infection

Question 1

what is acute pericarditis

Answer 1

inflammation of pericardial sac lasting less than 4-6 weeks

Question 2

what infections commonly cause acute pericarditis

Answer 2

viral eg coxsackie or TB

Question 3

what conditions can cause acute pericarditis

Answer 3

uraemia // post MI // lupus, RA // hypothyroid // malignancy

Question 4

features of acute pericarditis

Answer 4

chest pain better sitting up // cough, dyspnoae, flu // pericardial rub

Question 5

what invx should be done for all patients with acute pericarditis

Answer 5

echo

Question 6

what ECG changes are seen with acute pericarditis

Answer 6

saddle shaped ST elevation + PR depression

Question 7

what bloods can be done for acute pericarditis

Answer 7

inflamm eg ESR + troponin

Question 8

what would require inpatient treatment of acute pericarditis

Answer 8

troponin spike or temp 38+

Question 9

1st line mx for acute pericarditis

Answer 9

NSAIDS + colchicine

Question 10

what typically causes constrictive pericarditis

Answer 10

any cause of pericarditis but particularly TB

Question 11

features restrictive pericarditis

Answer 11

SOB // RS HF // JVP X + Y // pericardial knock (loud S3) // kussmauls sign - raised JVP on inspiration

Question 12

invx constrictive pericarditis

Answer 12

CXR - calcification

Question 13

which valve is most commonly affected in endocarditis

Answer 13

mitral

Question 14

RF for developing endocarditis

Answer 14

valve problem // rheumatic valve disease // prosthetic valve // congenital heart // IV drugs

Question 15

what valve in endocarditis is affected in drug users

Answer 15

tricuspid

Question 16

common organisms of endocarditis (4)

Answer 16

staph A // strep V // staph epidermis // strep bovis

Question 17

most common organism for endocarditis + especially in what type of person

Answer 17

staph A // IV drug users

Question 18

what organism causes endocarditis following dental procedure

Answer 18

strep viridains

Question 19

which is the most common organism causing endocarditis immediately after prosthetic valve surgery

Answer 19

staph epidermis

Question 20

which is the most common organism causing endocarditis 2 months after prosthetic valve surgery

Answer 20

staph aureus

Question 21

which organism for endocarditis is assoc with colorectal cancer

Answer 21

strep bovi

Question 22

what non-infective causes of endocarditis

Answer 22

SLE // malignancy

Question 23

symptoms endocarditis

Answer 23

FROM JANE: fever // roth spots // osler nodes // murmur // janeway legions // aneamia // nail haemorrhage // emboli

Question 24

what procedure would prophylaxis for high risk endocarditis patients

Answer 24

GI or gentourinary procedures where there is suspected infection in that area

Question 25

what criteria is used to diagnose endocarditis

Answer 25

modified duke

Question 26

what is needed to diagnose endocarditis

Answer 26

pathological positive // 2 major criteria // 1 major + 3 minor // 5 minor

Question 27

what atypical group of organisms can cause endocarditis

Answer 27

HACEK group (Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella)

Question 28

invx endocarditis

Answer 28

FBC blood cultures (x3) // echo

Question 29

poor prognosis for endocarditis (4)

Answer 29

staph A // prosthetic valve // culture negative // low complement levels

Question 30

emperical treatment for native valve endocarditis

Answer 30

amox +/- gent

Question 31

emperical treatment for prosthetic valve endocarditis

Answer 31

vanco + rifampicin + gent

Question 32

empirical treatment for pen allergy endocarditis

Answer 32

vanco + gent

Question 33

treatment native valve endocarditis from staph

Answer 33

fluclox // vanco + rifampicin

Question 34

treatment prosthetic valve endocarditis from staph

Answer 34

fluclox + rifampicin + gent // vanco + rifampicin + gent

Question 35

mx endocarditis caused by strep

Answer 35

pen V // vanco + gent

Question 36

indications for surgery endocarditis (5)

Answer 36

valve failure // aortic abscess // resistant to treatment // cardiac failure // recurrent emboli

Question 37

viral causes of myocarditis

Answer 37

coxsackie, IV

Question 38

bacterial causes of mycarditis

Answer 38

diptheria, clostridia

Question 39

other causes of myocarditis (non viral or vacterial) (4)

Answer 39

lymes // chagas or toxoplamsosi // autoimmmune // doxorubicin

Question 40

presentation myocarditis

Answer 40

young // acute chest pain // SOB

Question 41

what bloods are seen in myocarditis

Answer 41

inflamm // cardiac enzymes // BNP

Question 42

ECG myocarditis

Answer 42

tachy // arrhythmia // ST elevation or T wave inversion

Question 43

complications myocarditis

Answer 43

HF // arrhythmia // dilated cardiomyopathy

Question 44

how does rheumatic fever develop

Answer 44

2-4 weeks after strep pyogenes

Question 45

what is required for rheumatic fever diagnosis

Answer 45

evidence of recent strep infection + 2 major criteria OR 1 major + 2 minor

Question 46

major criteria for rheumatic fever (5)

Answer 46

erythema // sydenham chorea // arthritis // carditis with valulitis // subcut nodules

Question 47

minor criteria rheumatic fever (4)

Answer 47

raised ESR or CRP // pyrexia // arthralgia // prolonged PR