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10 Cards in this Set

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Woman comes in and is hypotensive, and was given 3 liters of normal saline and had some improvement. What was the problem
she was hypovolemic
On an EKG, it showed she has pericardial effusion.. which means.

What does it result from/
fluid accumulation in the lungs

Can occur due to bacterial disease. she's found to be positive for influenza A.
Echo showed cardiac tamponade. it was serosanguinous, which means?
Tamponade- percardial sac is filled with fluid.
Serosanguinous - contains blood.
The blood cultures were negative, viral culture of pericardial fluid were neg, urine and catheter cultures were also negative.

What does this indicate?
This means that any antibiotics given may have treated the infections such that the levels are now low enough to show negative cultures.
This pt then has a asystole code due to bradycardia and pulseless electircal activity. What does this mean?
peripherally, the blood isn't moving but there is still some electrical activity.

Heart cells are functioning.
This pt suddenly has worsening ventilation, acidemia, and inability to restore a stable rhythm. she was pronounced dead.

why?
Not sure, we need to do an autopsy
Heart shows petechial and confluent hemorrhage. What does this result from?
there could be some degeneration of the mitral valves.
Slides of the cross section of heart shows lots of white space. what is this?

There are also lots of small little round circles. what are these?

What does this indicate about the diagnosis?
fluid builds up between cells - edema.

small littel round circles = infiltrates. infiltrates eat up the cardiac cells (some of them) but there is still electrical activity. Most of these are lymphocytes.

lymphocytes eating up myocytes indicates myocarditis.
What could the myocarditis be a result of?
hemodynamic and septic complications following influenza A viremia.

-can be due to direct (polio) or induced viral infection (predispositions, auto-immune like triggers)
what is the mechanism of action for influenza A virus?
induce trypsins, particularly trypsin 2 in the myocardium trigger acute viral myocarditis through stimulation of IAV replication.