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36 Cards in this Set
- Front
- Back
ventricular septal defect:
etiology flow cyanotic? complications |
-failure of septal closure btw the ventricles
- lt->rt - acyanotic -death from rt-sided failure and endocarditis |
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ductus arteriosis:
location becomes failure to close becomes flow cyanotic? complications |
-btw aorta and pulmonary trunk
-ligamentum arteriosum -patent ductus arteriosis - lt->rt -acyanotic - rt-sided failure, endocarditis |
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dextroposition of aorta (3)
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-cyanotic heart disease
-shunt goes rt->lt -unoxogenated blood enters aorta |
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transposition of major vessels (2)
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-aorta comes out of rt ventricle, pulmonary arteries out of lt.
-incompatible w/ life |
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cyanotic heart defects that are compatible w/ life (2)
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-tetralogy of fallot
-eisenmenger's complex |
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tetralogy of fallot (4)
consequences (2) |
1) Pulmonary valve narrows (stenosis)
2) ventricular septal defect 3) dextroposed aorta, or aorta positioned directly over the septal defect 4) right ventricular hypertrophy (enlargement of myocardium) - rt-sided failure, endocarditis -> death |
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eisenmenger complex (3)
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1) ventricular septal defect
2) dextraposed aorta 3) rt ventricular hypertrophy (-like the Tet. of Fallot, but no pulmonary stenosis) |
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coarctation
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-constriction (of vessel or valve)
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stenosis
usually involves in these cases flow is consequences |
-constriction of heart valve
-arotic, mitral valves - left-sided failure |
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what types of stenosis lead to right-sided failure (2)
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-pulmonary
-bicuspid |
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Arteriosclerosis:
def sub categories (3) |
-"hardening of the arteries"
1) atherosclerosis (synonym) 2) Monckeber's calcific sclerosis 3) arteriolosclerosis |
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Monckeberg's calcific sclerosis:
etiol population |
-calcification of tunica media in bv's (bone can even form)
-however, lumen is NOT narrowed (:. blood flow is NOT impeded) - >50yo |
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arteriolosclerosis (5)
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-as'ed w/ diabetes (and as'ed w/ duration of disease and bp)
-hyaline thickening in the arterioles -lumen narrowed -contributes to htn |
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continue pg 7-19
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kkkk
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(ventricular) hypertrophy is a consequence of
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-increased work load
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talking points w/ patients regarding NOT getting prophylactic antibiotic therapy
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-bacteremia is higher w/ pts daily activities (eg. brushing, flossing)
-risk of adverse events exceeds benefits (eg. penicillin allergies) |
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when do we write prescription for antibiotics
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-w/ signs of swelling, inflammation, and pain
-pain alone is NOT enough to indicate infection |
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major changes in 2007
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-decided that extremely few IEs are avoided w/ prophylaxis
-bacteremia from daily activites more likely to cause IE than those as'ed w/ dental procedure -not recommended for GU or GI track -not recommended for body piercing, tattooing, vaginal delivery, hysterectomy -IS recommended for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of oral mucosa, only for pts in the high risk category -prophylaxis can be given 60-30min before procedure |
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"sticky" bacteria (?)
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-strep mutans
-strep viridans b/c of biofilm |
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steps of pathogenesis of IE (4)
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-formation of nonbacterial thrombotic plaque on valve or surface
-bacteremia -adherence of bact on plaque -proliferation of bact |
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what organisms does penicillin NOT get
what antibiotic would you prescribe instead |
-staph
-cephalexin (4x500mg 30-60min before appt) |
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prophylaxis Not recommended (exceptions)
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-injections through noninfected tissue
-radiographs -placement of removable appliances -placement/adjust of ortho _______ - |
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prophylaxis gray zone
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-biopsies
-suture removal -placement of ortho bands |
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for pts already on antibiotics ________ (2)
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-use drug from diff class
-delay procedure 10 days |
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if the antibiotics is inadvertently not administered befor the procedure
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-dosage may be given up to 2 hours after the procedure
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nonsuppurative necrotizing angiitides (angiitis):
def of angiitis characterized by (2) types (4) |
inflammation of bv (arteritis, phlebitis) or lymph vessel
-fibrinoid necrosis in muscular arteries, small arteries, and arterioles -involve kidneys, and maybe other organs 1) systemic lupus erythematosis (SLE) 2) polyarteritis nodosa (PN) 3) Wegener's granulomatosis 4) leukocytoclastic angiitis |
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Wegener's granulomatosis
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-type of non-spurr. nec ang.
-has lesions in lungs, upper respiratory, and kidneys -Antineutrophil cytoplasmic antibodies (ANCA) are detected in serum |
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In SLE, the ____ and ____ are frequently affected (as well as the kidneys)
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(systemic lupus erythematosis)
-heart -skin |
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PN lesion locales (6)
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(polyarteritis nodosa)
-GI, liver, lungs, muscle, heart, (kidneys) |
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leukocytoclastic angiitis:
def S&S sites of lesions (2) complications (2) |
-leukocytes w/ nuclear fragmentation infiltrate vascular walls
-skin purpura. Mucous membranes also affected -lung, kidney -hemoptysis, hematuria |
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atherosclerosis:
characterized by |
-atheromas. focal fibrofatty plaques and thickenings w/in the intima (or inner portion of tunica media of larger vessels and heart)
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artherosclerosis:
risk factors (6) |
-DIET!!
-htn, smoking, no exercise, stress, genetics |
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how are artherosclerosis and htn related
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-atherosclerosis does NOT cause htn, but it does add to it
-probably by accelerating the passage of lipids into the vessel wall |
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how are artherosclerosis and smoking related
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-smoking promotes vasospasm -> endothelial cell damage -> accelerate artherosclerosis
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most important factor in genesis of atherosclerosis
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-level of lipoprotein cholesterol (a fat) in blood
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start 7-22
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grrr
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