CV Micro

Question 1

4 clinical features of myocarditis?

Answer 1

Chest pain, dyspnea, fatigue and fever

Question 2

What heart sound will be associated with myocarditis and what does it indicate?

Answer 2

Soft s3/4 which is indicative of impaired systolic function.

Question 3

What does EKG most commonly show for myocarditis?

Answer 3

Sinus tach

Question 4

What 2 things will we see on chest X-ray?

Answer 4

PE and big heart

Question 5

What test can be used to help in making a definitive diagnosis of myocarditis?

Answer 5

Endomyocardial biopsy

Question 6

What 3 drugs to use for myocarditis and why?

Answer 6

The myocarditis is basically causing HF, so use beta blockers, ACEI, and diuretics

Question 7

What 3 things to avoid for myocarditis?

Answer 7

NSAIDS, alcohol, and exercise

Question 8

What are the three most common pathogens for myocarditis?

Answer 8

Cox V, T Cruzi, and t spiralis

Question 9

What type of pathogen is t cruzi and what is its route of transmission?

Answer 9

Parasite. Redivide bug

Question 10

What 3 things are going on in acute phase of chagas Disease?

Answer 10

Eye swollen, myocarditis, and severe meningioencephalitis

Question 11

What is going on during intermediate chagas?

Answer 11

Asymptomatic

Question 12

4 things going on during chronic chagas?

Answer 12

Dilated heart, arrhythmias, achalasia, and megacolon

Question 13

Where do we get t spiralis from and what tissue does it invade and what 3 areas of the body/

Answer 13

Raw pork. Skeletal muscle, brain and heart

Question 14

Consider a diagnosis of t spiralis infection if what 3 things are present?

Answer 14

Periorbital edema, myositis, tons of eosinophils

Question 15

3 clinical features of pericarditis?

Answer 15

Chest pain, palpitations and fever

Question 16

How do patients try and relieve the chest pain from pericarditis?

Answer 16

Lean forward

Question 17

What do we hear on auscultation for physical exam for pericarditis?

Answer 17

Friction rub

Question 18

What will EKG show for pericarditis?

Answer 18

Diffuse elevated ST

Question 19

What will you see on chest x ray for pericarditis?

Answer 19

Pleural effusions causing bilateral enlargement of the heart, water bottle sign.

Question 20

What is the complication of pericarditis and what three drugs to treat pericarditis?

Answer 20

Cardiac tamponade. Aspirin, NSAIDS, and colchicine.

Question 21

What med is contraindicated in pericarditis?

Answer 21

Anticoagulants

Question 22

2 most common pathogens causing pericarditis?

Answer 22

Cox b and myo TB

Question 23

What type of bacteria is Myo TB?

Answer 23

Acid fast bacillus gram positive

Question 24

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?

Answer 24

Red rods. Apple green.

Question 25

What is the MOA for infecting us with myo TB and why?

Answer 25

It primarily manifests as pulmonary TB, but it can spread via lymph and blood to cause Caseating pericarditis in the heart.

Question 26

What does IE start with?

Answer 26

Bacteremia

Question 27

What side of the heart is most commonly affected by acute IE and subacute IE?

Answer 27

Acute is right side and subacute is left side.

Question 28

4 major criteria to diagnose IE for duke criteria?

Answer 28

Positive culture, endocardial involvement, echo positive for IE, and new valve regurgitation

Question 29

How can we have a definitive diagnosis based on duke criteria?

Answer 29

2 major, 1 major and 3 minor, or 5 minor.

Question 30

Empiric treatment for IE?

Answer 30

Vancomycin and gentamicin

Question 31

4 most common pathogens for IE?

Answer 31

Staph aureus, strep viridans, epidermidis, and enterococci

Question 32

How does aureus breach us and what is their virulence?

Answer 32

Skin and specifically nasopharynx. | Host cell invasion, tissue and blood.

Question 33

3 toxic situations for staph?

Answer 33

Food poisoning, SSS, and toxic shock syndrome

Question 34

4 systemic manifestations of staph aureus?

Answer 34

acute Endocarditis, meningitis, osteomyelitis, and arthritis

Question 35

2 manifestations/conditions caused by viridans?

Answer 35

Subacute endocarditis and cavities

Question 36

What is the virulence of epidermidis?

Answer 36

Attaches to prosthetic valves

Question 37

What type of endocarditis does epidermidis cause?

Answer 37

Subacute

Question 38

Treatment for epidermidis?

Answer 38

Vancomycin

Question 39

What type of endocarditis is caused by enterococcus and what are the 2 media requirements for it to grow?

Answer 39

Subacute. Bile and sodium chloride

Question 40

Non enterococci causes what type of endocarditis and what is the media requirement?

Answer 40

Subacute. Bile only.

Question 41

Streptococcus bovis is associated with what two conditions?

Answer 41

Colon cancer and IBD