Review of posters 23/04/2016

Question 1

Causes of myocarditis

Answer 1

Cocksackie viridans
Rheumatic fever- streptococcus infection where the immune system  makes antibodies that attack the myocardium)
Idiopathic
Lyme disease
Cardiotoxic drugs e.g. cocaine, alcohol

Question 2

Lab tests for myocarditis

Answer 2

CRP
CPK- elevated in damage to brain, heart or muscle
Troponin- specific to heart
Erythrocyte sedimentation rate increased
White cell count increased

Question 3

Treatment of myocarditis

Answer 3

ACE inhibitor
Beta blocker
Diuretic (for any fluid retention)
Antibiotics- not in viral cases

Question 4

Causes of pericarditis

Answer 4

Viral- herpes simplex, HIV
Bacterial- TB
Trauma
Cancer
Post MI- Dresslers syndrome- 2-3 weeks after an MI, the immune system starts attacking the hearts pericardium.

Question 5

Signs of pericarditis

Answer 5

Elevated JVP
Possible murmurs
Distant heart sounds

Question 6

Dilated cardiomyopathy symptoms

Answer 6

Heart failure esc symptoms- oedema, SOB, fatigue, chest pain, syncope (possibly in extreme cases)

Question 7

Hypertrophic cardiomopathy symptoms

Answer 7

Intermittent- patient may be asymptomatic or have symptoms. When symptoms show they include:
SOB
Fainting
Can cause sudden death

Question 8

Signs of hypertrophic cardiomyopathy

Answer 8

Systolic ejection murmur- valsalva manouvre will accentuate it because it briefly decreases flow back to the heart and therefore the heart chambers constrict and the obstruction worsens, therefore accentuating the murmur.

Question 9

Restrictive cardiomyopathy symptoms

Answer 9

Decreased filling may cause syncope
odema
SOB
weakness and fatigue

Question 10

Treatment of hypertrophic cardiomyopathy

Answer 10

Septal reduction

Beta blockers or calcium channel blockers

Question 11

Treatment of restrictive cardiomyopathy and dilated cardiomyopathy

Answer 11

Diuretics, ACE inhibitors/ARB and lifestyle changes to decrease fluid.
Possible pacemaker insertion
Beta blockers/ calcium channel blockers in dilated cardiomyopathy.
Digoxin

Question 12

Symptoms in severe cases of acute pancreatitis

Answer 12

Tachycardia
Hypotension
Grey Turners sign
Cullens sign

Question 13

Blood tests for acute pancreatitis

Answer 13

SERUM AMYLASE #1

Urinary amylase

Question 14

Pathogenesis of chronic pancreatitis

Answer 14

Excess alcohol. Causes premature activation of trypsinogen to trypsin. This leads to protein depositation in the pancreatic duct forming plugs. These may obstruct the duct- lead to pancreatic hypertension and increased intracellular conc of calcium.

Question 15

Tests for chronic pancreatitis

Answer 15

Serum amylase- may be ok in chronic

Faecal elastase! raised.

Question 16

Treatment for chronic pancreatitis

Answer 16

NSAIDs and opiates to manage abdominal pain

Question 17

Causes of chronic pancreatitis

Answer 17

Alcohol or autoimmune chronic pancreatitis. Defect in the IgG4, causing increase in serum. Causes dense lymphoplasthytic infiltrates. Responds to steroids.

Question 18

Cholelithasis

Answer 18

Gallstones

Two types- cholesterol or pigment stones

Question 19

How are cholesterol stones formed?

Answer 19

Difference in ratio of cholesterol to bile salts.

Question 20

How are pigment gall stones formed?

Answer 20

Too much bile can’t all be formed into bile salts.

Question 21

Risk factors for developing gall stones

Answer 21

Obesity
Too much cholesterol
Diabetes
Female
Genetic

Question 22

Cholecystitis

Answer 22

Inflammation of the bile duct due to impaction of gall stones.
Acute- gall stone obstructing ampulla of Vater.
Chronic- Gall bladder wall becomes thickened (associated with gall stones)

Question 23

Symptoms of cholecystitis

Answer 23

Acute
Epigastric pain
Jaundice
May develop peritonitis if it becomes infected