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Q2 Clin Med Final (Cardiology, Hyperlip) > Endo/Pericarditis > Flashcards

Endo/Pericarditis Flashcards

1
Q

Endocartitis definition?

A

inflamed lining of chambers and/or valves

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2
Q

3 categories of Infective Endocartitis?

A

1) native valve
2) IV drug users
3) prosthetic valve

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3
Q

Native valve endocartitis etiology?

A

strep, entero or staphylococci

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4
Q

IV drug user endocartitis etiology?

A

1/2 staph aureus

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5
Q

Prosthetic valve endocartitis etiology?

A

staph
G-
fungi

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6
Q

Acute Infective Endocartitis etiology?

Regression?

A

(U) staph areus

rapid destruction
fatal <6wks w/o tx

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7
Q

Subacute Bacterial Endocartitis etiology?

A

(U) viridans strep (normal mouth flora)

slower

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8
Q

Infective Endocartitis epidemiology?

A

Up to 80% have predisposing cardiac lesion

(U) >60yo

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9
Q

Infective Endocartitis presentation?

A 
viral sxs
murmur
splenomegaly
arterial emboli
PETECHIAE (last 2-3 days)
focal neuro impairment
clubbing/splinter hemorrages
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10
Q

Osler’s Nodes?

A

1/4 of Infective Endocartitis pt present w/:
PALPABLE, small, tender purple-red sub-q nodules on hands/feet,
tiny infarcts

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11
Q

Roth’s Spots?

A

Some Infective Endocartitis pt present w/:

oval retinal hemorrh w/ pale center

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12
Q

Janeway lesions?

A

Infective Endocartitis pt present w/:

small, NONTENDER hemorr macules on hands/feet

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13
Q

Typical lab findings in Infective Endocartitis? (6)

A 
\+ Blood culture
High sed rate
\+ anemia
\+ proteinuria
\+ rheumatoid factor
circulating immune complexes
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14
Q

Duke diagnostic criteria for definitive Infective Endocartitis:

Pathologic

A

+ microorganisms
and + vegetation
or intracardiac abscess

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15
Q

Duke diagnostic criteria for definitive Infective Endocartitis:

Clinical

A

2 major criteria
Or one major and 3 minor
or 5 minor

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16
Q

Infective Endocartitis Major Criteria? (2)

A

1) Typical microorg from 2 separate blood cx

2) Endocardial involvement: + echo or new valvular regurge

17
Q

Infective Endocartitis Minor Criteria? (6)

A

1) Heart condition or IV drug use
2) Fever >=100.4
3) Vascular phenom (emboil, hemorr, Janeway)
4) Immun phenom (glomnephritis, Osler, Roth, +RF)
5) Microbio evidence (one + blood cx)
6) Endocardiographic evidence (other than major criteria)

18
Q

Infective Endocartitis tx?

A

Abx: sustained cidal [ ] confirmed by cx (U) 6wks

(P) surgery

19
Q

Infective Endocartitis (valvular) surgery when?

A

CHF
Persistent or uncontrolled infection w/ abx
Recurrent emboli

20
Q

Prophylaxis for IE, pre procedures?

A

amoxicillin, one 2gm dose

azythro for PCN allergies

21
Q

Pericardial Disease definitons:

Acute
Subacute
Chronic

A

acute = 6mo

22
Q

Pericarditis etiology:

Infectious? (4)

A

viral
pyogenic (bacterial)
TB
fungal

23
Q

Pericarditis etiology:

Non-infectious? (4)

A

2º to acute MI
neoplasm
uremic
traumatic

24
Q

Pericarditis etiology:

Hypersens/Autoimmune? (3)

A

Rheumatic fever
Collagen vascular (SLE, RA)
Drug-induced (procainamide)

25
Q

Acute Pericarditis sxs?

A

Chest pain:
severe, sharp

Worse w/ lying down, cough, breathing

Better sitting and leaning forward

26
Q

Acute Pericarditis tests?

A

friction rub audible:
med/high pitch
loudest in inspiration

EKG = widespread ST elev, T inver only after several days

27
Q

Pericardial Effusion definition?

A

fluid build-up w/i pericardial space

28
Q

Pericardial Effusion presentation?

A

Fluid increases space b/w wall and organs Ѧ:
reduced friction rub
reduced heart sounds

29
Q

Pericardial Effusion diagnostic test of choice?

A

Echo

30
Q

Pericardial Effusion (P) CXR and EKG findings?

A

CXR = elargment w/ water bottle appearance

EKG = low voltage of QRS

31
Q

Tamponade is?

A

compression that impairs filling due to increased fluid

32
Q

Pericardial Effusion w/ Tamponade shows on EKG how?

A

Electrical alterans =

alternating size of QRS complexes

33
Q

Pericardial Effusion w/ Tamponade causes (3)?

A

1) neoplasm
2) idiopathic pericarditis
3) uremia (renal failure)

34
Q

Key features of tamponade? (3)

A

1) elevated intracardiac P = JVD
2) limited vent filling = paradoxical pulse
3) reduced cardiac output = hypotension

35
Q

Paradoxical Pulse is?

Caused by?

A

> 10 mmHg reduction in systolic BP during inspiration

reduced pericardial space makes it so L vent can’t expand against over-filled R vent ->
temp reduced LV output

36
Q

Acute Pericarditis tx?

A

underlying cause
rest
anti-inflm (asprin) for viral or idiopathic

avoid anticoag

Q2 Clin Med Final (Cardiology, Hyperlip) (8 decks)

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