CV Micro Flashcards
4 clinical features of myocarditis?
Chest pain, dyspnea, fatigue and fever
What heart sound will be associated with myocarditis and what does it indicate?
Soft s3/4 which is indicative of impaired systolic function.
What does EKG most commonly show for myocarditis?
Sinus tach
What 2 things will we see on chest X-ray?
PE and big heart
What test can be used to help in making a definitive diagnosis of myocarditis?
Endomyocardial biopsy
What 3 drugs to use for myocarditis and why?
The myocarditis is basically causing HF, so use beta blockers, ACEI, and diuretics
What 3 things to avoid for myocarditis?
NSAIDS, alcohol, and exercise
What are the three most common pathogens for myocarditis?
Cox V, T Cruzi, and t spiralis
What type of pathogen is t cruzi and what is its route of transmission?
Parasite. Redivide bug
What 3 things are going on in acute phase of chagas Disease?
Eye swollen, myocarditis, and severe meningioencephalitis
What is going on during intermediate chagas?
Asymptomatic
4 things going on during chronic chagas?
Dilated heart, arrhythmias, achalasia, and megacolon
Where do we get t spiralis from and what tissue does it invade and what 3 areas of the body/
Raw pork. Skeletal muscle, brain and heart
Consider a diagnosis of t spiralis infection if what 3 things are present?
Periorbital edema, myositis, tons of eosinophils
3 clinical features of pericarditis?
Chest pain, palpitations and fever
How do patients try and relieve the chest pain from pericarditis?
Lean forward
What do we hear on auscultation for physical exam for pericarditis?
Friction rub
What will EKG show for pericarditis?
Diffuse elevated ST
What will you see on chest x ray for pericarditis?
Pleural effusions causing bilateral enlargement of the heart, water bottle sign.
What is the complication of pericarditis and what three drugs to treat pericarditis?
Cardiac tamponade. Aspirin, NSAIDS, and colchicine.
What med is contraindicated in pericarditis?
Anticoagulants
2 most common pathogens causing pericarditis?
Cox b and myo TB
What type of bacteria is Myo TB?
Acid fast bacillus gram positive
If we do an acid fast test for myo, what will the result be? If we do an auramine rhodamine test, what will the result be for myo?
Red rods. Apple green.
What is the MOA for infecting us with myo TB and why?
It primarily manifests as pulmonary TB, but it can spread via lymph and blood to cause Caseating pericarditis in the heart.
What does IE start with?
Bacteremia
What side of the heart is most commonly affected by acute IE and subacute IE?
Acute is right side and subacute is left side.
4 major criteria to diagnose IE for duke criteria?
Positive culture, endocardial involvement, echo positive for IE, and new valve regurgitation
How can we have a definitive diagnosis based on duke criteria?
2 major, 1 major and 3 minor, or 5 minor.
Empiric treatment for IE?
Vancomycin and gentamicin
4 most common pathogens for IE?
Staph aureus, strep viridans, epidermidis, and enterococci
How does aureus breach us and what is their virulence?
Skin and specifically nasopharynx.
Host cell invasion, tissue and blood.
3 toxic situations for staph?
Food poisoning, SSS, and toxic shock syndrome
4 systemic manifestations of staph aureus?
acute Endocarditis, meningitis, osteomyelitis, and arthritis
2 manifestations/conditions caused by viridans?
Subacute endocarditis and cavities
What is the virulence of epidermidis?
Attaches to prosthetic valves
What type of endocarditis does epidermidis cause?
Subacute
Treatment for epidermidis?
Vancomycin
What type of endocarditis is caused by enterococcus and what are the 2 media requirements for it to grow?
Subacute. Bile and sodium chloride
Non enterococci causes what type of endocarditis and what is the media requirement?
Subacute. Bile only.
Streptococcus bovis is associated with what two conditions?
Colon cancer and IBD
