HLTH 2501: inflammation and infection in the heart

Question 1

rheumatic fever

Answer 1

an acute systemic inflammatory condition that results from an abnormal immune reaction occuring a few weeks after an untreated infection

Question 2

what is the main cause of infection in rheumatoid fever

Answer 2

group A beta-hemolytic Strepococcus

Question 3

where does inflammation occur in rheumatoid fever?

Answer 3

in the heart, brain, joints, and skin

Question 4

who does rheumatic fever most commonly affect?

Answer 4

children aged 5 to 15

Question 5

long-term effects of rheumatic fever

Answer 5

rheumatic heart disease, infective endocarditis, and heart failrue

Question 6

what does the preceding infection of rheumatic fever commonly persist as?

Answer 6

an upper respiratory infection, tonsillitis, pharyngitis, or strep throat

Question 7

how does rheumatic fever cause damage to the heart?

Answer 7

antibodies to the infection react with collagen in the heart, but scar tissue will develop which causes rheumatic heart disease

Question 8

pericaditis

Answer 8

inflammation of the heart outer layer and may include effusion which impairs filling

Question 9

effusion

Answer 9

excessive fluid accumulation

Question 10

myocarditis

Answer 10

inflammation develops as localised lesion in the heart muscle (Aschoff bodies), and these interfere with heart conduction

Question 11

lesions in myocarditis

Answer 11

are called aschoff bodies

Question 12

endocarditis

Answer 12

inflammation that affects the valves, causing them to become edematous and verruca; this disrupts the flow of blow leads to stenosis and rheumatic heart disease

Question 13

verrucae

Answer 13

rows of small, wart like vegetations along the outer edge of the valve cusps

Question 14

what valve is most commonly affected by endocarditis?

Answer 14

the mitral valve

Question 15

how are the joints affected in rheumatic fever?

Answer 15

large joints, particularly in the legs may have synovitis

Question 16

how is the skin affected in rheumatic fever?

Answer 16

a nonpruritic rash known as erythema marginatum develops (red with white centre)

Question 17

how are the wrists, elbows, knees, and ankles affected in rheumatic fever?

Answer 17

non tender subcutaneous nodules may develop

Question 18

how are the basal nuclei affected in rheumatic fever?

Answer 18

cause involuntary jerky movements of the face, arms, or legs; called sydenham chorea or saint vitus dance

Question 19

what is diagnosis of rheumatic fever based on?

Answer 19

general signs of inflammatory disease, high levels of antistreptolysin O antibodies, anemia, leukocytosis, a history or a prior streptococcal infection, and an abnormal ECG

Question 20

signs and symptoms of rheumatoid fever

Answer 20

low-grade fever, leukocytosis, malaise, anorexia, fatigue, tachycardia, heart murmurs, epistaxis, and abdominal pain

Question 21

epistaxis

Answer 21

nose bleeding

Question 22

treatment for rheumatoid fever

Answer 22

antibacterial agents such as penicillin V, ASA, corticosteroids all help will preventing additional infection and inflammation; valve replacement may be necessary

Question 23

infective endocarditis

Answer 23

occurs in two types (subacute and acute) and in general is when a microorganism invades heart valves

Question 24

subacute type of infective endocarditis

Answer 24

occurs when defective valves are invaded by organisms of low virulence

Question 25

example of a low virulent organism in subacute infective endocarditis

Answer 25

streptococcus viridans (part of the normal flora in the mouth)

Question 26

acute type of infective endocarditis

Answer 26

occurs when normal heart valves are attacked by highly virulent organisms; vegetations in valves may interfere with the opening and closing of valves

Question 27

example of microorganism in the acute type of infective endocarditis

Answer 27

staphylococcus aureus (can cause severe tissue damage)

Question 28

basic effects of infective endocarditis

Answer 28

the microorganism in the general circulation attaches to the endocardium and invade the heart valves, causing inflammation and the formation of vegetations on the cusps

Question 29

what are vegetations?

Answer 29

large, fragile masses made up of fibrin strands, platelets, other blood cells, and microbes

Question 30

causes of infective endocarditis

Answer 30

presence of abnormal heart tissue, presence of microbes in the blood, reduced host defences, and predisposing conditions

Question 31

predisposing conditions of infective endocarditis

Answer 31

congenital defects, rheumatic fever, mitral prolapse, and valve replacements

Question 32

diagnostic tests for infective endocarditis

Answer 32

new heart murmurs and transesophageal echocardiogram

Question 33

signs and symptoms of subacute infective endocarditis

Answer 33

low-grade fever, anorexia, splenomegaly, olser nodes, vascular occlusion, and CHF in severe case

Question 34

osler nodes

Answer 34

painful red nodes on the fingers; present in subacute infective endocarditis

Question 35

signs and symptoms of acute infective endocarditis

Answer 35

spiking fever, chills, drowsiness, and severe impairment of heart function

Question 36

treatment for infective endocarditis

Answer 36

blood test to identify the microbial agent and antimicrobial drugs

Question 37

pericarditis

Answer 37

usually occurs secondary due to other conditions and is normally classified based on the type of exudate associated with the inflammation

Question 38

2 types of pericarditis

Answer 38

acute or chronic

Question 39

acute pericarditis

Answer 39

simple inflammation of the pericardium, in which rough, swollen surface cause chest pain and a friction rub, and in some cases effusion may develop

Question 40

friction rub

Answer 40

a grating heart sound heard on the chest with a stethoscope

Question 41

types of exudate in pericarditis

Answer 41

serous, fibrinous, purulent, and blood containing

Question 42

what are the effects of pericarditis

Answer 42

if lots of fluid accumulates, the heart ability to expand and fill is impaired, thus decreasing CO

Question 43

cardiac tamponade

Answer 43

CO is decreased due to fluid in the pericardium

Question 44

what side of the heart is affected in pericarditis?

Answer 44

the right side because it is the low pressure side

Question 45

chronic pericarditis

Answer 45

formation of adhesions between the pericardial membranes that may become constrictive, causing the pericardium to become a tight, fibrous enclose, thus limiting the movement of the heart

Question 46

causes of acute pericarditis

Answer 46

can be secondary to open heart surgery, MI, rheumatic fever, renal failure, trauma, or a viral infection

Question 47

causes of chronic pericarditis

Answer 47

tuberculosis or radiation to the mediastinum or infection or inflammation developing from adjacent structures

Question 48

signs of pericarditis

Answer 48

chest pain, tachycardia, dyspnea, and cough, as well as changes in ECG or a friction rub

Question 49

what can effusion in pericarditis lead to?

Answer 49

distended neck veins, faint heart sounds, and pulsus paradoxus (systolic pressure drop during inspiration_

Question 50

treatment for pericarditis

Answer 50

fluid must be aspirated from the cavity

Question 51

paracentesis

Answer 51

aspirating fluid from the pericardial cavity