HTN + Endocarditis Flashcards Preview

MS4 - CVS > HTN + Endocarditis > Flashcards

Flashcards in HTN + Endocarditis Deck (40)
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1

Stages of HTN

Stage 1: Clinic BP > 140/90, ABP/HBP 135/85
Stage 2: Clinic BP > 160/100, ABP/HBP 150/95
Severe: Clinic BP > 180/110
Malignant HTN

2

Malignant HTN definition

BP > 200/130

+ bilateral retinal haemorrhage / papilloedema

+/- Sx

3

Sx of malignant HTN

Headache

Visual disturbance

4

Hypertensive emergencies

Acute renal failure

Heart failure

Encephalopathy

5

HTN investigations

24h ambulatory BP

Home BP

QRISK2

Urine: haematuria, Alb:Cr ratio

Bloods: FBC, U+Es, eGFR, glucose, fasting lipids

12 lead ECG

6

When to Rx HTN

Severe HTN

Stage 2 after ABP/HBP

Stage 1 if QRISK2 10 yr risk > 20%

7

Mx of HTN

1) ACEi or ARB if <55yrs, Calcium channel blocker(CCB) if >55 or black
2)ACEi/ARB + CCB
3) ACEi/ARB + CCB + Thiazide like Diuretic
4) (resistant hypertension) Add further diuretic or a/B blocker

8

Treatment of malignant HTN

Controlled reduction in BP to avoid watershed stroke
Atenolol or long acting calcium channel blocker

9

Causes of HTN

Primary

Renal

Endocrine

Drugs

ICP↑

Aortic coarctation

Fluid overload

10

Renal causes of HTN

Renal artery stenosis

Glomerulonephritis

Autosomal dominant polycystic kidney disease

11

Endocrine causes of HTN

Hyperthyroid

Cushing's

Phaeochromocytoma

Acromegaly

12

Drugs causing HTN

Cocaine

NSAIDs

OCP

13

End organ damage in HTN (CANER)

1) Cardiac - IHD, L ventricular hypertrophy, Aortic/mitral regurg
2) Aortic - Aneurysm, Dissection
3) Neuro - Stroke, Encephalopathy
4) Eyes - hypertensive retinopathy
5) Renal - Proteinuria, CKD

14

Fever + new murmur

Endocarditis until proven otherwise

15

RFs for infective endocarditis

Dermatitis

IV injections

Renal failure

DM

Prosthetic valves

Dental hygiene

16

Causes of endocarditis

Bacteraemia

Fungi

SLE

Malignancy

17

Libman-Sacks endocarditis

SLE associated endocarditis

18

Bacterial causes of infective endocarditis

Strep viridans

Staph aureus

Staph epidermis

Diphtheroids

HACEK

19

HACEK definition

Gram negative bacteria

Rare causes of endocarditis

20

HACEK bacteria

Haemophilus

Actinobacillus

Cardiobacterium

Eikenella

Kingella

21

Fungal causes of infective endocarditis

Candida

Aspergillus

Histoplasma

22

Septic signs of infective endocarditis

Fever

Sweats

Weight loss

Splenomegaly

Anaemia

23

Hand signs of infective endocarditis

Clubbing

Splinter haemorrhages

Osler's nodes

Janeway lesions

24

Cardiac signs of infective endocarditis

New / changing murmur

Vegetations

Long PR

Emboli

25

Immune complex deposition signs of infective endocarditis

Vasculitis

Glomerulonephritis

Roth spots

Splinter haemorrhages

26

Roth spots

Boat shaped retinal haemorrhages

Pale centre

27

Diagnosis of infective endocarditis

Duke criteria:

- 2 major or

- 1 major + 3 minor

- 5 minor

28

Major Duke criteria

Positive blood cultures

Endocardium involvement:

- Positive echo

- or new valve regurgitation

29

Minor Duke criteria

Fever

Predisposition

Vascular / immunological signs

Positive blood culture (doesn't meet major criteria)

Positive echo (doesn't meet major criteria)

30

Predisposition to infective endocarditis

Cardiac lesion

IVDU