Miscelaneous and Pericardial Disease Flashcards
The vast majority of recurrent pericarditis cases respond to …, initially given in a high dose.
prednisone
To diagnose a pleural effusion as exudates, 1/3 criteria has to be met:…
LDH>45, cholesterol >45, proteins >2.9
… has typical ECG findings of PR depression and diffuse ST elevation.
Pericarditis
The risk of postoperative complications declines if smoking was stopped for at least… before surgery.
8 weeks
Perioperative ABx used for general skin flora coverage is… .
cefazolin (Ancef®) - 1 g given 30 minutes prior to surgery (repeat with 500 mg to 1 g during prolonged surgery); followed by 500 mg to 1 g every 6-9 hours for 24 hours postop
Patients unable to achieve functional capacity equivalent to climbing up… are at increased risk for perioperative cardiac events.
one flight of stairs
Patients with poor functional capacity or intermediate cardiac risk should have … before high-risk surgery.
noninvasive testing
… are adequate screening in patients with no history of bleeding having procedures with moderate or high bleeding risk.
Platelets, PT and PTT
Clopidogrel and ticlopidine should be discontinued for … before surgery.
one week
NSAIDs should be discontinued for … before surgery.
3 days
In a patient with acute pericarditis still complaining of CP after 2 weeks of treatment with an NSAID,… (intervention) or colchicine added.
a different NSAID should be given
Patients with recurrent tamponade despite therapy in pericarditis should be considered for… (test).
pericardial biopsy.
Patients with a relapse of pericarditis after a short-term course of steroids often obtain symptomatic relief when higher-dose prednisone therapy (1-1.5mg/Kg/day) is administered for… weeks.
4
The fluid analysis in pericardiocentesis should consist in microscopic exam, culture, white and red cell counts, cytology and…
triglycerides.
The preferred NSAID in acute pericarditis is…
ibuprofen.
The stage I ECG changes in acute pericarditis occur in 80% of patients and consist of…
diffuse STE and PR depression.
A rapidly collapsing y-descent in the jugular venous pulse with marked JVD is classical for…
constrictive pericarditis.
If there is CP radiating to the trapezius ridge, the pain is nearly specific for…
pericarditis.
The most common causes of acute pericarditis are idiopathic or due to the following viruses:
Coxsackie A and B, echovirus and adenovirus.
… has been shown to be effective as prophylaxis in patients with chronic, recurrent idiopathic pericarditis.
1mg colchicine/day
… is virtually pathognomonic of a large pericardial effusion and is caused by the curious phenomenon of the heart swinging with a frequency equal to half of the heart rate.
Electrical alternans
CNS autoregulation of blood flow fails when the mean BP falls below…
55-60mmHg.
Persistent upright T-waves or early normalization of inverted T following AMI are highly sensitive for…
postinfarction pericarditis (Dressler’s syndrome).
Simultaneous… should be performed in most of the patients suspected of having constrictive pericarditis.
left and right heart catheterization
The leading cause of cardiac tamponade in the developed countries is…
malignancy (lung, breast, lymphomas).
… is the most common cardiac manifestation of HIV infection.
Pericardial dz (effusion)
Pulsus paradoxus is an exaggeration of the normal, very small inspiratory decline in the LV stroke volume and systemic arterial pressure (>10 mmHg) in…
cardiac tamponade.
Lack of a decrease or an increase in jugular venous pressure during inspiration, called Kussmaul’s sign, is abnormal and is observed in a number of conditions, the most common being…
constrictive pericarditis
The therapy in fungal pericarditis is symptomatic (no amphotericin B except in disseminated dz) and associated with this measure…
admission due to the risk of rapidly developing tamponade.
The management of uremic pericarditis is…
HD.
… should be used cautiously during HD in patients with uremic pericarditis due to risks of hemorrhage with tamponade and chronic constriction.
Heparin
… interferes with the normal sequence of right and left ventricular filling and results in early downward motion of the septum, followed by paradoxical motion.
Constrictive pericarditis
Pericardial effusion occurs in approximately … % of patients with transmural myocardial infarction.
40
Moderate pericardial effusions typically are … in dimension and tend to be more circumferential.
15 to 20 mm
Large pericardial effusions are defined as those larger than … (width).
20 mm.
The collapse of the right ventricular outflow tract during early diastole was described in … (the precise timing and duration of right ventricular collapse can best be determined with M-mode echocardiography).
cardiac tamponade
An indirect sign of … is an exaggerated respiratory variation in septal position with marked bowing of the ventricular septum toward the left ventricle during inspiration.
pericardial constriction
Abnormal septal motion, exaggerated respiratory variation, and an elevated E/A ratio provide the majority of the confirmatory evidence for …
constrictive pericarditis.
The diagnosis of… requires documentation of pericardial thickening by means of MRI and confirmatory hemodynamic values by means of catheterization.
constrictive pericarditis
Preoperative… (diagnostic test) is reserved for patients with high-risk results at noninvasive testing and for patients at high risk with equivocal results of noninvasive tests.
coronary angiography
