Brainscape's Knowledge GenomeTM

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


See full index

CPR II Exam 1 > Clinical Medicine: Carditis > Flashcards

Clinical Medicine: Carditis Flashcards

1
Q

What is acute infective endocarditis?

A

Staph Aureus

develops on normal heart valve endothelium

fatal in <6wks if not treated

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

What is subacute infective endocarditis?

A

less virulent, S. viridans, Enterococcus

develops on damaged heart valve endothelium

fatal >6wks if not treated

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

What is non-bacterial thrombotic endocarditis

(Marantic endocarditis)

A

sterile platelet vegetations on cardiac valves

seen in pt’s with metastatic cancer

found on autopsy

may present with new onset murmur

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

What is non-bacterial verrucous endocarditis

(libman-sacks)

A

sterile platelet vegetations on cardiac valves

typically seen in patients with SLE

may have new onset murmur

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

What are risk factors for infective endocarditis?

A

older age

male

IV drug use (right sided)

poor dentition

structural heart disease

implanted device

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

What bacteria is the most common cause of right sided endocarditis among IV drug users

A

S. Aureus

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

HACEK bacteria include the following and are a small cause of infective endocarditis?

A

Fastidious g- bacilli

Haemophilus

Actinobacillis

Cardiobacterium

Eiknella

Kingella

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

What is the classical presentation of infective endocarditis?

A

Fever

Constitutional sx

new cardiac murmur

vascular embolic events

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

What are the physical exam findings for infective endocarditis

A

splenomegaly

petechiae

splinter hemorrhages

osler’s nodes

Janeway lesion

Roth spots

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

What is he Modified Duke Criteria?

A

Echocardiography

Blood cultures (must draw before starting abx)

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

What are the cardiac complications of infective endocarditis?

A

heart failure

abscess

pericarditis

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

What are metastatic infections as a result of infective endocarditis?

A

septic embolization leading to stroke, paralysis, infarct of other organs, PE, etc.

metastatic abscess

meningitis

mycotic aneurysm

osteomyelitis

septic arthritis

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

What are the renal complications of infective endocarditis?

A

septic embolization

glomerulonepthritis with renal failure

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

What is the management for infective endocarditis?

A

Infectious disease consult and consider Vanc

may need to remove cardiac devices

consider surg. consult for patients with complications

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

When is endocarditis prophylaxis used?

A

Only in high risk patients

Hx of infective endocarditis

hx of prosthetic heart valve replacement

hx of cardiac valve repair with prosthetic material

hx of cardiac transplant with valve regurg.

congenital heart disease

before dental procedures

not indicated for GI/GU precedures unless known infection

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

what is myocarditis?

A

inflammatory disease of mycardium diagnosed by bx

17
Q

What are the main causes of myocarditis?

A

idiopathic

infectious (mainly viral-coxaskie B, HHV6, ParvoB19)

18
Q

What is the clinical presentation for myocarditis?

A

varies, but can lead to sudden cardiac death

recent viral infection weeks prior to developing myocarditis

19
Q

What are the three patterns of presentation for myocarditis?

A

new onset or worsening heart failure

cardiac conduction abnormalities

acute myocardial infarction-like syndrome

20
Q

How is a definitive diagnosis of myocarditis made?

What images are taken?

What labs?

A

Endomyocardial biopsy

CXR, ECG, Echo, CMR

CBC with diff (leukocytosis), elevated ESR/CRP, elevated cardiac enzymes, elevated BNP

21
Q

What is the standard treatment for myocarditis?

A

ACEi or ARB

B-blockers

Diuretics

Aldsoterone receptor blocker

refractory heart failure devices (LVAD, ECMO, transplant)

antiarrhymthmic therapy as needed

heart pacers

22
Q

Pericarditis can lead to what life-threatening state?

A

Cardiac tamponade with the accumulation of pericardial fluid that compresses the heart and impairs diastolic filling and decreases cardiac output

23
Q

what is constrictive pericarditis?

A

results from scarred, thickened and frequently calcified pericardium which constricts the heart and impairing cardiac filling and cardiac output

24
Q

What is the epidemiology of pericarditis?

A

rare, but most common disease of pericardium

iodiopthic or viral, most cases in developing world are from TB

diagnosing etiology is not necessary in most patients

25
Q

what are the major causes of pericardial disease?

A

idiopathic

infectious (viral and then bacterial)

noninfectious (autoimmune, malignancy, cardiac, trauma, metabolic/uremic, radiation, etc)

26
Q

What are the clinical manifestations of acute pericarditis?

A

chest pain radiating to trap

pain worsens with lying flat, better with sitting up/forward

pericardial friction rub

dyspnea

fever

leukocytosis

27
Q

What labs/imaging are ordered for suspected pericarditis?

A

CBC with diff

elevated ESR and CRP

Troponin I

CXR

ECHO

ECG changes

most of the time a definitive cause of the acute pericarditis is not given and the course is relatively benign

28
Q

What is Beck’s Triad for Cardiac Tamponade?

What other features may be present

A

Hypotension

Muffled heart sounds

JVD

may also see:

Pericardial friction rubs

JV waveforms

Pulsus peadoxus

ECG changes with electrical alternans and low voltage QRS

29
Q

What are the images/studies ordered for cardiac tamponade?

A

CXR with water bottle sign

ECG

ECHO

30
Q

What are the clinical manifestations of constrictive pericarditis?

A

volume overload

reduced cardiac output

JVD

Pulsus paradoxus

Kussmaul’s sign

Pericardial knock

difficult to distinguish from restrictive cardiomyopathy

31
Q

What is ordered for constrictive pericarditis?

A

CXR with pericardial calcifications

ECG with no specific changes

ECHO

CMR and or CT

Cardiac cath

32
Q

What is the treatment for acute pericarditis?

A

treat underlying cause if possible

avoid strenuous exercise untile sx are better

NSAIDs (indomethacin), Cochicine, Glucocorticoids

33
Q

What is the treatment for cardiac tamponade?

A

therapuetic pericadiocentesis to remove fluid

34
Q

What is the treatment for constrictive pericarditis?

A

pericardiectomy

CPR II Exam 1 (25 decks)

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