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36 Cards in this Set
- Front
- Back
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What diseases can affect the pericardium and its functions?
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-Pericarditis
-Pericardial Effusion -Tamponade -Constrictive pericarditis |
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What is pericarditis?
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acute or chronic inflammation of the visceral and parietal pericardium
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What are some causes of pericarditis?
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-infections
-non-infections |
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Whar are the classic findings of pericarditis?
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-feve
-tachycardia -pericardial friction rub |
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What does the intitial evalutaion consist of for pericarditis?
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-hx
-physical exam -EKG |
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What does the EKG often show in pericarditis?
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-ST segment elevation in most leads
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What is pericarditis often associated with?
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-leukocytosis
-elevated sedimentation rate |
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What should be obtained in the presence of suspected pericardial disease?
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Echo
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What are the goals of treatment with pericarditis?
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-relief of symptoms
-treat underlying cause |
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What is usually the treatment for pericarditis?
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-NSAIDS
-bed rest |
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What is pericardial effusion?
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fluid collection between the visceral and pariety layers of the pericardium
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What is cardiac tamponade?
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compression of the heart that occurs when blood or fluid builds up in the space between the mycardium and the pericardium
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What is the most common cause of tamponade
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-Malignancy
then: -Metabolic disorders -renal failure myxedema |
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Clinical manifestations of pericardial effusion?
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-SOB
-CP -Pressure -discomfort -light-headedness -syncope -palpitations -cough -dyspnea -hoarseness -anxiety -confusion |
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What is Beck's triad of tamponade?
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-Hypotension
-JVD -dimished heart sounds |
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What is seen in 75% of cases of tamponade?
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pulsus paradoxus
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What is heard in some tamponade patients that is best heard in the supine position, at the end of exhalation, and with diaphragm?
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pericardial friction rub
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What does CXR show for tamponade/
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-globular/water bottle heart
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WHat test for tamponade?
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TTE
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What are things seen on TEE for tamponade?
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-right atrial compression
-RV diastolic collapse |
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In tamponade, what is all equal?
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-RA, RV, and LV end-diastolic pressures
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What does treatment of peridardial effusion depend on?
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presence or absence of cardiac tamponade
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What requires urgent drainage in pericardial effusion?
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-cyanosis
-shock -change in mental status |
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When is pericardial drainage done for effusion?
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-tamponade
-purulent effusion |
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What is constrictive pericarditis?
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inflammation of pericardium iwth subsequent thickening, scarring, and contracture of pericardium
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What does diagnosis of constrictive pericarditis require?
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evidence of systemic venous congestion without myocardial dysfunction or other cause of congestion
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What are the most common causes of constrictive pericarditis?
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-TB
-radiation to the chest -cardiac surgery |
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What are the clinical manifestations of constrictive pericarditis?
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-atypical or typical CP
-cheast heaviness or pressure -fatigue -peripheral edema -DOE |
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What are some common findings in constrictive pericarditis?
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-pulses paradoxus
-JVD -tachycardia -tachypnea -hepatomegaly -ascites -peripheral edema -pleural effusion -pericardial friction rub |
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How is the diagnosis of constictive pericarditis made?
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-CXR
-EKG -atrial arrhythmias -AFib -Echo -CT -MRI |
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In tamponade, what is all equal?
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-RA, RV, and LV end-diastolic pressures
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What does treatment of peridardial effusion depend on?
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presence or absence of cardiac tamponade
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What requires urgent drainage in pericardial effusion?
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-cyanosis
-shock -change in mental status |
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When is pericardial drainage done for effusion?
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-tamponade
-purulent effusion |
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What is the treatment for constrictive pericarditis?
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-supportive
-steriods -NSAIDS -antibiotics if needed |
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What is the most effective therapy ofr effusive-constrictive pericarditis?
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pericardiectomy with complete removal of the parietal and visceral membranes
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