IF TIME :D Flashcards
Acute Pericarditis
- Cause
- Symptoms
- Gold standard test
- Enterovirus - coxsackie
- Dressler’s & AMI
- RA/SLE
- Uric acid –> gout & CKD & tumour lysis
- Malignancy & radiotherapy
- RHD
- Pleuritic chest pain worse lying, better leaning forward
- Neck and shoulder pain
- Fever
- Friction rub
- ECG –> wide spread STEMI
- Colchicine & NSAID
Becks Triad
CARDIAC TAMPONADE!
- Hypotension (obstructive shock)
- Muffled heart sounds
- Elevated JVP (Kussmal’s - increased with inspiration)
Cardiac tamponade investigation findings
Exam
- Becks triad
- Pulsus paradoxus
- Dyspnoea
- Dysphagia
ECG
- Low voltages
- Electrical alternans
- Pulseless electrical activity
CXR
- Water bottle sign
JVP - Deep and sharp Y waves
Constrictive pericarditis
Pericardial effusion investigation findings & management
Exam
- Displaced apex beat
TTE
- Heart dancing in pericardium
CXR
- Enlarged cardiac silhouette
Management
- Pericardial window
Tricuspid regurgitation murmur
- Pansystolic increased on inspiration and leg-raising
- Large J-waves
- Pulsatile liver
- S3 and parasternal heave
- P-pulmonale from RAE
Pulmonary stenosis murmur
- Late ejection systolic murmur
- S2 splitting
- S4
- Parasternal heave
- Predominant A wave
JONES criteria
Major criteria for diagnosing RHD
J -joints –> migratory polyarthritis
O - heart –> pancarditis
N - nodules –> subcutaneous nodules, extensors, painless
E - erythema marginatum –> smoke ring rash, worse with heat
S - Sydenham’s chorea –> face, tongue and ULs
Rheumatic fever treatment
IM Benzylpenicillin (G) or PO phenoxymethylpenicillin (V)
NSAID - pain
HOCM signs, symptoms & mutation
- Sudden cardiac arrest in otherwise healthy individual
- Beta-myosin heavy light chain (sarcomere) mutation
- Exertion SOB, angina, syncope
- Jerky pulse/pulsus bisferiens - sudden deacceleration
- Ejection systolic loudest at the sternal edge
- S4
- Triple impulse apex, pressure loaded and displaced
Dilated cardiomyopathy aetiology
- Alcohol
- Myocarditis
- AMI
- Autoimmune
- Chemotherapy
Myocarditis aetiology
- Coxsackie virus (enterovirus)
- Bacteria
- Fungi
- Autoimmune
- Pregnancy
- Drugs and toxins
- Trauma
Idiopathic pulmonary fibrosis (IPF)
- Most common ILD
- > 60yrs
- Smoking
- UIP pattern –> honey combing, subpleural, apical-basal
- Fibrinolytic and oxygen therapy
- Men > women
Pneumoconiosis
Silicosis
- Diffuse pulmonary nodules
- Egg-shell calcifications
- Acute –> Massive exposure –> lavage
- Accelerative –> ongoing high dose –> poor prognosis
- Chronic –> chronic low dose –> fibrosis over many years
- Stone mason’s and concreters
- Calcified LNs
Berylliosis
Coal-workers lung
- Long wall mining –> very high exposure
- Anthracnosis –> black lung pigment
Hypersensitivity pneumonitis
- Non-caseating granulomatous fibrosis
- Repeated exposure to an allergen
- Bird financiers lung
- Farmer’s lung –> aspergillus mouldy grain/hay
- Fever, cough and dyspnoea
- Allergen avoidance and corticosteroids