Im Cv Carditis Usmle 2

Front 1

Most common infectious cause of Myocarditis

Back 1

Coxsackie B

Front 2

(4) systemic diseases that causes Myocarditis

Back 2

KISS:
- Kawasaki's
- Inflammatory conditions
- SLE
- Sarcoidosis

Hint 2

KISS

Front 3

(4) Parasites that cause Myocarditis

Back 3

Trypanosoma Cruzi (Chagas);
Toxoplasmosis;
Trichinella;
Echinococcus

Front 4

(5) Bacterial causes of Myocarditis

Back 4

women Trick Corny Men to Strip and Lie down:

Group A beta-hemolytic Strep (rheumatic fever);
Corynebacterium;
Meningococcus;
Lyme (B. burgdorferi);
Trichinella

Hint 4

women TRICk CORny MEN to STRiP and LY down

Front 5

(8) viral causes of myocarditis

Back 5

Coxsackie A or B;
HIV;
Echovirus;
EBV:
CMV;
HBV;
Influenza;
Adenovirus

Hint 5

In CHEEch And CHong

Front 6

(3) drugs that cause pericarditis

Back 6

It Hurts Pericardium:

Isoniazid;
Hydralazine;
Procainamide

Hint 6

It Hurts Pericardium

Front 7

Etiology of Pericarditis (5)

Back 7

Bacterial, viral or fungal infections;
Post-MI (Dressler's);
Uremia;
Serositis from: RA or SLE
Scleroderma;

Hint 7

Bacterial PUSS

Front 8

Tx for pericarditis if:
- infection
- pain/inflammation
- Dressler's
- Recurrent cases

Back 8

Infection - Abx;

Relieve pain + reduce inflammation - NSAIDs;

Dressler's - Steroids;

Recurrent Cases - Pericardectomy
(only of recurrent cases)

Front 9

Dx:
Transient fall in BP > 10 mmHg during inspiration

Back 9

Pulsus Paradoxus

Front 10

Dx:
Physiologic result of rapid accumulation of fluid in the pericardial sac; impairs cardiac filling and reduces cardiac output

Back 10

Pericardial Tamponade

Front 11

Etiology of Pericardial Tamponade (3)

Back 11

- Aortic dissection or ventricular rupture into pericardium
- Pericarditis
- Trauma

Hint 11

A PT

Front 12

Beck's triad of the pericardial tamponade

(4) other signs/Sx

Back 12

Beck's triad:
- JVD
- Muffled heart sounds
- Hypotension

Other Sx:
Tachycardia
Pulsus Paradoxus*;
Dyspnea;
Narrow Pulse Pressure

Front 13

Tx for Pericardial Tamponade for:
1. unstable
2. stable
3. both

Back 13

Unstable:
Immediate Pericardiocentesis;

Stable:
Pericardial window

Both:
Infuse fluids to expand volume

Front 14

Failure of venous pressure to fall during inspiration

Back 14

Kussmaul's sign

Front 15

If pericardiocentesis has clots, what is likely source of blood?

Back 15

Right Ventricle

Front 16

Dx:
Patient has chest pain w/ inspiration that radiates to the left trapezial ridge; Pain is relieved by sitting up and leaning forward; does not respond to nitroglycerine

Back 16

Pericarditis

Front 17

additional signs/Sx for Constrictive pericarditis (versus pericarditis)
(4)

Back 17

Extra fluid:

- JVD
- Kussmaul's sign
- peripheral edema
- LV failure

Front 18

When a patient has VHD or previous endocarditis, what (3) procedure types must they obtain endocarditis prophylaxis medications?

Back 18

Dental procedures
Urologic procedures
GI procedures

Front 19

Dx:
acute onset of fever, chills and rigors; new cardiac murmur, possible associated meningitis or pneumonia

Back 19

Acute Bacterial Endocarditis (ABE)

Front 20

Infection of healthy heart valves by high-virulence organisms

MCC?

Px if not treated?

