Cardiac Infection Flashcards

1
Q

TB pericarditis symptoms

A

*fever
*generally unwell
*normal or low BP
*JVP raised
*pulseless pluses paradoxes
*apex not palpable
*tender hepatomegaly and ascites

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2
Q

TB pericarditis spread

A

*retrograde lymphatic spread by mediastinal lymph node
*haematogenic spread
*direct spread from adjacent structures

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3
Q

Cardiac effusion pathophysiology

A

1-cardiac chambers conpressed
2-compromise venous return
3-septal shift to the left ventricle
4-diminished stroke vol and cardiac output

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4
Q

Diagnose TB pericarditis

A

1-confirm pericardial effusion(cxr show cardiomegaly, ECG show concave ST elevation and height of QRS change the whole time)
2-pericardial synthesis to confirm TB etiology

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5
Q

Rule out the following before diagnosis of tb pericarditis

A

-PUS
-Uremia
-Hypothyroidism

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6
Q

Tb pericarditis complication

A

-tamponade
-heart failure
-constrictive pericarditis

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7
Q

Treatment for TB pericarditis

A

HIV pos
-pericardial synthesis
-anti tb therapy
-no vorticosteroids

HIV negative
-pericardial synthesis
-anti tb drug
-Corticosteroid(reduce constrictive pericarditis)

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8
Q

Higher risk for endocarditis

A

-vsd
-repaired tetrology of fallot
-prosthetic valve or abnormal valves

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9
Q

Symptoms of infective endocarditis

A

Fever
Night sweats
Rigors
Weight loss
Malaise
Arthralgia
Pallor

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10
Q

Examine patient with infective endocarditis

A

Splinter hemorrhages(proximal)
Clubbing
Oslers node
Jane way lesions
IV drug use signs
Dental health
Subconjuctival haemorrhages
Roth spots

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11
Q

Blood culture with Infective endocarditis

A

3 an hour apart, at three different sites

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12
Q

Organism that cause infective endocarditis

A

-oropharynx: streptococcus viridans
-GIT: enterococcus and strep bovis
-skin:staph aureus
-urogenital: neisseria gonorrhea

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13
Q

Investigations of infective endocarditis

A

-anaemia
-ESR and CRP elevated
-hematuria and proteinuria

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14
Q

3 major duke criteria

A

-microbiological evidence
-echo evidence of vegitations
-new valve regurgitation

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15
Q

7 minor duke criteria

A

Predisposing condition
Fever more than 38
Microbiological criteria not meeting major criteria
Elevated inflammatory markers
Embolic phenomena
Immunological phenomena
Suspicious echo

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16
Q

Criteria for endocarditis

A

2major
Or
1major and 3 minor
Or
5 minor

17
Q

Association with infective endocarditis

A

Valve regurgition
Heart failure
Heart block

18
Q

Neurological complications of IE

A

Mycotic aneurysm(arterial wall dilation)
Embolic stroke
Meningitis
Encephalitis

19
Q

Renal complication of IE

A

Glomeruloneohritis
Embolic infarct

20
Q

Musculoskeletal complications of IE

A

Arthralgia
Arthritis
Lumbar back ache
Limb ischemia

21
Q

IE treatment

A

Antibiotics for organism and monitor bactericidal levels
Surgical

22
Q

Prevention and prophylaxis for IE

A

Good dental health
Antibiotic prophylaxis if undergo surgery