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Cardiology > IE, Rheumatic fever, myocardial/pericardial disease, dissection > Flashcards

IE, Rheumatic fever, myocardial/pericardial disease, dissection Flashcards

1
Q

IE risk factors

A

Prosthetic valves
Valve disease (VSD, PDA, CoA)
Rheumatic fever
Dental caries, IVDU

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2
Q

Causative agents of IE

A

Strep. viridans, S. bovi
Staph aureus, epidermis
HACEK

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3
Q

Main clinical features in IE

A

Fever, rigors, splenomegaly, clubbing
New/changing murmur
Haematuria, roth spots

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4
Q

Hand features of IE

A

Janeway lesions, Osler’s node, splinter haemorrhages

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5
Q

Duke major

A 
\+ve blood culture 
Endocardium involved (echo/valve regurg)
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6
Q

Duke minor - 5

A 
Predisposition 
Fever>38
Emboli (septic infarcts)
Immune phenomenon - GN, oslers node, roth spots 
\+ve blood culture
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7
Q

Diagnose IE if

A

2 major or
1 major + 3 minor or
5 minor

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8
Q

ECG change in IE

A

AV block

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9
Q

Treat empiric IE acute and subacute

A

Acute - fluclox + gent

Subacute - benpen + gen

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10
Q

IE due to strep and enterococci treat

A

Strep - Benpen + gent

Enterococci - Amox + gent

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11
Q

IE due to staph treat

A

Fluclo + rifampicin

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12
Q

Cause of rheumatic fever

A

Group A beta-haemolytic strep

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13
Q

Diagnose rheumatic fever

A

Evidence of GAS infection (scarlet fever, +ve throat culture, ASOT +ve, rapid strep antigen)
2 major or
1 major + 2 minor

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14
Q

Major Jones criteria

A 
STREP 
S - Sydenham's chorea 
T - Transient arthritis 
R - Subcutaneous nodules 
E - Erythema marginatum 
P - Pancarditis (pericarditis, myocarditis, endocarditis)
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15
Q

Minor Jones criteria

A 
Prolonged PR 
Raised ESR/CRP 
Temp rise 
Previous rheumatic fever
Arthralgia
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16
Q

Patient with pancarditis (AV block/chest pain) + joint pain cause

A

Rheumatic fever

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17
Q

Treat rheumatic fever

A

IM benpen
Analgesia
Chorea - Haloperidol

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18
Q

Drug causes of pericarditis

A

Penicillin
Isoniazid
Procainamide
Hydralazine

19
Q

ECG changes in pericarditis

A

Saddle shaped ST elevation

PR depression

20
Q

Blood changes in pericardtis and myocarditis

A

Troponin can be raised

21
Q

Infective causes of pericarditis

A

Coxsackie, flu, EBV, HIV, pneumonia

22
Q

Clinical feature in constrictive pericarditis

A

Kussmaul’s sign (raised JVO in inspiration)
S3
Quiet heart sounds

23
Q

Treat pericarditis

A

Analgesia (ibruprofen)
Treat cause
Consider steroids

24
Q

ECG change in pericardial effusion

ECHO results

A

Low voltage QRS
Electrical alternans
Echo free zone around heart

25
Q

Treat pericardial effusion

A

Pericardiocentesis + treat cause

26
Q

Tamponade signs

A

Beck’s triad - reduced BP, raised JVP, quiet HS
Pulsus paradox - pulse fades on inspiration
Kussmaul sign

27
Q

Treat tamponade

A

Treat cause + pericardiocentesis

28
Q

Drug causes of myocarditis

A

Cyclophosphamide
Herceptic
CBZ, phenytoin

29
Q

Autoimmune cause of myocarditis

A

SLE

30
Q

Treat myocarditis

A

supportive and treat cause

31
Q

Treat HOCM

A

-ve inotropes (B blocker, Ca blocker)
Amiodarone
Anticoagulate if AF

32
Q

Features of cardiac myxoma

A

Clubbing, fever, raised ESR

Signs as in MS

33
Q

Treat dilated cardiomyopathy

A

Heart failure medication

Biventricular pacing, ICD

34
Q

Drug causes of dilated cardiomyopathy

A

Alcohol

Doxorubicin, cyclophosphamide

35
Q

Causes of dilated cardiomyopathy

A

Dystophy - muscular, myotonic, glycogen storage disease
SLE
thyrotoxicosis

36
Q

Features Ehlers Danlos

A

Hyperelastic skin + hypermobile joints
cardiac - MVP, AR, MR, aneurysm
Fragile blood vessels

37
Q

Marfan’s syndrome inheritance

A

Autosomal dominant

38
Q

Marfan cardiac, ocular features

A

Cardiac - aortic aneurysm/dissection, MVP/regurg

Ocular - superotemporal lens dislocation

39
Q

Marfan MSK features

A

High-arched palate, pectus excavatum, scoliosis, pes planus, joint hypermobility

40
Q

Mx marfans

A

Refer to ortho, cardio, ophthal

B blockers, reduce cardiointensive sports

41
Q

Stanford A and B aortic dissection

A

A - ascending aorta involved

B - Ascending aorta not involved

42
Q

Risk factors for dissection

A

HTN, CoA
Trauma
Vasculitis, marfans, ehlers danlos

43
Q

Diagnose dissection

A

Spiral CT

44
Q

Mx dissection

A

HDU, BP control, analgesia, surgery

Cardiology (6 decks)

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