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CVR Biweekly 3 > Malozzi- Pericardium > Flashcards

Malozzi- Pericardium Flashcards

1
Q

2 layers of pericardium

A

parietal and visceral

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2
Q

is pericardium essential for life

A

no

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3
Q

causes of this include:
viral
bacterial
fungal
autoimmune
tumor metastasis
metabolic
trauma

A

pericarditis

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4
Q

inflammatory syndrome of pericardium w/ or w/out effusion and infectious or non-infectious causes

A

acute pericarditis

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5
Q

most common cause of pericarditis

A

from viral infection (Coxsackie B)

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6
Q

signs of this include:
fever
sob
chest pain worse when lying down
friction rub

A

acute pericarditis

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7
Q

happy ST

A

pericarditis

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8
Q

sad ST

A

STEMI

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9
Q

what will you see in labs drawn for acute pericarditis

A

elevated WBC’s, ESR, CRP, troponin I

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10
Q

effusion seen in echo

A

pericarditis

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11
Q
A

CXR for pericarditis

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12
Q

Rx acute pericarditis

A

aspirin and NSAIDs; then corticosteroids

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13
Q

what happens if patient doesn’t complete Rx for acute pericarditis

A

recurrent pericarditis

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14
Q

to Rx recurrent pericarditis

A

aspirin and NSAIDs first; then corticosteroids

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15
Q

this is thought to be immune mediated

A

recurrent pericarditis

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16
Q

can be caused by coxsackie B, herpes, and adenovirus

A

infectious pericarditis

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17
Q

most common type of infectious pericarditis in developing countries

A

tuberculous

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18
Q

to Dx tuberculous pericarditis

A

acid fast bacilli (stain)

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19
Q

2 phases of tuberculous pericarditis seen in 30% of patients

A

effusive and constrictive

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20
Q

this phase is due to fluid accumulation

A

effusive

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21
Q

this phase is due to calcified lesion accumulation

A

constrictive

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22
Q

to Rx tuberculous pericarditis

A

rifampicin and isoniazid and others for up to 6 months

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23
Q

2 main causes of bacterial pericarditis

A

staph and strep

24
Q

what can present with bacterial pericarditis

A

cardiac tamponade

25
Q

pericarditis or effusion related to metastatic spread of cancer

A

malignant pericarditis

26
Q

to Dx malignant pericarditis

A

fluid analysis (cytology and tumor markers)

27
Q

main autoimmune diseases that can cause pericarditis

A

SLE
sarcoidosis
RA

28
Q

trauma and surgery can cause what

A

pericarditis

29
Q

post MI pericarditis aka

A

Dressler Syndrome

30
Q

Rx Dressler syndrome

A

Aspirin

31
Q

more exposure to ______ can cause pericarditis

A

radiation

32
Q
A

pericardial effusion

33
Q

this can be incidental or emergent (cardiac tamponade)

A

pericardial effusion

34
Q

2 main ways fluid accumulates in pericardial effusion

A

exudative
transudative

35
Q

fluid build up due to inflammation of pericardium layers

A

exudative fluid

36
Q

fluid build up due to impaired lymphatic drainage

A

transudative fluid

37
Q

pericardium can stretch to a certain degree; what happens when it is maxed out

A

will put pressure on heart chambers

38
Q

patient presents as hypotensive and tachycardic (compensatory)

A

rapid pericardial effusion

39
Q

patient presents w/ diminished heart sounds, JVD, low voltage on EKG

A

slow pericardial effusion

40
Q

this is represented by impaired ventricular diastolic filling

A

increased jugular venous pressure

41
Q
A

electrical alternans seen in pericardial effusion

42
Q

a drop of >10 mmHg SBP during inspiration

A

pulses paradoxus in pericardial effusion due to ventricular interdependence

43
Q

this is due to RV filling and pushing interventricular septum against L heart

A

pulsus paradoxus

44
Q

to Rx cardiac tamponade/pericardial effusion

A

pericardiocentesis
pericardial window

45
Q

due to ongoing inflammation resulting in fibrosis of pericardial sac

A

constrictive pericarditis

46
Q

most common cause in developed world of contrictive pericarditis

A

radiation
prior cardiac surgery

47
Q

presents with:
exertional dyspnea
abd distention
edema
JVD
Kussmaul’s sign

A

constrictive pericarditis

48
Q

paradoxical increase in JVP with inspiration (seen under mandible)

A

Kussmaul’s sign

49
Q
A

constrictive pericarditis

50
Q

Decreased compliance (stiffness of pericardium)
Increase filling pressures
Decreased SV and CO

Ventricular interdependence (pressed against LV)

A

due to fibrosis of pericardium

51
Q

shows discordance; LVP decreases and RVP increases

A

constrictive pericarditis

52
Q

doesn’t have ventricular interdependence b/c muscle problem; shows concordance (LVP and RVP move in same pattern)

A

restrictive cardiomyopathy

53
Q

to Rx constrictive pericarditis

A

pericardiectomy
pericardial window

54
Q

Kussmaul’s sign seen in what

A

constrictive pericarditis

55
Q

pulsus paradoxus seen in what

A

pericardial effusion/ cardiac tamponade

CVR Biweekly 3 (12 decks)

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