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Cardiology > Endocarditis, Pericarditis, Tamponade > Flashcards

Endocarditis, Pericarditis, Tamponade Flashcards

1
Q

infection of the endocardial surface of the heart, most commonly the valves

A

infective endocarditis

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2
Q

what 2 organisms usually cause infective endocarditis?

A

staph
strep

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3
Q

what heart structure is most commonly affected by community acquired infective endocarditis?

A

mitral valve

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4
Q

what heart structure is most commonly affected by infective endocarditis due to IV drug use?

A

tricuspid valve

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5
Q

a patient presents with fever, murmur, petechiae, osler/janeway lesions, splinter hemorrhages, weight loss, cough, and splenomegaly. what are they likely experiencing?

A

infective endocarditis

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6
Q

what criteria is used to diagnose infective endocarditis?

A

modified duke criteria

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7
Q

what would an echo of a patient with infective endocarditis, show? (3)

A

vegetations
new regurg
abscess

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8
Q

what is the test of choice to diagnose infective endocarditis?

A

transthoracic echocardiogram

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9
Q

what are the treatment steps for a stable patient suspected of infective endocarditis?

A

admit
await blood culture before antibiotics

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10
Q

what are the treatment steps for an unstable patient suspected of infective endocarditis?

A

admit
begin empiric antibiotics after blood culture sample is taken

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11
Q

what antibiotic can be used as empiric therapy for infective endocarditis?

A

vancomycin

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12
Q

a patient’s blood culture for infective endocarditis comes back as strep positive. what antibiotic therapy should be given?

A

IV penicillin G

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13
Q

a patient’s blood culture for infective endocarditis comes back as staph positive. what antibiotic therapy should be given? (2)

A

IV nafcillin
IV cefazolin

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14
Q

a patient’s blood culture for infective endocarditis comes back as resistant staph. what antibiotic therapy should be given?

A

vancomycin

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15
Q

what are 2 antibiotic alternatives if a patient is allergic to penicillin?

A

ceftriaxone
vancomycin

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16
Q

when is surgical treatment indicated for infective endocarditis? (2)

A

mod-severe heart failure

unavailable antimicrobial therapy for specific organism

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17
Q

what medication can be used as prophylaxis for surgical procedures of infective endocarditis?

A

amoxicillin

18
Q

what are 3 symptoms to indicate acute pericarditis?

A

pleuritic chest pain
ECG changes
pericardial friction rub

19
Q

what position makes pleuritic chest pain worse? better?

A

laying down
leaning forward

20
Q

what would an ECG of acute pericarditis show?

A

diffuse ST elevations

21
Q

what would a CXR of acute pericarditis show?

A

large effusion

22
Q

when should an echo be URGENTLY ordered for acute pericarditis?

A

if tamponade is suspected

23
Q

what cardiac enzyme may be elevated in acute pericarditis?

24
Q

what is the goal of therapy for acute pericarditis? (2)

A

pain relief
resolve inflammation

25
what treatment regimen is indicated for viral or idiopathic acute pericarditis?
colchicine (3 mo) + NSAIDS (2 wks)
26
what treatment regimen is indicated acute pericarditis in post MI patients?
colchicine + aspirin
27
what treatment can be considered for acute pericarditis if symptoms are refractory to NSAIDS/ASA and colchicine?
steroids (prednisone)
28
what 2 meds should be avoided in post MI patients?
NSAIDS steroids
29
in increased amount of pericardial fluid, over 250 ml
pericardial effusion/tamponade
30
a patient presents with dyspnea, dysphagia, hoarseness, hiccups, and atypical chest pain. what are they likely experiencing?
pericardial effusion
31
a patient presents with hypotension, JVD, muffled heart tones, atypical chest pain, and tachycardia. what are they likely experiencing?
pericardial tamponade
32
an ECG shows flat T waves and low voltage. what is this?
pericardial effusion
33
an ECG shows electrical alternans and low voltage. what is this?
pericardial tamponade
34
what is the management for a mild pericardial effusion that is asymptomatic?
frequent observation with serial echos
35
what is the treatment for moderate to severe pericardial effusions that are symptomatic?
pericardiocentesis / percutaneous catheter drain
36
what is the last resort treatment of pericardial effusions?
pericardiectomy
37
what diagnostic is used to directly measure intracardiac and intrapericardial pressures in tamponades?
cardiac catheterization
38
inflammatory signs suggests what diagnosis?
acute idiopathic pericarditis
39
large effusion without inflammatory signs or tamponade suggests what diagnosis?
chronic idiopathic pericardial effusion
40
tamponade without inflammatory signs suggests what diagnosis?
malignant effusion

Cardiology (19 decks)

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