Week 6 Flashcards
What does the presence of a parasternal heave indicate?
Right ventricular overload
During the first heart sound, what valves close?
Mitral and tricuspid
What does the 2nd heart sound indicate?
Aortic and pulmonary valves closing
A patient’s murmur radiates to the carotids. What type of valvular issue do they have?
Aortic stenosis
A patient’s murmur radiates to the axilla. What type of valvular disease do they have?
Mitral regurgitation
What is the congenital cause of aortic stenosis?
Bicuspid valve
What type of pulse would you find on a patient with aortic stenosis?
Low volume
What is a TAVI?
Transcatheter Aortic Valve Implantation
What is the pharmalogical treatment for a person with mitral regurgitation?
Diuretics and heart failure medication
What are some of the signs of mitral stenosis?
Malar flush
Tapping apex
Mid diastolic rumbling
Diastolic murmur localised to apex
What could you see on the X-ray of a patient with mitral stenosis?
Straight left heart border
If a patient has a collapsing pulse, what heart murmur does this indicate that they have?
Aortic regurgitation
An early diastolic murmur found on the left sternal edge is a sign of what murmur?
Aortic regurgitation
What medication should be given to a patient with aortic regurgitation?
ACE-i
What antibody is transported across the placenta to the foetus?
IgG
What are the 3 shunts found in a foetus?
Ductus venosus
Foramen ovale
Ductus arteriosus
What does the Ductus venosus do?
Connects the umbilical vein to the inferior vena cava
What does the Ductus arteriosus do?
Connects pulmonary bifurcation to the descending aorta
What is the treatment for patent ductus arteriosus?
Waiting
NSAIDS
Surgery
What drug can be used to keep the ductus arteriosus open until an alternative shunt can be established or surgery?
IV prostalandin E2
What colour is the bottom of a positive blood culture bottle?
yellow/brown
What colour is the bottom of a negative culture bottle?
Purple
What is infective endocarditis an infection of?
The endothelium of the heart valves
Dental treatment increases the risk of what infection?
Infective endocarditis
What is the most common bacteria causing endocarditis?
Staphylococcus aureus
What are rose spots a sign of?
Typhoid
What are roth spots a sign of?
Endocarditis
What are Janeway lesions and Olser nodes a sign of?
Endocarditis
How many sets of bloods should be taken when diagnosing endocarditis?
3
What type of bacteria are associated with prosthetic valve endocarditis?
Staphylococcus epidermidis
Staphylococcus aureus
What is the treatment for a patient who has prosthetic valve endocarditis?
Vancomycin
Gentamicin
Rifampicin
What bacteria usually causes right sided endocarditis?
Staphylococcus aureus
What is the empirical treatment for native valve bacterial endocarditis?
Amoxicillin and gentamicin
What is the empirical treatment for prosthetic valve endocarditis?
Vancomycin
Gentamicin
at 3-5 days add in oral rifampicin
What is the treatment for drug user endocarditis?
Flucloxacillin
What is the treatment for staphylococcus aureus endocarditis?
FLUCLOXACILLIN
What is the treatment for Viridans streptococci?
Benzylpenicillin and gentamicin
What is the treatment for enterococcus endocarditis?
Amoxicillin/vancomycin and gentamicin
What is the treatment for staphylococcus epidermidis?
Vancomycin IV
Gentamicin IV
Rifampicin (oral)
How is endocarditis treatment monitored?
Cardiac function
Temp
CRP
What infection of the heart is more common in younger people and a cause of sudden death?
Myocarditis
What usually causes myocarditis?
Enteroviruses e.g. coxsackie A and B, echovirus etc
How is myocarditis usually diagnosed?
Viral PCR
Throat swab and stool swab
What does pericarditis often occur with?
Myocarditis
What is the most common cause of pericarditis? Viral or bacterial?
Viral
What is Brugada syndrome?
Affects the way that electrical signals pass through the heart
ST elevation and AF common
ST elevation and RBBB in V1-V3
VF triggers at rest, fever, excess alcohol
