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Pericardite Flashcards

(41 cards)

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1
Q

Tratament pericardite

A 
Aspirina
Ibuprifen
Colchicina
De evitat anticoag orale
Corticoterapie(esec la prima linie, a fost exclusa o cazua infectioasa sau are boala autoimuna)

Nu sport
Pcr ghideaza raspunsul

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2
Q

Tratament linia 3 si 4 pericardita

A

Imunoglobuline iv
Azatioprina
Pericardectomie

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3
Q

Roluri fiziologice pericard

A

Limitare crestere brsca de volum cardiac(distensibilitatea scade)-complianta creste daca se aduna lent
Interdependenta ventriculara

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4
Q

Am 10 la cardio

A 
Am 10 la cardio
Am 10 la cardio
Am 10 la cardio
Am 10 la cardio
Am 10 la cardio
Am 10 la cardio
Am 10 la cardio
Am 10 la cardio
Am 10 la cardio
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5
Q

Pericardit acuta criterii

A

Frecatura
Durere
Supradeniv difuza st sau subdenivelare pr
Efuzie pericardica(noua sau agravata)

+mk inflamatie, evidenta inflamatie prin imagistica
Pcr vsh leucocitoza

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6
Q

Stadii pericardita

A

1 Supradenivelare st subdeniv or NU INGLOBEAZA T

2normalizare

3 t negativ

4 normaluzare

Bav sau tv

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7
Q

Efecte hemodinamice pericardita

A

Icd

Tamponada

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8
Q

Rasunet hemodinamic pericard

A

Tamponada

Constructie=>icd

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9
Q

Anatomie pericard

A

Pericard parietal: tes conjunctiv epicardic, fibrosa, serisa

Visceral: mezoteliu

Artere tocracic intern
Vene in azygos
Nerv frenic
Ggl mediastin anterior
Lichidul priduc de pericardul visceral si contine:
Albumina proteine, fosfolipide, prostaglandine

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10
Q

Tipuri de pericardita

A

Continua 4-6sapt->3luni

Recurenta interval asimpt de 4-6 s

Cronica pericardita>3 luni

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11
Q

Pericardita cauze

A 
Idiopatic
Inf virala in trecut
Cancer
Viral
Infectii
Colagenoze
Uremie, chir cardiaca, iradiere, ima
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12
Q

Aspect clinic pericsrdita

A

Durere ascutita brusca variabila cu pozitie si insoir

Frecatura oarasternal stang cu 3 comp, tranzitorie

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13
Q

Paraclinic pericardita

A

VSH ,leucocitoza, pcr
IDR la ppd uree creatininei factor reumatoid
ECO fără ecouri in jurul inimii, efuzie medie 60%

Lichid și biopsie rar

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14
Q

Predicatori de progn negativ majori

A 
Febra
Debut subacut
Tamponada
Cantitate mare lichid
Nu Răspunde la ains sau aspirina
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15
Q

Predicatori de progn negativ minori

A

Miopericardita
Imunosupresie
Trauma
Aco

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16
Q

Dacă n are factori majori progn neg pericardita

A

Ii dau tratament empiric și l trimi acasă dar îl urmaresc
Dacă nu Răspunde atunci e risc moderat
Dacă Răspunde e al Food

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17
Q

Tratament pericardita

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A

Aspirina
Ibuprofen
Colchicina da diaree ca ea
NU ACO(risc de transf in lichid hemoragic)
Urmăresc pcr serica
Corticosteroizi dacă nu i merge cu prima linie și n are boala infecțioasă sau are boala imună
NU EFORT

18
Q

Algoritm pericardita

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A 
Ii dau aspirina bla-bla-bla
Dacă e recurenta
Fie reiau prima
Fie colchicina
Fiec imunoglobuline iv și azatioprina
Fie pericardiectomie
19
Q

Epansament

Study These Flashcards
A 
Mic->extrem
Poate sa apara in 
Pericardite
Ic(creste pres hidrostatica)
Sdr nefrotic
Hipotiroidism(creste permeabilitatea)
Neoplazii(obstr limfatica)
20
Q

