CVS Flashcards
Boleh, boleh, boleh!
1
Q
What is Rheumatic Fever? Definition and causes.
A
group A B-hemolytic streptococci infection
due to:
- poverty
- overcrowded
- humidity
- genetic
- cross reactivity with specific human tissue
2
Q
CP of Rheumatic Fever
A
5 -15 years old
- have history of sore throat
- Major criteria:
- Polyarthritis
- knee, ankle, wrist
- hot, red, swollen, painfull - Carditis- pancarditis
- Sydenham’s chorea
- psychological disturbance
- choreic movement (clumsy gait, difficult hold object)
- muscle weakness - Erythema marginitum
- Subcutaneous nodule
- Minor criteria:
- fever
- arthralgia
- increase ESR, CRP
- prolonged P-R interval in ECG
3
Q
Explain more about Pancarditis
A
- Pericaritis
- chest pain
- pericardial rub - Myocarditis
- Palpitation
- decrease COP
- Ch.HF
- Tachycardia - Endocarditis
- Murmur
- Muffle HS
4
Q
Investigation of Rheumatic Fever
A
- Throat culture
- increase ESR, CRP
- for Carditis
- ECG: prolonged P-R interval
- Xray: cardiomegally
- Echo: chamber dilatation - for Chorea: present antineural Ab.
5
Q
Treatment of Rheumatic fever
A
- Prevention: therapy of tonsilitis
- Bed rest
- Ab: Penicillin orally for 10 days
- Antiinflammatory
- Salicyalate 100 mg/kg (4-6 weeks)
- Prednisone 2 mg/kg - Diuretic
- Treatment of Chorea:
- Pheobarbitol 16-32 mg/6hr
- Na valporate 15-20 mh/kg - Valve replacement
6
Q
Definition and causes of heart failure
A
Failure of hert to pump blood to meet oxygen and metabolic requirement.
causes:
1.Volume overload: valvular insufficiency
- Pressure overload: hypertension
- Affect inotropic state:
- Myocarditis
- Hypoxia
- Shock - Alter chronotropic state:
- Ventricular tachycardia
- Heart block - Inadequate diastolic filling: constrictive pericarditis
7
Q
Clinical picture of Heart Failure
A
- Infant
- FTT
- Dyspnea
- Short of breath
- puffiness of face
- pedal edema - Child
- Dyspnea
- Exercise intolerance
- Syncope
- Hepatic congestion
8
Q
Investigation of Heart Failure
A
- ECG: S-T segment
- xray: cardiomegally
- Echo: valvular regurgitation
- ABG: hypoxemia
- Renal function test: decrease GFR
- Urine analysis: Proteinuria
- CBC
9
Q
Treatment of Heart Failure
A
- General
- Hospitalization
- Head up to 45°
- Humidified oxygen therapy
- Sedation: Morphine sulphate
- Diet: decrease salt - Drug
- inotropic agent: Digoxin, Epinephrine
- Diuretic: Loop (furosamide), K sparing, Thiazide
- VD: Na nitroglyceride, ACEi
- Heart transplant
- Digitalis
10
Q
Explain about Digitalis
A
Action:
- increase contractility
- diuretic effect
- decrease HR
Dose: 30- 40 ug/kg
Maintenance: 5-10 ug/kg
Contraindication:
- Heart block
- Paroxysmal Ventricular Tachycardia
- Junctional rhythm
11
Q
Etiology of Infective Endocarditis
A
- Cardiac
- Rheumatic HD: aortic stenosis, aortic insufficiency
- Congenital HD: VSD
- Artificial valve - Bacteria
- Strep. viridian
- Staphy. aureus - Surgery
- IV catheter
12
Q
Clinical picture of Inf. Endocarditis
A
- Toxic
- Fever
- loss weight
- splenomegally
- clubbing
2. Embolic (Left side) - renal infarction - splenic infarction - cerebral infarction
(Right side)
- chest pain
- SOB
- Immunological
- splinter Hge
- petechial tension in hand, trunk
- Osler nodule: pain, small, red in terminal phalanges
- Janeway lesion
- Roth’s spot: Hge in retina - Preexisting valvular/ shunt lesion
- Manifest HF
- Tachycardia
- hepatomegally
13
Q
What is investigation of infective endocarditis?
A
- Blood culture
- Blood picture: anemia, leucocytosis
- ESR increase
- Echo: detect vegetation
14
Q
What is treatment of Infective Endocarditis?
A
- Prophylactic
- Ab: Amoxicillin 50 mg/kg/dose
- Oral hygiene
- correct congenital defact - Curative:
- Ab start immediately
- Crystalline penicillin G 200k-300k unit /kg/dose
+Gentamycin 4mg/kg/day
- continue 4-6 weeks
- surgical ttt in aortic abscess
15
Q
DD in Generalized edema
A
- Cardiac
- congestive HF
- cardiomegally - Liver
- ascites
- liver cirrhosis
- splenomegally - Allegic
- urticaria - Nutritional
- Kwashiorkor - Renal
- Nephritic Syndrome
- Nephrotix Syndrome
