cava syndrome

50
Q

what is superior vena cava syndrome?

A

swelling and flushing of pts head/ neck

51
Q

what are severe sx of AA

A

ripping or tearing CP

52
Q

AAA rupture sx

A

severe back, abdominal, or flank pain, hypotension and shock

53
Q

what is the dx study of choice for AAA?

A

Abdominal US

54
Q

what is the current screening recommendation of rAA

A

single abdominal US fo men older than 65 you who have ever smoked (must be followed by contrast CT)

55
Q

what is the dx study of choice for TAA

A

CT/ MRI

56
Q

Rheumatic fever?

A

systemic immune response occuring usually 2-3 wks after B hemolytic streptococcal pharyngitis

57
Q

what part o the body does rheumatic fever most commonly affect?

A

heart, joint, skin, CNS

58
Q

what pt population is most lkely to get rheumatic fever?

A

recent immigrants; kids 5-15yo

59
Q

what is rheumatic valve dz?

A

either self-limited or can lead to progressive deformity of the valve

60
Q

what is the typical lesion of rheumatic valve dz?

A

perivascular granuloma w/ vasculitis

61
Q

what is the most common valve involved in rheumatic valve dz

A

mitral, followed by aortic then tricuspid

62
Q

what are the requirements for dx of rheumatic fever?

A

two major or one majore and two minors of the jones critera

63
Q

what are the major criteria?

A 
carditis
erythema marginatum
subcutaneous nodules,
chorea
polyarthritis
64
Q

what are the minor criteria?

A

fever, polyarthralgia, reversible PR prolongations, increased ESR, or CRP

65
Q

tx of Rheumaticfever?

A

IM PCN

ASA, corticosteroids

66
Q

how can RFever be prevented

A

early tx of strep

benzathine PCN every 4 weeks is a common prophylactic regimen

Cardiology (inpatient) (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions