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Clin Med Exam 1 (Shelby) > Pericarditis/Endocarditis > Flashcards

Pericarditis/Endocarditis Flashcards

1
Q

What is the treatment for pericarditis

A
  1. NSAIDs
  2. Colchicine

If contraindicated for patient, glucocorticoids

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3
Q

What is the most common cause of death in patients with endocarditis

A

Heart failure

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4
Q

What position relieves the pain in pericarditis

A

Sitting up and leaning forward

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5
Q

Diagnosis for endocarditis is based on what three things

A
  1. Clinical manifestations
  2. Blood cultures
  3. Echo
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7
Q

What are the non-cardiac risk factors for endocarditis

A
  1. IV durg use
  2. Indwelling intravenous catheter
  3. Immunosuppression
  4. Sental or surgical procedure
  5. Being old
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8
Q

What unique feature of endocarditis is the reason why a patient’s presenting complaint may not be centered around the heart, but rather on a body system affected by IE

A

Spectic emboli (vegetations) shower throughout the body

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10
Q

Treatment for endocarditis

A

No acute symptoms = wait 3 days for blood culutre

Acute symptoms = vancomycin

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12
Q

In the patient population that does not include healthcare workers and IV drug users, what are the most common pathogens associated with infectious endocarditis

A

Staphy aureus
Viridans Streptococci

Euqal proportions

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13
Q

What is the most common indication for cardiac surgery in patient with infective endocarditis

A

Heart failure

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15
Q

Which is more difficult to treat, endocarditis of native valve or prosthetic valve

A

Prosthetic valve - may require surgical replacement

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16
Q

Dental procedures that require prophylaxis with abx only include these things:

A

Prosthetic heart valve
Prior infectious endocarditis
Congenital heart disease
Procedures on infected skin or MSK tissue

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17
Q

What is Beck’s triad

A

Hypotension
Muffled heart sounds
JVD

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19
Q

What is the definitive treatment for constrictive pericarditis

A

Pericardiectomy

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20
Q

Which echo has a higher sensitivity for endocarditis

A

Transesophageal echo

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21
Q

What are the cardiac risk factors associated with endocarditis

A
  1. Prior infectious endocarditis
  2. Prosthetic valve
  3. Cardiac device
  4. Valvular/congenital heart disease
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28
Q

What is the MOST COMMON symptoms of infectious endocarditis

A

FEVER!

Especially if it is longer than a week

FEVER OF UNKNOWN ORIGIN

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30
Q

Petechiae and splinter hemorrhages are cutaneous manifestations of:

A

Endocarditis

31
Q

How many patients with pericarditis have recurrent pericarditis

A

1/3

32
Q

What is a normal amount of ultrafiltrae of plasma in the pericardial sac

A

15-50mL

35
Q

You think your patient has pericarditis but you don’t hear that classic pericardial friction rub, a scratchy squeaky noise over the left sternal border. Can you rule it out?

A

Nope, the pericardial friction rub can vary in intesity and can come and go

36
Q

Which pathogen is responsible for the majority of cases of healthcare- associated infectous endocarditis AND IE in IV drug users

A

Staph aureus

37
Q

What are osler nodes

A

Tender subcutaemous violaceous nodules pads of fingers and toes

Endocarditis

39
Q

What is the name of the triad assocaited with cardiac tamponade

A

Beck’s triad

40
Q

What are Janeway lesions?

What are they associated with

A

Non-tender erythematous macules, palms and soles

Endocarditis

41
Q

Why are glucocorticoids not a first line treatment for pericarditits

A

Because they can cause recurrent pericarditis

42
Q

What are Roth spots

What are they associated with

A

Exudative, edematous hemorrhagic lesions of the retina with pale centers

Endocarditis

43
Q

How do you take blood cultures for infective endocarditis

A

At least three sets
Separate venipuncture sites
Spaced over 30-60 minutes

45
Q

Where does the pain radiate in pericarditis

A

Tricccccck it doesn’t!

48
Q

Janeway lesions are more common in acute or subacute endocarditis

A

Acute

49
Q

Osler nodes are more common in acute or subacute endocarditis

A

Subacute

51
Q

What labs can you order for pericarditis that are sensitive and specific?

A

None!

You can order troponin, ESR, CRP, and CBCN but none of them are sensitive nor specific

53
Q

What physical exam findings occur is most cases of infectious endocarditis (85%)

A

Cardiac murmurs

54
Q

What is the traetment for cardiac tamponade

A

Cardiac tamponade DEMANDS PERICARDIOCENTESIS or SURGERY

55
Q

The majority (60%) of patient with pericarditis will have an associated :

A

Pericardial effusion

56
Q

What does pleuritic mean

A

Worse when you take a deep breath

62
Q

If the etiology of pericarditis needs to be delineated (because its lasting a long time) what tests can you order to help you determine the cause

A
  1. TB test
  2. ANA (rheum stuff)
  3. HIV serology
  4. Chest CT (effusion)
  5. MRI
63
Q

What type of chest pain is associated with pericarditis

A

SHARP, PLEURITIC

66
Q

How do you describe a pericardial friction rub

A

Scratchy or squeaking heart sound

70
Q

In western countries, what is the most common etiology of pericarditis

A

Viral

72
Q

Which viruses are most common for causing pericarditis

A

Coxsackievirus and influenza

Clin Med Exam 1 (Shelby) (10 decks)

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