Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EOR Family med > CHF > Flashcards

CHF Flashcards

1
Q

what is the MC cause of CHF

A

coronary artery disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

left-sided failure

A

increased pulmonary venous pressure from fluid backing up into lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

sx for left-sided failure

A

pulmonary sx - progressive dyspnea MC, cough, rales, pink frothy sputum (surfactant), wheezing, pleural effusion, Cheyne’s stokes breathing

Think L for left sided and lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is cheyne stoke’s breathing

A

deeper faster breathing w gradual decrease and periods of apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

right-sided failure

A

due to increased systemic venous pressure –> signs of systemic fluid retention; causes systemic vascular congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

sx right-sided failure

A

peripheral edema
JVD
GI/hepatic congestion
anorexia
N/V due to GI
hepatosplenomegaly
hepatojugular reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

systolic HF

A

decreased EF associated w S3 (filling of dilated ventricles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

diastolic HF

A

normal/increased EF associated w S4 (atrial contraction into stiff ventricle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Class 1 HF

A

no limitation to physical activity
ordinary physical activity does not cause undue fatigue, dyspnea, or anginal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

class 2 HF

A

slight limitation of physical activity, ordinary physical activity results in symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

class 3 HF

A

marked limitation of physical activity
comfortable at rest
less than ordinary activity causes sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Class 4 HF

A

unable to engage in any physical activity without discomfort
sx may be present even at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what will you see on CXR for CHF

A

Kerley b lines
butterfly/bat wing appearance - bilateral perihilar alveolar edema
cephalization of vessels
cardiomegaly
pleural effusions
pulmonary edema (bilateral interstitial markings)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the most useful imaging to assess size and function in heart failure

A

echocardiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what will echo show for systolic HF

A

decreased EF
thin ventricular walls
dilated LV chamber
S3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what will echo show for diastolic HF

A

normal/increased HF
thick ventricular walls
small LV chamber
S4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

BNP and N-terminal proBNP levels that indicate HF is likely

A

BNP > 100
N-terminal proBNP > 125

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

BNP levels increase with

A

age
renal insufficiency
may be decreased on chronic tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is indicated if atherosclerosis is suspected in the presence of HF

A

cardiac cath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the cornerstone agents in treating coronary disease

A

Anti-platelet agents (Aspirin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what valve is MC affected in endocarditis

A

Mitral valve (M > A > T > P)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what valve is most commonly affected in endocarditis in IV drug users

A

tricuspid valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

RF for endocarditis

A

increased age (> 60)
rheumatic heart disease
IV drug use
immunosuppression
prosthetic heart valves
congenital heart disease

24
Q

sx endocarditis

A

fever
EKG conduction abnormalities
anorexia
wt loss
Janeway lesions
roth spots
osler nodes
splinter hemorrhages of proximal nail bed
clubbing
hepatosplenomegaly
petechiae
septic emboli: CNS, kidneys, spleen, joints

25
Q

what are Janeway lesions

A

painless erythematous macules on palms/soles

26
Q

what are Roth spots

A

retinal hemorrhage w pale center

27
Q

osler nodes

A

tender nodules on pads of digits

28
Q

staphylococcus aureus and endocarditis

A

MC cause, including ACUTE infective endocarditis, prosthetic valve infective endocarditis, and IVDA infective endocarditis (especially MRSA)

29
Q

what valves are usually affected in staphylococcus aureus in infective endocarditis

A

normal valves

30
Q

streptococcus viridans in infective endocarditis

A

MC cause of SUBACUTE infective endocarditis

part of the oral flora; associated w endocarditis from transient bacteremia secondary to gingivitis, poor dentition, dental procedures

31
Q

what valves are usually affected by streptococcus viridans in infective endocarditis

A

damaged valve

32
Q

staphylococcus epidermis in infective endocarditis

A

early prosthetic valve endocarditis (especially within 60 days of the procedure) is usually caused by S. aureus or S. epidermidis

