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CVM DF > Hersh CIS > Flashcards

Hersh CIS Flashcards

1
Q

acute pericarditis diagnostic criteria

A

2 of following 4

pericarditic chest pain
pericardial rubs
new widespread ST elevation or PR depression on ECG
pericardial effusion

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2
Q

recurrent pericarditis

A

recurrence of pericarditis after first episode and symptom free for 4-6 weeks or longer

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3
Q

duke criteria major

A

Bacterial blood culture positive
ECG ID of valve change
New murmur

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4
Q

antibiotic prophylaxis IE

A

amoxicillin

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5
Q

what are janeway lesions

A

painless non tender lesions on palms and soles

do not blanch

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6
Q

what are the gram positive bacterias

A

staph, strep (coccus)
bacillius, clostridium (spore forming rods)
listeria, corynebacterium (non spore forming rods)

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7
Q

pericarditis presentation

A

anterior pleuritic chest pain
-uremic pts generally painless

fever

pericardial rub

dyspneas

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8
Q

heart side affected in Acute IE

A

R>L

tri>Bi>aorta>Pulm

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9
Q

empiric treatment IE

A

vancomycin and ceftriaxone

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10
Q

in regards to antibiotic prophylaxis of person getting future dental procedures for a person who has history of endocarditis
-pt with penicillin allergy

A

oral cephalexin

could also give amoxicillin, clindomyocin

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11
Q

risk factors for infective endocarditis

A

over 60
male
iv drug use
poor dentition

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12
Q

people with CF that have endocarditis

A

pseudomonas infection

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13
Q

what is the best empiric treatment for suspected endocarditis

A

vancomycin and ceftriaxone

-staph can be methocillin and penicillin resistant

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14
Q 
PPD interpretation
HIV positive 
recent contact with active TB pt
nodular or fibrotic changes on chest x ray
organ transplant
A

greater than or = to 5 mm is positive test

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15
Q

predisposing factors for IE

A 
structural heart disease, valve disease, CHD, prostethic heart valves
previosus IE
intravasuclar device
hemodialysis
HIV
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16
Q

symptoms of acute IE

A 
high fever, chills
sob 
arthralgias/myalgias
ab pain
pleuritic chest pain
ack pain
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17
Q

what test would you run if you are suspicious of endocarditits

A

transthoracic echocardiogram - non invasive, can pick up on vegetations

TEE- is good for acute bacterial endocarditis or any kind of carditis, can see posterior struictures of the heart, but invasive and have to sedate pts

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18
Q

EKG progression of pericarditis

A

diffuse ST elevation–>ST normalization–> inverted T wave–>return to baseline

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19
Q

staph epidermidids

affects what
virulance factor
urease and coag
treatments

A

affects prostattic valves–>endocarditis

produces biofilm to help stick to surfaaces (dextran)

urease +
coag -

treat with vancomycin

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20
Q

incessant pericarditits

A

pericarditis lasting for over 4-6 weeks but less than 3 months without remission

21
Q

chronic pericarditis

A

pericarditis lasting for over 3 months

22
Q

treatment for pericarditis

A

ASA and colchicine

23
Q

duke criteria minor

A

FIVE PM

Fever
Immuno phenom: GN, osler nodes, roth spots, RF
Vacular lesions: janeway lesions
ECG findings consistent with endocarditis

Predisposing heart lesions and IV drug use
Microbiological evidence including single culture positive for unusual organism

24
Q

symptoms of subacute IE

A 
low grade fevere
anorexia
arthralgia/myalgia
ab pain
fatigue
25
Q

test for mycobacteria (TB)

A

AFB stain
ziel-Neelsen stain
red rods

26
Q

oslers nodes

A

painful lesions on fingers and tips of fingers

27
Q

more likely to get TB with CD count under what

A

500

28
Q

IF CD count below 200 then ____

A

AIDS

29
Q

orthomyxovirus (flu) structure

A

single stranded 8 segmented RNA virus

30
Q

heart side affected subacute IE

A

L>R

31
Q

what are roth spots

A

retinal hemmhorages

32
Q

antibiotic prophylaxis IE: allergic to penicillin or ampicllin and unable to take oral med

A

cephalexin
ceftriaxone
clindamycin

give IV

33
Q

treatment for pericarditis caused by TB

A

RIPE

Rifampin
isonizid
pyrazinamide
ethambutol

34
Q

positive IE with DUKE criteria

A

2 major met

1 major and 3 minor

5 minor

35
Q

strep viridans

A 
dextran 
mitral valve
catalase neg
a hemolytic
subacute endocarditits
36
Q

treatment for pericarditis without response to high dose aspirin and colchincine

A

high dose corticosteroids and colchicine

37
Q

antibiotic prophylaxis IE: allergic to penicillin or ampicilin

A

cephalexin
clindamycin
azithromycin
clarithromycin

38
Q

enterococcus faceilis

A

lives in GI tract
can get infection with chrons diseasse, GI surgery, uclercholisits

resistant to Abs
-treat with linezoid or tigecylince

39
Q

PPD interpretation

-recent arrivals from high prevalence countries
IV drug users
high risk lab employees
children under 4

A

greater than or equal to 10mm = positive

40
Q

what do you order with pericarditis to track treatment

A

CRP

41
Q

staph aureus

virulance factor
coag and catalse

A

protein A

catalase + and coagulase +

effects tricuspid valve

42
Q

what can be elevated in infection and inflammaotry processes

A

CRP

43
Q

etiology of pericarditis

A

coxsackie B
echovirus
flu

44
Q

what key player in IE grows on sodium chloride and bile salts

A

enterococcus

45
Q

antibiotic prophylaxis IE: can’t take oral

A

ampicillin or cefazolin or ceftriaxone

46
Q

pericarditis and EKG

A

ST intervals are elevated in all leads (above isoelectric line)
Pr is a little dipped down

47
Q

does increased or decreased ESR suppor diagnosis of subacute endocarditis

A

increased

48
Q

PPD interpretation

-persons with no known risk factors for TB

A

greater than or equal to 15 mm = positive

CVM DF (15 decks)

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