Flashcards in Review of posters 23/04/2016 Deck (23):
Causes of myocarditis
Rheumatic fever- streptococcus infection where the immune system makes antibodies that attack the myocardium)
Cardiotoxic drugs e.g. cocaine, alcohol
Lab tests for myocarditis
CPK- elevated in damage to brain, heart or muscle
Troponin- specific to heart
Erythrocyte sedimentation rate increased
White cell count increased
Treatment of myocarditis
Diuretic (for any fluid retention)
Antibiotics- not in viral cases
Causes of pericarditis
Viral- herpes simplex, HIV
Post MI- Dresslers syndrome- 2-3 weeks after an MI, the immune system starts attacking the hearts pericardium.
Signs of pericarditis
Distant heart sounds
Dilated cardiomyopathy symptoms
Heart failure esc symptoms- oedema, SOB, fatigue, chest pain, syncope (possibly in extreme cases)
Hypertrophic cardiomopathy symptoms
Intermittent- patient may be asymptomatic or have symptoms. When symptoms show they include:
Can cause sudden death
Signs of hypertrophic cardiomyopathy
Systolic ejection murmur- valsalva manouvre will accentuate it because it briefly decreases flow back to the heart and therefore the heart chambers constrict and the obstruction worsens, therefore accentuating the murmur.
Restrictive cardiomyopathy symptoms
Decreased filling may cause syncope
weakness and fatigue
Treatment of hypertrophic cardiomyopathy
Beta blockers or calcium channel blockers
Treatment of restrictive cardiomyopathy and dilated cardiomyopathy
Diuretics, ACE inhibitors/ARB and lifestyle changes to decrease fluid.
Possible pacemaker insertion
Beta blockers/ calcium channel blockers in dilated cardiomyopathy.
Symptoms in severe cases of acute pancreatitis
Grey Turners sign
Blood tests for acute pancreatitis
SERUM AMYLASE #1
Pathogenesis of chronic pancreatitis
Excess alcohol. Causes premature activation of trypsinogen to trypsin. This leads to protein depositation in the pancreatic duct forming plugs. These may obstruct the duct- lead to pancreatic hypertension and increased intracellular conc of calcium.
Tests for chronic pancreatitis
Serum amylase- may be ok in chronic
Faecal elastase! raised.
Treatment for chronic pancreatitis
NSAIDs and opiates to manage abdominal pain
Causes of chronic pancreatitis
Alcohol or autoimmune chronic pancreatitis. Defect in the IgG4, causing increase in serum. Causes dense lymphoplasthytic infiltrates. Responds to steroids.
Two types- cholesterol or pigment stones
How are cholesterol stones formed?
Difference in ratio of cholesterol to bile salts.
How are pigment gall stones formed?
Too much bile can't all be formed into bile salts.
Risk factors for developing gall stones
Too much cholesterol
Inflammation of the bile duct due to impaction of gall stones.
Acute- gall stone obstructing ampulla of Vater.
Chronic- Gall bladder wall becomes thickened (associated with gall stones)