Clinic efuzie

Study These Flashcards
A

Asimpt
Dispnee
Compresie cardiaca

21
Q

Tamponada depinde de

Study These Flashcards
A

V de acumulare a lichidului
Volum luchid
Complianta pericard

22
Q

Pericardita

Study These Flashcards
A

Ekg microvoltaj
Cord in carafa
Eco lichid

23
Q

Tipuri efuzie dupa impocat

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A

Non constructiv
Tamponada
Efuziv constructiv

24
Q

Clinic efuzie

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A 
Dispnee de toate tipurile
Asimptomatic
Durere toracica
Zgomote cardiace asurzite
Tamponada
25
Efuzie tratament
Daca i pericardita dau ains Daca crd ca are neoplasm sau tampinada fac pericardocenteza si mai vad Daca nu nu si nu puroi dar prot c react mare-ains Daca e >20 ml mai ales daca e de mai mult de 3 luni fac prricardiocenteza
26
Drenaj efuzie
Compresie cardiaca Pericardita putulenta Etiologie neclara Tamponada
27
Tamponada
Pres din pericard comprima cavitatile cardiace Pres diastolica ceeste si dev egala cu cea din pericarD Intoarcerea venoasa e compomisa, logic=> Crsste pres jugulara Congestie pulmonara Scadecdebit cardiac ``` Activare simpatic(tahicardie si vasoconstr periferica) Soc deces ```
28
Tamponada clinic
``` Dispnee Tahipnee tahicardie hipotens Distensie jugulare(PIERDE UNDA Y) Soc Puls paradoxal(scade ta>10% in inspir) ``` Triada beck hipotensiune, jugulare turgescente asurzire zg cardiace
29
Tamponada la doppler
Lich in pericard Colaps diastolic ad si vd Scade unda e>25% in inspir La cateterism vd=vs=15-20=pnintraperic
30
Ce se int cu vs in tamponada
Faza e ca fluxul transmitral scade ptc septul bombeaza spre vs ptc vd e dilatat La fluxul tricusp e invers
31
Pericardita constrictiva
Stadiul final al inflamatiei pericardului Fibroza calcificari aderente Idiop virala Post chir Tbc Uree
32
Pericardita constr fiziopat
Anomalia e in diastolsistola e ok Umplerea e posibila in protodiastola, vd isi atinge limita si umplerea se opreste brusc Intoarcere venoasa compromisa=> creste presiunea jugulara edeme Umplere v in diastola redusa=> debit scazut
33
Clinic pericardita constructiva
Icd: efem, hepatomeg, ascuta, vene jugulare turgescente(kussmaul-cresc in inspir ptc fluxul mare care nu mai poate intra in inima se acum in venele toracice sist Debit mic: astenie fatigabilitate tahicardie reflexa CLACMENT PERICARDUC REGURGITARARE TRICUSIDIANA(?) PULS PARADOXAL
34
Eco doppler pericard constr
Ingrisare pericard Scadere e>25 in inspir Tde<160 ms Inversare flux venos hepatic SEMNUL RADICAKULUI❤️ Pad=w Pvd=radical Pvs=pad=pas=15-20 L rx-tanc inima
35
Tratament constructiva
Diuretic etiologic ains Pericardectomia mortalitate 10-15% E o boala progresiva care afecteaza si miocardul(desprinzi si miocard)
36
Pericardita tbc
Prezentare in orice mod Pe cale retrograda ggl Hematogena focar primar Rx, idr la ppd, sputa, biopsie, ADENOZIN DEAMINAZA tratament rifampicina m,izoniazida, etambutol, pirazinamida
37
Pericardita uremica
Uremica(8 sapt inainte de dializa) Dializa Percard constr Morab toxicu hipercalcemie hiperuricemie hemoragii Apare ca perucardita acuta sau epansament=>tamponada post dializa Nu da durere prin abs inflamatiei Trat: HEMODIALIZA, PERICARDECTOMIE, STEROIZI INTRAPERICARD
38
Pericarduta autoimuna
Les Ar Scleroza sustemica Sjongen Poate asocia miocardita
39
Pericardita post iradiere
Pa, epansament asimt, pc Dd cu pericardita neoplazica!!-daca e neoplazica posibiL sa nu se mai poata opera cancerul Poate asocia cmd Pericardectomie forma constr
40
Pericard neoplazic
Plaman san limfom Metastatic sau obstr limfatic Frecvent tampinada Trat antineoplazic, drenaj, citistatice instilate(cisplatin) radioterapie
41
Fenomen autonom inima
Depolarizare lenta diastolica

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