Inflammatory + infectious highlights

Question 1

List 2 important causes/ etiologies of acute pericarditis

Answer 1

1) Post MI – Dressler syndrome
2) Uremia

Question 2

Dressler syndrome: When does it occur? What is it?

Answer 2

Post MI - Inflammatory reaction to transmural infarction and necrosis

Question 3

What is diagnostic for constrictive pericarditis?

Answer 3

Cardiac catheterization

Question 4

Constrictive pericarditis: List some important things abt the presentation

Answer 4

1) Beck’s triad: Hypotension, JVD, Muffled heart sounds
2) Narrow pulse pressure
3) Pulsus paradoxus
4) Tachycardia, hypotension, tachypnea

Question 5

Pulsus paradoxus orparadoxical pulse: An abnormally large __________ in stroke volume, systolic blood pressure andpulsewave amplitude during inspiration.

Answer 5

decrease

Question 6

_________ are ineffective for myocarditis and relatively contraindicated in HF

Answer 6

NSAIDS

Question 7

Myocarditis is associated with ___________ use in COVID-19

Answer 7

azithromycin

Question 8

Infective endocarditis (IE):
1) What cause is rapidly progressive & affects healthy valves?
2) What cause is a normal flora of GI and has insidious onset & affects damaged valves

Answer 8

1) S. aureus
2) Viridans Group Streptococcus sps

Question 9

IE (infective endocarditis):
1) What is the most common cause in Native valves (VHD)?
2) What abt in prosthetic valves?
3) What abt in IV drug use?

(important, need to know these)

Answer 9

1) Strep Viridans
2) Strep epidermidis
3) Staph aureus

Question 10

List 2 cutaneous manifestations of IE

Answer 10

1) Splinter hemorrhages
2) Osler nodes (ouchy SQ nodules)

Question 11

List the symptoms of IE

(important)

Answer 11

Varies – acute vs. subacute
Fever
CP
Dyspnea
Cough
Hemoptysis
Rash

Question 12

What may you see on PE with IE?

(important)

Answer 12

New heart murmur
Splinter hemorrhages, petechiae
Janeway lesions
Osler nodes
Roth spots

Question 13

IE: Describe Janeway lesions. Are they painful?

Answer 13

Non-tender erythematous, hemorrhagic or pustular lesions on palms and soles - septic emboli

Question 14

What eye issue is assoc. with IE?

Answer 14

Roth’s spots

Question 15

How may modified Duke criteria are needed to Dx IE?

Answer 15

2 major, 1 major + 3 minor, or 5 minor criteria

Question 16

What are the major modified Duke’s criteria for IE?

Answer 16

1) + blood culture for IE
2) Evidence of endocardial involvement
+ echo
New valvular regurgitation

Question 17

Jone’s Criteria is used to Dx what?

Answer 17

Acute Rheumatic HD

Question 18

What is key to Dx of IE?

Answer 18

Echo

(TTE initially, TEE)