Back 20

ABE

S. Aureus

Px:
fatal if not Tx w/i 6 weeks

Front 21

Dx:
seeding of previously damaged heart valves by rheumatic fever, mitral prolapse, etc by low-virulence organisms

MCC?
What valve is affected the most?

Back 21

Subacute Bacterial Endocarditis

Strep Viridans

Mitral valve

Front 22

What valve is most commonly affected w/ IV drug users?

What bug?

Back 22

Tricuspid

S. Aureus

Front 23

what endocarditis bug is associated w/ colonic neoplasms?

Back 23

Strep Bovis

Front 24

Dx:
gradual onset of fever, sweats, weakness, anorexia, new murmur, splenomegaly, Osler's nodes, splinter hemorrhages, Janeway lesions, Roth spots

Back 24

Subacute Bacterial Endocarditis (SBE)

Front 25

Name sign:
Tender violaceous subcutaneous nodules on fingers & toes

Back 25

Osler's nodes (SBE)

Front 26

Name sign:
fine linear hemorrhages in the middle of nailbeds

Back 26

Splinter Hemorrhages

Front 27

Name sign:
multiple hemorrhagic nontender macules or nodules on palms & soles

Back 27

Janeway Lesions

Front 28

Name sign:
retinal hemorrhages w/ clear central areas seen on fundoscopy (w/ new murmur)

Back 28

Roth's spots (SBE)

Front 29

What is considered Major criteria in the Duke's criteria for endocarditis?
(2)

Back 29

1. Two positive blood cultures
2. Echo showing vegetations

Front 30

What are the (6) Minor criteria in the Duke's criteria for endocarditis?

Back 30

1. Fever
2. Predisposing heart abnormality
3. Arterial emboli (Janeway)
4. Osler nodes or Roth's spots
5. positive blood culture not meeting major criteria
6. Echo suspicious of endocarditis, but not meeting major criteria

Front 31

For the Duke's criteria of Endocarditis, what are the (3) ways to dx w/ major and minor signs?

Back 31

1. (2) major criteria
2. (1) major + (3) minor
3. (5) minor criteria

Front 32

Tx for endocarditis that cultures:

1. Strep

2. Staph

3. MRSA

Back 32

1. Ceftriaxone or Penicillin G (4 weeks)

2. Naficillin (4 weeks)

3. Vancomycin (4 weeks)

Front 33

What is the Tx for patients w/ Valular abnormalities if they are having dental procedures, GI or GU surgery? (2 possible)

Back 33

Prophylactic:

1. Amoxicillin
or
2. Clarithromycin

Front 34

Valvular dysfunction requiring surgery is common w/ which type of organism?

Back 34

Fungi (Candida or Aspergillus)

Front 35

Endocarditis type:
due to cancer seeding heart valves during metastasis what can it lead to?

Back 35

Marantic endocarditis

leads to cerebral infarcts

Front 36

Endocarditis type:
may be due to autoantibody damage of valves by SLE

Back 36

Libman-Sacks endocarditis

Front 37

MC valve affected by RHD

Back 37

Mitral

Front 38

Cause of Rheumatic fever?

What does it lead to?

Back 38

Group A Strep leads to Rheumatic Heart Disease (RHD)

- immune complex deposits on valves

Front 39

Major criteria (JONES criteria) for Dx Rheumatic fever (5)

Back 39

JCNES:
Joints (arthritis)
Carditis (myo-, endo- or peri-)
Nodules (sub-Q)
Erythema marginatum rash
Sydenham's chorea (face, tongue, upper limb)

Front 40

Minor criteria for Dx Rheumatic fever (5)

Back 40

Pump FEAR:

Prolonged PR interval;
Fever;
Elevated ESR;
Arthralgias;
Recent Strep infection;

Hint 40

Pump FEAR

Front 41

Tx for Rheumatic fever due to:

1. Strep

2. Arthritis

3. Carditis

Back 41

Penicillin for strep;

ASA for arthritis;

Steroids for carditis