Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular > Valve Disease, Endo + Pericarditis, Pericardial Effusion > Flashcards

Valve Disease, Endo + Pericarditis, Pericardial Effusion Flashcards

1
Q

Symptoms + signs of aortic stenosis

A 
SOB on exertion 
Angina 
Dizziness + syncope 
HF
Gallavardin's phenomenon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Aortic stenosis murmur

A

Disappearance of 2nd aortic sound

Crescendo-decrescendo systolic ejection murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

S+S endocarditis

A

Fever, chills, poor appetite + weight loss
Polymyalgia, heart murmurs
Fatigue, flu-like illness
Anorexia, back pain, pleuritic pain, abdo symptoms
CVA, PE or splenic emboli (any stroke with fever = IE)
Congestive HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the order that valves tend to become affected in endocarditis?

A

Mitral
Aortic
Tricuspid
Pulmonary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Management of endocarditis

A

IV Amoxicillin + gentamicin
Oral (if IVDU) cipro, linezolid or rifampicin
Surgery if HF present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management of macrocytic anaemia

A

B12 then folate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of mitral stenosis

A 
Rheumatic disease (most common) endo/myo/pericarditis 
Calcium build up
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Symptoms mitral stenosis

A

SOB on exertion + when lying flat
Malar flush
Decreased exercise tolerance
Haemopytsis, chest pain, fatigue + ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mitral stenosis murmur

A

Loud 1st heart sound
Normal 2nd heart sound
Opening snap after 2nd heart sound
low pitched murmur

^^Diastolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Management of mitral stenosis

A

Antiplatelets
Surgery if symptomatic
Rheumatic MS should get abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of mitral regurgitation (+ which is most common)

A

Degenerative changes, coronary artery disease , LV dysfunction, rheumatic heart disease, infective endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Symptoms + signs of mitral regurgitation

A

Pulmonary oedema
Exertional SOB + fatigue
AF
Brisk pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mitral regurgitation murmur

A

Pansystolic murmur at apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Investigation + management of mitral regurgitation

A

Echo
Surgery
Nitrates, diuretics, ACE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the criteria for diagnosing pericarditis?

A 
2 of the following:
Pericardic chest pain (sharp, pleuritic, relieved by sitting up)
Widespread ST elevations
Pericardial effusion
Pericardial rubs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Management of pericarditis

A

Restriction of exercise
Colchicine, aspirin or ibuprofen
Continue until CRP is normalised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Causes of pericarditis

A

Viral (coxsackie), bacterial, MI, Dressler’s, drugs, uraemia, SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

S+S pericarditis

A

Central chest pain relieved by sitting forward - can be pleuritic
Worse on inspiration or lying flat
Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Investigations for pericarditis

A

ECG - PR depression, saddle shaped ST elevationCXR, echo (increased cardiothoracic ratio with globular or flask shaped outline)
Echo
CXR
Bloods

20
Q

Pathology of mitral regurg

A

LV has excessive volume load leading to compensatory adjustments (eventually leading to HF) causing enlargement + stress of LV

21
Q

Pathology of mitral stenosis

A

Stenosis of vale leads to obstruction in blood flow from LA to LV.
Leads to increase in pressure in LA then pulmonary vessels then right heart

22
Q

What precipitates symptoms in mitral stenosis?

A

Anything that increases cardiac output:

Exertion, stress, fever, pulmonary infection, AF, pregnancy

23
Q

Causes of aortic regurg

A

Congenital causes (bicuspid valve), rheumatic disease, infective endocarditis, degenerative disease

24
Q

RF for aortic regurg

A

SLE, Marfans + Ehlers-Danlos + Turners
Behcet’s disease
Aortic dissection

25
Q

Signs + murmur of aortic regurg

A

Exaggerated pulse (Waterhammer)
Diastolic murmur in aortic area, best heard with pt sat forward + on expiration
Low diastolic pressure (wide pulse pressure)

26
Q

Investigations + management of aortic regurg

A

Echo
Cardiac catheterisation + surgical intervention for symptomatic pts (valve replacement)
Vasodilators + inotropic agents can be used short term before surgery if HF is present

27
Q

Aortic stenosis pathology

A

Obstruction of blood flow across aortic valve

Progressive disease that presents after a long subclinical period

28
Q

RF for aortic stenosis

A

Age >60
Congenitally bicuspid aortic valve
Rheumatic heart disease
CKD

29
Q

Investigations + management of aortic stenosis

A

Echo + ECG
Cardiac catheterisation
Transcatheter aortic valve implantation (TAVI) or aortic valve replacement
Diuretics + ACEi for HTN

30
Q

RF for endocarditis

A 
Valvular heart disease + replacement 
Congenital heart disease 
Previous IE 
Hypertrophic cardiomyopathy
Recreational drug use 
Invasive vascular procedures
31
Q

Pathology of endocarditis

A

Non bacterial thrombotic endocarditis as pre-requisite for adhesion + invasion
Site of thrombus is influenced by Venturi effect (will be on the low pressure side)

32
Q

Organisms causing endocarditis

A 
Staph aureus (most common - related to prosthetic valves _ drug abuse) 
Strep (viridans, D, intermedius, A, B, C + G)
Pseudomonas aeruginosa
33
Q

When is atypical presentation of endocarditis common?

A

In elderly, after abx, in immunocompromised pt or IE with atypical organisms

34
Q

What is the most common murmur with IE?

A

Aortic regurg

35
Q

Signs on examination in endocarditis

A 
Petechiae in conjunctivae, hands + feet, chest + abdo wall + mucosa 
Splinter hemorrhages 
Osler's nodes 
Clubbing 
Roth's spots 
Janeway's lesions 
Splenomegaly 
Meningitis
36
Q

When should IE be suspected?

A 
Febrile illness AND:
New regurg murmur 
Pre-existing RF 
Congestive HF 
Vascular or immunological phenomena 
New stroke 
Peripheral abscesses 
Any new embolic event 
Unexplained blood cultures
37
Q

Investigations for ?IE

A

CXR, ECG, bloods
Blood cultures
Echo (TTE)
Serology testing for bacteria

38
Q

What diagnostic criteria is used for IE?

A

Duke’s criteria - 2 majors, 1 major + 3 minor or 5 minor

39
Q

What are the major criteria for IE?

A

2 separate positive blood cultures for IE

Evidence of endocardial involvement (+ve echo)

40
Q

What are the minor criteria for IE?

A 
Predisposition 
Fever >38
Vascular phenomena 
Immunological phenomena 
Microbiological phenomen 
PCR
41
Q

What are the vascular phenomena with IE?

A

Major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial haemorrhage, conjunctival haemorrhages and Janeway’s lesions

42
Q

What are the immunological phenomena with IE?

A

Glomerulonephritis, Osler’s nodes, Roth’s spots and rheumatoid factor

43
Q

Complications of IE

A 
MI, pericarditis, cardiac arrhythmias 
HF, valve insufficiency 
Arterial emboli 
Stroke syndromes 
AKI
44
Q

Pathology of pericardial effusion

A

Can develop in any condition which affects the pericardium inc pericarditis

45
Q

Investigations for ?pericardial effusion

A

ECG, CXR, echo (diagnostic)

46
Q

Management of pericardial effusion

A

Tx for underlying disease
Pericardial fluid drainage if there is significant hemodynamic compromise - use echo to guide pericardiocentesis + leave catheter in place for 24 hrs
If not, serial echos every 5 days

Cardiovascular (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions