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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?

A

troponin

24
Q

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

A

pain relief
resolve inflammation

25
Q

what treatment regimen is indicated for viral or idiopathic acute pericarditis?

A

colchicine (3 mo) + NSAIDS (2 wks)

26
Q

what treatment regimen is indicated acute pericarditis in post MI patients?

A

colchicine + aspirin

27
Q

what treatment can be considered for acute pericarditis if symptoms are refractory to NSAIDS/ASA and colchicine?

A

steroids (prednisone)

28
Q

what 2 meds should be avoided in post MI patients?

A

NSAIDS
steroids

29
Q

in increased amount of pericardial fluid, over 250 ml

A

pericardial effusion/tamponade

30
Q

a patient presents with dyspnea, dysphagia, hoarseness, hiccups, and atypical chest pain. what are they likely experiencing?

A

pericardial effusion

31
Q

a patient presents with hypotension, JVD, muffled heart tones, atypical chest pain, and tachycardia. what are they likely experiencing?

A

pericardial tamponade

32
Q

an ECG shows flat T waves and low voltage. what is this?

A

pericardial effusion

33
Q

an ECG shows electrical alternans and low voltage. what is this?

A

pericardial tamponade

34
Q

what is the management for a mild pericardial effusion that is asymptomatic?

A

frequent observation with serial echos

35
Q

what is the treatment for moderate to severe pericardial effusions that are symptomatic?

A

pericardiocentesis / percutaneous catheter drain

36
Q

what is the last resort treatment of pericardial effusions?

A

pericardiectomy

37
Q

what diagnostic is used to directly measure intracardiac and intrapericardial pressures in tamponades?

A

cardiac catheterization

38
Q

inflammatory signs suggests what diagnosis?

A

acute idiopathic pericarditis

39
Q

large effusion without inflammatory signs or tamponade suggests what diagnosis?

A

chronic idiopathic pericardial effusion

40
Q

tamponade without inflammatory signs suggests what diagnosis?

A

malignant effusion

Cardiology (19 decks)

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