Test 2

Question 1

What is infective endocarditis?

Answer 1

an infection of the endocarditis the most inner layer of the heart this includes the valves

Question 2

What valves does infective endocarditis usually affect?

Answer 2

Aortic and mitral

Question 3

What are the classifications for endocarditis 3

and two more ways to classify

Answer 3

IV drug use, Fungal, or at site

Acute and subacute

Question 4

What bacteria are responsible for IE and how do they work

Answer 4

Strep viridans, and staph aureus

make a biofilm that protects them

Question 5

What are the risk factors for IE 9

Answer 5

Heart damage, marfan syndrome, pacemaker, prostethtic vavles, mitral valve regurg, rheumatic heart disease, dialysis, IV use, age

Question 6

What are vegetations and what disease are they associated with and one concern

Answer 6

fibrin, leukocytes, platelets, microbes IE can cause embolism

Question 7

What can IE cause 2. to remember

Answer 7

sepsis and heart block

Question 8

Manifestations with IE general with 3 things

Answer 8

General dont feel well low grade fever is the biggest

systolic murmur

Question 9

Subacute form of IE s/s 8

Answer 9

arthalagias and myo back pain ab discomfprt weight loss HA clubing fingers

Question 10

Vascular manifestations with IE 5

Answer 10

Splinter hem, petechiae, osler nodes-PAINFUL raised legions on hands and feet, janeways roth spots

Question 11

What to look for in hx for patient with IE and what is the time frame 6

Answer 11

3-6 months

IV stuff, dental work, downstairs procedures, recent cath lab, infections of skin resp or urinary, dialysis

Question 12

Diagnositics for IE 8

Answer 12

Keep neg cultures for 3 weeks transesoph echo to see veg, EKG for av block, cath for valve function, reg echo. mild leukocytes, erythrocyte sedementaiton and crp increased

Question 13

criteria for IE diagnosis

Answer 13

2 of the following, positive culture, new or changed murmur, mass or vegetationon echo

Question 14

tx for IE

Answer 14

antibiotics for 4-6 weeks IV antibiotics

heart compensation people need to prophylactically tx with any incision, infection, uti

Question 15

What causes acute pericarditis?
Examples for infection-
non infection
autoimmune

Answer 15

infections (limes) noninfection- radition trauma autoimmune- rheumatic fever, rhem arth, systemic lupus, sclerosis

Question 16

Acute pericarditis s/s 6

Answer 16

severe sharp chest pain- worse when laying down or with inspiration relieved by sitting up and forward 
pericardial friction rub
angina like pain
dyspnea
fever
anxiety

Question 17

Complications of pericarditis with examples

Answer 17

effusion-couch, tachy hickups

cardiac tamp-confused, anxious, becks (Low art BP, DNV, muffled heart sounds)

Question 18

Diagnostics for Acute pericarditis 5

Answer 18

WIde spread ST elevation or depression, cardiomegaly, increase crp, esr and leukocytosis

Question 19

Tx for acute pericarditis

Answer 19

Antibiotics pericardial centesis

Question 20

Rheumatic fever and rheumatic disease

Answer 20

inflam disease from abnormal immune response to group A strep after about 3 weeks affects skin, joints, cns

chronic scaring and deformity of heart valves vegetations

Question 21

Manifestations of rhematic fever 7

Answer 21

Erythemia marg, arthritis, carditis, subcut nodules, sydenhams chorea, increase in esr and cpr prolonged PR,

Question 22

What is the most common thing that rheumatic fever will lead to

Answer 22

mitral valve stenosis or other valve disease

Question 23

2 things about RF

Answer 23

Antibiotics for 5 yrs maybe life and assess for pulmonary edema and clear lung sounds

Question 24

patho of MV regurg and major risk

Answer 24

LV thickens, LA enlarges, blood backs up to lungs, makes heart work harder,
cardiogenic shock

Question 25

S/s of pulmonary edema

Answer 25

Cool, clammy, pink frothy speutum, s3

Question 26

s/s of mitral valve regurg 6

Answer 26

Thready weak pulse, new holostolic murmur, signs of left vent fail, and peripheral edema, PVC, nitro dosent work

Question 27

Tx of mitral valve regurg

Answer 27

valve repair

Question 28

Marfins syndrome risk for

Answer 28

IE and mitral valve prolapse

Question 29

TX for mitral valve stuff

Answer 29

Beta blockers, keep hydrated, exercise, avoid caffeine or stimulants, if symptomatic-valve surg

Question 30

Aortic valve stenosis and adults vs kids

Answer 30

Generally found in kids. If found in adults it is due to deterioration or RF ( if associated with mitral valve)

Question 31

Complications of aortic valve stenosis

Answer 31

dec co, pulm hypertn, heart fail

Question 32

Symptoms of aortic valve stenosis and one thing to remember

Answer 32

(SAD) Angian, syncope, exertional dyspnea, soft systolic murmur Dont use nitroglycerin

Question 33

Aortic Valve regurg caused by

Answer 33

Syphalyis, connective tissue disorder, post surg

Question 34

Manifestations 1 acute | and 3 others aortic regerg

Answer 34

Sudden vascular colapse hammer pulse soft or absent s1 diastolic murmur

Question 35

TAVR vs TMVR

Answer 35

TAVR- with cath lab and or | TMVR for those who cant have surg and have a long expected life

Question 36

How do we treat heart fail 3 drugs you really need to know

Answer 36

vasodilators, positive intropes, adrenergic blockers, diuretics, low sodium diet

Question 37

how do we measure if someone should get a replacement or a repair?

