HLTH 2501: inflammation and infection in the heart Flashcards

1
Q

rheumatic fever

A

an acute systemic inflammatory condition that results from an abnormal immune reaction occuring a few weeks after an untreated infection

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2
Q

what is the main cause of infection in rheumatoid fever

A

group A beta-hemolytic Strepococcus

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3
Q

where does inflammation occur in rheumatoid fever?

A

in the heart, brain, joints, and skin

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4
Q

who does rheumatic fever most commonly affect?

A

children aged 5 to 15

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5
Q

long-term effects of rheumatic fever

A

rheumatic heart disease, infective endocarditis, and heart failrue

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6
Q

what does the preceding infection of rheumatic fever commonly persist as?

A

an upper respiratory infection, tonsillitis, pharyngitis, or strep throat

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7
Q

how does rheumatic fever cause damage to the heart?

A

antibodies to the infection react with collagen in the heart, but scar tissue will develop which causes rheumatic heart disease

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8
Q

pericaditis

A

inflammation of the heart outer layer and may include effusion which impairs filling

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9
Q

effusion

A

excessive fluid accumulation

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10
Q

myocarditis

A

inflammation develops as localised lesion in the heart muscle (Aschoff bodies), and these interfere with heart conduction

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11
Q

lesions in myocarditis

A

are called aschoff bodies

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12
Q

endocarditis

A

inflammation that affects the valves, causing them to become edematous and verruca; this disrupts the flow of blow leads to stenosis and rheumatic heart disease

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13
Q

verrucae

A

rows of small, wart like vegetations along the outer edge of the valve cusps

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14
Q

what valve is most commonly affected by endocarditis?

A

the mitral valve

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15
Q

how are the joints affected in rheumatic fever?

A

large joints, particularly in the legs may have synovitis

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16
Q

how is the skin affected in rheumatic fever?

A

a nonpruritic rash known as erythema marginatum develops (red with white centre)

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17
Q

how are the wrists, elbows, knees, and ankles affected in rheumatic fever?

A

non tender subcutaneous nodules may develop

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18
Q

how are the basal nuclei affected in rheumatic fever?

A

cause involuntary jerky movements of the face, arms, or legs; called sydenham chorea or saint vitus dance

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19
Q

what is diagnosis of rheumatic fever based on?

A

general signs of inflammatory disease, high levels of antistreptolysin O antibodies, anemia, leukocytosis, a history or a prior streptococcal infection, and an abnormal ECG

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20
Q

signs and symptoms of rheumatoid fever

A

low-grade fever, leukocytosis, malaise, anorexia, fatigue, tachycardia, heart murmurs, epistaxis, and abdominal pain

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21
Q

epistaxis

A

nose bleeding

22
Q

treatment for rheumatoid fever

A

antibacterial agents such as penicillin V, ASA, corticosteroids all help will preventing additional infection and inflammation; valve replacement may be necessary

23
Q

infective endocarditis

A

occurs in two types (subacute and acute) and in general is when a microorganism invades heart valves

24
Q

subacute type of infective endocarditis

A

occurs when defective valves are invaded by organisms of low virulence

25
Q

example of a low virulent organism in subacute infective endocarditis

A

streptococcus viridans (part of the normal flora in the mouth)

26
Q

acute type of infective endocarditis

A

occurs when normal heart valves are attacked by highly virulent organisms; vegetations in valves may interfere with the opening and closing of valves

27
Q

example of microorganism in the acute type of infective endocarditis

A

staphylococcus aureus (can cause severe tissue damage)

28
Q

basic effects of infective endocarditis

A

the microorganism in the general circulation attaches to the endocardium and invade the heart valves, causing inflammation and the formation of vegetations on the cusps

29
Q

what are vegetations?

A

large, fragile masses made up of fibrin strands, platelets, other blood cells, and microbes

30
Q

causes of infective endocarditis

A

presence of abnormal heart tissue, presence of microbes in the blood, reduced host defences, and predisposing conditions

31
Q

predisposing conditions of infective endocarditis

A

congenital defects, rheumatic fever, mitral prolapse, and valve replacements

32
Q

diagnostic tests for infective endocarditis

A

new heart murmurs and transesophageal echocardiogram

33
Q

signs and symptoms of subacute infective endocarditis

A

low-grade fever, anorexia, splenomegaly, olser nodes, vascular occlusion, and CHF in severe case

34
Q

osler nodes

A

painful red nodes on the fingers; present in subacute infective endocarditis

35
Q

signs and symptoms of acute infective endocarditis

A

spiking fever, chills, drowsiness, and severe impairment of heart function

36
Q

treatment for infective endocarditis

A

blood test to identify the microbial agent and antimicrobial drugs

37
Q

pericarditis

A

usually occurs secondary due to other conditions and is normally classified based on the type of exudate associated with the inflammation

38
Q

2 types of pericarditis

A

acute or chronic

39
Q

acute pericarditis

A

simple inflammation of the pericardium, in which rough, swollen surface cause chest pain and a friction rub, and in some cases effusion may develop

40
Q

friction rub

A

a grating heart sound heard on the chest with a stethoscope

41
Q

types of exudate in pericarditis

A

serous, fibrinous, purulent, and blood containing

42
Q

what are the effects of pericarditis

A

if lots of fluid accumulates, the heart ability to expand and fill is impaired, thus decreasing CO

43
Q

cardiac tamponade

A

CO is decreased due to fluid in the pericardium

44
Q

what side of the heart is affected in pericarditis?

A

the right side because it is the low pressure side

45
Q

chronic pericarditis

A

formation of adhesions between the pericardial membranes that may become constrictive, causing the pericardium to become a tight, fibrous enclose, thus limiting the movement of the heart

46
Q

causes of acute pericarditis

A

can be secondary to open heart surgery, MI, rheumatic fever, renal failure, trauma, or a viral infection

47
Q

causes of chronic pericarditis

A

tuberculosis or radiation to the mediastinum or infection or inflammation developing from adjacent structures

48
Q

signs of pericarditis

A

chest pain, tachycardia, dyspnea, and cough, as well as changes in ECG or a friction rub

49
Q

what can effusion in pericarditis lead to?

A

distended neck veins, faint heart sounds, and pulsus paradoxus (systolic pressure drop during inspiration_

50
Q

treatment for pericarditis

A

fluid must be aspirated from the cavity

51
Q

paracentesis

A

aspirating fluid from the pericardial cavity