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Systems 1a Revision Decks > CVS Diverse > Flashcards

CVS Diverse Flashcards

1
Q

What organisms typically causes infective endocarditis?

A

staph. aureus

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2
Q

What risk factors are there for IE?

A 
Injection drug use
Indwelling medical devices
Diabetes
AIDS
Chronic skin infections/burns
Genitourinary infections 
Solid organ transplant 
Homelessness
Pneumonia
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3
Q

What are the specific signs of IE?

A
  • Splinter haemorrhages - Janeway lesions
  • Vasculitic rash
  • Roth spots
  • Oslers nodes
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4
Q

What are non-specific signs of IE?

A

Fever, malaise and fatigue

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5
Q

What constituents a high index of suspicion of IE?

A
  • New murmur
  • Pyrexia
  • Known IE organism
  • Prosthetic material
  • Previous IE
  • CHD
  • Conduction disorder
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6
Q

What investigations are useful for IE?

A
  • Inflammatory biomarkers
  • Us and Es
  • Bloods
  • Urinalysis
  • ECG
  • CXR
  • Echo
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7
Q

What are examples of inflammatory biomarkers?

A
  • FBC
  • CRP
  • ESR
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8
Q

What is ESR?

A

Erythrocyte sedimentation rate

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9
Q

What can Us and Es be an indication of?

A
  • Nephritis
  • Infection
  • Sepsis
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10
Q

What can staggered blood cultures tell you?

A

The effectiveness of antibiotic treatment

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11
Q

What does conduction delay in an ECG indicate?

A

Vegetation

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12
Q

What steps are required with echoes?

A

Do trans-thoracic, only if high suspicion do a trans-oesophageal

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13
Q

How is IE of native valves treated?

A

IV amoxycillin and gentamicin

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14
Q

How is IE of native valves with sepsis treated?

A

IV amoxycillin and vancomycin

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15
Q

How is IE of prosthetic valves treated?

A

Gentamicin, vancomycin and rifampicin

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16
Q

What types of cardiomyopathy are there?

A
  • Restrictive
  • Hypertrophic
  • Dilated
  • Myocarditis (Inflammation cardiomyopathy)
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17
Q

What are the characteristics of restrictive cardiomyopathy?

A

Stiffer and less compliant myocardium but no hypertrophy

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18
Q

What are the characteristics of hypertrophic cardiomyopathy?

A

Stiffer, bulky and hypercontractile heart muscle

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19
Q

What is dilated cardiomyopathy?

A

Where the heart chambers get larger

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20
Q

What is myocarditis?

A

Inflammation of the heart muscle

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21
Q

What are the genetics of hypertrophic cardiomyopathy?

A

Autosomal dominant mis-sense mutation of gene which codes for protein in the sarcomere

22
Q

What is the clinical presentation of restrictive cardiomyopathy?

A

Diastolic heart failure and low amplitude/smaller QRS-complex

23
Q

What is the clinical presentation of dilated cardiomyopathy?

A

Systolic heart failure, AV regurgitation, potential S3 heart sound

24
Q

What is the clinical presentation of hypertrophic cardiomyopathy?

A

LVH accompanied by diastolic heart failure

25
Q

What is the venturi effect?

A

Hypertrophy of the IV-septum causes higher flow rate of blood through the aortic valve which pulls the anterior leaflet of the mitral valve with the blood

26
Q

What is the treatment plan for restrictive cardiomyopathy?

A

Treat underlying cause and heart transplant

27
Q

What is the treatment plan for Dilated cardiomyopathy?

A

Left ventricular assistive device and heart transplant

28
Q

What is the treatment plan for hypertrophic cardiomyopathy?

A

Beta-blockers and CCBs (rate limiting)

29
Q

What are the two single gene disorders resulting in CVS disorders?

A

Noonan’s Syndrome and Noonan-like syndrome

30
Q

What are the presentations of Noonas’s syndrome?

A

Excess nuchal folds, Pulmonary stenosis, Short stature, neck webbing, Cryptorchidism, Characteristic face, PTPNN11 gene (cr12)

31
Q

What is cryptorchidism?

A

Absence of one or more testicles

32
Q

What are the examples of Noonan-like syndromes?

A

Cardio-Facio syndrome
Leopard syndrome
Costello syndrome

33
Q

What are the distinguishing features of cardio-facio syndrome?

A

Ectodermal problems and developmental delay

34
Q

What are the distinguishing features of leopard syndrome?

A

Multiple lentigenes and deafness

35
Q

What are the distinguishing features of Costello syndrome?

A

Thickened skin folds
Susceptible to warts
Cardiomyopathy
Later risk of cancer

36
Q

What two chromosomal disorders are related to the CVS?

A

Turner and Downs syndrome

37
Q

What is the profile of Turner syndrome?

A

30% mosaic

Coarctation of the aorta, short stature, gonadal dysgenesis, puffy hands

38
Q

What is the profile of Downs syndrome?

A

15% AV septal defects cystic hygroma/lymphaginoma

39
Q

What are the two micro deletion syndromes prevalent in the CVS?

A

22q11 deletion syndrome

Williams syndrome

40
Q

What are the CATCH characteristics of 22q11 deletion syndrome?

A 
C - cardiac malformations 
A - abnormal face 
T - thymic hypoplasia 
C - cleft palate
H - hypoparathyroidism
41
Q

What two other syndromes does 22q11 micro deletion syndrome encompass?

A

DiGeorge and Velocardiofacial (Sphritzen) syndrome

42
Q

What other health issues are associated with 22q11 deletion syndrome?

A

Psychiatric issues

43
Q

What are the signs and symptoms of DVT?

A
  • Unilateral limb swelling
  • Persisting discomfort
  • Calf tenderness
  • Warmth
  • Erythema
  • Can be clinically silent
44
Q

What are the signs and symptoms of PE?

A 
Pleuritic pain 
Breathlessness 
Haemoptysis 
Tachycardia 
Pleural rub
45
Q

What are the intensified symptoms of massive PE?

A 
Severe breathless
Collapse
Tachycardia 
Hypotension 
Raised JVP
Altered heart sounds 
May cause sudden death
46
Q

What are some clinical assessment criteria for the diagnosis of DVT?

A 
Active cancer
Paralysis
Bed >3 days 
Leg/calf swelling 
Pitting oedema
47
Q

What other investigations may be ordered to confirm a diagnosis of DVT?

A

D-dimer test and compression ultrasound

48
Q

What imaging may be useful in the diagnosis of PE?

A

Isotope V/Q scan

CT pulmonary angiogram

49
Q

How is VTE prevented in hospital?

A
  • Early mobilisation
  • Anti-embolism stockings
  • Daily injections of low molecular weight heparin
50
Q

What are the treatment options for VTE?

A

LMW heparin for >5 days

Vena caval filter and thrombolysis in massive PE

51
Q

What are varicose veins?

A

Tortuous and dilated uperficial vein disease

52
Q

Where does varicose veins usually occur?

A

In the great saphenous vein mostly

Systems 1a Revision Decks (22 decks)

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