Answer 37

New YOrk assosiation calssification for functional disability

Question 38

Acid base numbers

Answer 38

``` Ph 7.35-7.45 Paco2-35-45 Pa02- 80-100 HCO3-22-26 spo2 above 95 ```

Question 39

s/s of respiratory acidosis 7

Answer 39

skin pale, HA, Hyperk, Dysr, drowsiness, mm weaknees, hyperreflexia

Question 40

s/s of repiratiory alk 9

Answer 40

tachy, low to normal bp, hypok, numbness and tingling, hyper reflexes, mm cramping, seixures, anxiety, tremmors,

Question 41

MEtabolic acidosis 8

Answer 41

HA, hyper k, mm twitching, warm flushed skin, NV, decreased mm tone, decreased reflexes, kussumal

Question 42

Metabolic acidosis s/s 9

Answer 42

confusion, dysr, dizzy, n/v/d/ seixures, tremors, mm cramps, tingling, decreased ca

Question 43

Cardiogenic shock diastolic vs systolic

Answer 43

d-heart cant fill s-heart cant pump

Question 44

What is the most common cause of a systolic cardio shock what are the others? 5

Answer 44

MI cardiomyopathy, blunt cardiac injury, systemic or pulmonic HTN =, medibolic problems like diabetes

Question 45

Patho behind diastolic cardioshock

Answer 45

increase pulm pressure increase edema decrease o2

Question 46

causes of diastolic cardio shock 6

Answer 46

cardiac tamp, vent hypertrophy, cardiomyopathy, brady or tachy, valve issues tension pneumo

Question 47

what are the stages of shock give examples in each

Answer 47

initial- no signs lactic acid , compensatory signs, decrease in bp blood shunts , progressive-changes in mental status edema, organs start to fail , refractory organs fail

Question 48

some risks you did not know about pulmonary emboli2

Answer 48

Oral contraceptives, hormone therapy

Question 49

s/s of PE 3

Answer 49

Cough, crackles, wheezing, fever,

Question 50

complications from PE 2

Answer 50

Abcess, pleural effusion,

Question 51

Best test for PE

Answer 51

CT

Question 52

What is the movement with fillet chest?

Answer 52

Paradoxical

Question 53

What is a spontaneous pneumo

Answer 53

Rupture of blebs on surfece of lungs- little air sacs

Question 54

What is a tension pneumo and one thing about it

Answer 54

air can get in but not out | EMERGENCY

Question 55

Where does a chest tube go in?

Answer 55

4th or 5th space anterior to midaxil

Question 56

how is tube secured in chest tube

Answer 56

Heavy no absorbant sutur

Question 57

What to wrap chest tube in

Answer 57

petrolium gauze and sponge gauze

Question 58

What is suction on for chest tube?

Answer 58

80

Question 59

Submurge in how much water for chest tube

Answer 59

250ml

Question 60

Aortic an measurement for surg

Answer 60

5.5 or bigger

Question 61

s/s for AA 6

Answer 61

Low back pain, mild heart fail, dyspnea, edema, blue areas, bruit

Question 62

What is the best diagnostic for AA

Answer 62

CT scan

Question 63

EVAR proceedure

Answer 63

For AA shorter hospital stay, graft, must have ct rest of life

Question 64

What is cardiomyopathy 3 types

Answer 64

disease that affects myocardial structure or finction dilation, hypertrophic, restrictive

Question 65

Dilatercardiomyop and biomarkers

Answer 65

consistant with heart fail but cath lab rules it out

Question 66

7 things about cardiomyopathy dilations

Answer 66

follows IE, maybe autoimmune, inflammation and deterioration of mm fibers=vent dilation, blood stasis causes megaly and contractile dysfunction but no hypertrophy in walls

Question 67

S/s od dilated cardiomyop

Answer 67

dry cough, palp, ab bloating, abnormal s1 or s4

Question 68

5 about cardiomyopathy and hypertorpic

Answer 68

LV hypertrophy without dilation, septum inbeteween vents can enlarge and block blood flow happens in young healthy people use echo

Question 69

restirictive cardiomyopathy 3

Answer 69

impairs filling and stretch, stiff walls, can cause pulm issues including effusion

Question 70

What is something to teach someone with cardiomyop 2

Answer 70

CPR for family members, no drinking