Path 16- Valvular Heart Diseases/rheumatic Fever

Front 1

Insufficiency or incompetency or regurgitation is what?

Back 1

Valves fail to close completely

Front 2

Stenosis of valves

Back 2

Fibrosis of valves, valves fail to open completely

Front 3

Valves that are stenotic are almost always insufficient
-If a valve fails to open completely, it most likely can't close completely

Back 3

Notes

Front 4

What is the equation for work?

Back 4

Work = Flow X Pressure

Front 5

Murmurs are caused by

Back 5

Turbulence

Front 6

Jet flow leads to

Back 6

Pseudo valves or plaques (due to impact from blood flowing through a narrow orifice)

Front 7

What is the most common cause of right ventricular failure?

Back 7

Left ventricular failure

Front 8

Complications of artificial valves (5)

Back 8

1- Infection
2- Obstruction
3- Thromboembolism
4- Structural deterioration
5- Intravascular hemolysis

Front 9

Major criteria for diagnosing Rheumatic Fever (5)

Back 9

1- Carditis
2- Arthritis
3- Subcutaneous nodules
4- Erythema marginatum
5- Chorea

Front 10

Increased Antistreptokinase (ASK) or Antistreptolysin 'O' (ASO) are indicative of

Back 10

Rheumatic Fever because of group A B-hemolytic streptococcal infection

Front 11

What is the most serious problem in acute RF?

Back 11

Myocarditis

Front 12

Myocarditis may cause what (5)

Back 12

1- Cardiac failure
2- Arrhythmia
3- Sudden death
4- Embolism
5- Valve ring dilatation causing incompetence

Front 13

Age for RF

Back 13

5-15 years old

Front 14

RF is what type of hypersensitivity reactions?

Back 14

Type 2 and 4

Front 15

What is cause of RF?

Back 15

Abs against Group A streptococcal M proteins (S pyogenes)

Front 16

Most common cause of death RF

Back 16

Myocarditis

Front 17

Anitschkow cells and Aschoff bodies

Back 17

RF

Front 18

Most common initial presentation of RF

Back 18

Migratory polyarthritis

Front 19

RF clinical (7)

Back 19

FEVERSS

Fever, Erythema marginatum, Valvular damage (vegetation and fibrosis), ESR incrase, Red hot joints (migratory polyarthritis), Subcutaneous nodules (Aschoff bodies), Sydenham's Chorea

2- Fibrinous pericarditis
3- Myocarditis
4- Endocarditis

Front 20

Sydenham's chorea

Back 20

Late manifestation of RF
Reversible, rapid, involuntary movements affecting all muscles

Front 21

What is Jones criteria for acute RF?

Back 21

1 major and 2 minor if supported by evidence of prior group A streptococcal pharyngitis

Front 22

Major criteria of Jones (5)

Back 22

CASEC
1- Carditis
2- Migratory polyarthritis
3- Chorea
4- Erythema marginatum
5- Subcutaneous nodules

Front 23

Jones Minor criteria (5)

Back 23

1- Previous RF
2- Athralgia
3- Fever
4- Acute phase reactants (ESR, C-reactive protein, absolute neutrophil leukocytosis)
5- Prolonged PR interval

Front 24

RF tests

Back 24

1- increased ASO
2- DNase B titers

Front 25

RF treatment

Back 25

Penicillin
Aspirin

Front 26

Most common cause of mitral valve stenosis

Back 26

RF

Front 27

Atrial fib- valve disease?

Back 27

Mitral stenosis

Front 28

Mitral stenosis murmur

Back 28

Opening snap followed by an early to mid-diastolic rumble

Front 29

Most common cause of mitral valve regurgitation

Back 29

Mitral valve prolapse

Front 30

Mitral valve prolapse murmur

Back 30

Mid systolic click followed by late systolic crescendo murmur

Front 31

Standing and valsalva _______ venous return

Back 31

Decrease

Front 32

Squatting and sustained hand grip ______

Back 32

Increase TPR

Front 33

Tx for symptomatic mitral valve prolapse

Back 33

Beta blockers to decrease HR and force of contraction

Front 34

Most common cause of AV stenosis in patients >60y/o, <30

Back 34

>60- calcific valve

<30- congenital

Front 35

Murmur of aortic stenosis

Back 35

Systolic ejection murmur or ejection click

Front 36

Syncope and angina with exercise, which valve lesion?

Back 36

Aortic Stenosis

Front 37

Most common cause of aortic regurg

Back 37

Isolated (Aortic Valve) AV root dilation

Front 38

Wide pulse pressure

Back 38

Aortic Regurg

Front 39

High pitched diastolic blowing murmur

Back 39

Aortic Regurg

Front 40

Bounding pulses

Back 40

Aortic Regurg

Front 41

Corrigan's water hammer pulse

Back 41

Bounding pulses in Aortic regurg

Front 42

Austin Flint Murmur means

Back 42

Sign for AV replacement

Front 43

Holosystolic high pitched blowing murmur

Back 43

Either mitral or tricuspid regurgitation

Front 44

Radiates toward axilla- murmur

Back 44

Mitral regurg

Front 45

Radiates to right sternal border-

Back 45

Triscuspid regurg

Front 46

Graham Steell murmur

Back 46

Pulmonary Regurg

Front 47

Carcinoid heart disease

Back 47

PV stenosis, TV regurgitation
-Due to liver metastasis from carcinoid tumor of small intestine

Front 48

Mitral valve prolapse most common in what age and gender?

Back 48

Women 20-40

Front 49

Aortic stenosis related to what 2 disorders

Back 49

1) Age-related calcific aortic stenosis
2) Bicuspid aortic valve