33
Q

enterococcus in infective endocarditis

A

seen especially in men > 50 w a recent history of GI or GU procedure

34
Q

HACEK organisms

A

haemophilus aphrophilus
Actinobacillus
Cardiobacterium hominis
Eikenella corrodens
Kingella kingae

gram-negative organisms that are hard to culture

35
Q

when should you suspect HACEK organisms in infective endocarditis

A

endocarditis + negative blood cultures

36
Q

streptococcus gallolyticus and bovis in infective endocarditis

A

commensal bacteria of the gut seen w increased incidence in patients w colorectal CA and UC

colonoscopy should be performed in these patients to rule out both

37
Q

two most important tests for suspected endocarditis

A

blood cultures
echocardiography

38
Q

blood cultures in infective endocarditis

A

before antibiotic initiation
3 sets at least 1 hour apart if patient is stable

39
Q

what echocardiogram should be obtained first in infective endocarditis

A

TTE first
TEE if TTE is nondiagnostic
TEE is much more sensitive than TTE

40
Q

clinical criteria for infective endocarditis

A

2 major OR 1 major + 3 minor OR 5 minor

41
Q

major Duke criteria

A

sustained bacteremia (2 positive blood cultures by organism known to cause endocarditis)

endocardial involvement documented by either positive echocardiogram (vegetation, abscess, valve perforation, prosthetic dehiscence) OR clearly established new valvular regurgitation (aortic or mitral regurgitation)

42
Q

minor Duke criteria

A

predisposing condition (abnormal valves, IVDA, indwelling catheter)

fever > 38C/100.4F

vascular and embolic phenomena (Janeway lesions, septic arterial or pulmonary emboli, ICH)

immunologic phenomena: Osler’s nodes, Roth spots, positive rheumatoid factor, acute glomerulonephritis

positive blood culture not meeting major criteria

echocardiogram not meeting major criteria (worsening of existing murmur)

43
Q

endocarditis prophylaxis indications for cardiac conditions

A

prosthetic heart valves
heart repairs using prosthetic material (not including stents)
prior history of endocarditis
congenital heart disease
cardiac valvulopathy in a transplanted heart

44
Q

what procedures require prophylaxis for infective endocarditis

A

dental - involving manipulation of gums, roots of teeth, oral mucosa perforation

respiratory - surgery on respiratory mucosa, rigid bronchoscopy

procedures involving infected skin/MSK tissues (including abscess incision and drainage)

45
Q

prophylactic tx for indicated conditions and procedures

A

amoxicillin 2g 30-60 main before
Clindamycin 600mg if pcn allergy

Macrolide or Cephalexin are other options

46
Q

tx for native valve (MSSA) IE

A

anti-staphylococcal PCN (nafcillin, oxacillin) + either Ceftriaxone of Gentamicin

if PCN allergy - Cefazolin; Vancomycin or Daptomycin

47
Q

tx for native valve (MRSA) or unknown IE

A

Vancomycin plus either Ceftriaxone or Gentamicin

Daptomycin if unable to tolerate Vancomycin

48
Q

tx for fungal IE

A

parenteral antifungal (Amphotericin containing product) with or without combo (Flucytosine)

49
Q

how long is therapy for fungal IE

A

6 weeks or more

50
Q

how long is therapy for non-fungal IE

A

4-6 weeks

51
Q

indications for surgery for IE

A

refractory CHF
persistent or refractory infection
invasive infection
prosthetic valve
recurrent systemic emboli
fungal infxn

52
Q

acute bacterial endocarditis

A

infection of normal vales with virulent organism (s aureus)

53
Q

subacute bacterial endocarditis

A

indolent infection of abnormal valves w less virulent organism (S viridian’s)

54
Q

endocarditis w IVDA

A

MRSA (s aures)
pseudomonas
candida - esp in HIV patients

55
Q

prosthetic valve endocarditis

A

early (after 60 days) - staph epidermis = MC

56
Q

initial pharm therapy for reduced ejection fraction HF

A

ACEI, ARB, or ARNI
Diuretic
BB

57
Q

BB that have proven beneficial in HF

A

Carvedilol
Metoprolol
Bisoprolol

EOR Family med (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions