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CARDIOLOGY - RIA > HF + cardio > Flashcards

HF + cardio Flashcards

1
Q

List 5 peripheral signs of Infective endocarditis;

A
  1. Petechiae
  2. Janeway lesions
  3. Splinter haemorrhages
  4. Osler nodes
  5. Roth spots
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2
Q

Describe PETECHIAE

A

dots of blood due to leaking from capillaries - non specific finding; also seen in vasculitis.

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3
Q

Describe OSLER NODES

A

Tender subcutaneous nodules located on the distal pads of digits.

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4
Q

Describe JANEWAY LESIONS

A

Non tender maculae on the palms and soles.

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5
Q

Describe SPLINTER HAEMORRHAGES

A

Dark red linear lesions on the nail beds.

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6
Q

Describe ROTH SPOTS

A

Retinal haemorrhages with small, clear centres (rare and observed in only 5% of patients w/ IE).

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7
Q

The modified Duke criteria for the diagnosis of IE requires what combinations of major and minor criteria?

A

2 major
1 major + 3 minor
5 minor

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8
Q

name 2 MAJOR CRITERIA.

A

2 positive blood cultures (typical microorganism IE)

and

evidence of endocardial involvement

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9
Q

MAJOR CRITERIA - positive echo for IE;

A
  • oscillating intra cardiac mass on valve
  • abscess
  • new partial dehiscence of prosthetic valve
  • new valvular regurgitation
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10
Q

What does negative blood cultures for IE indicate?

A

IE in which no causative micro-organism can be grown usual the usual blood culture method; can be due to previous antibiotic administration.

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11
Q

What are the 5 stages of action potential?

A 
0 - rapid depolarisationi 
1 - early repolarisation 
2 - plateau phase 
3 - repolarisation 
4 - resting membrane potential
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12
Q

What % is reduced ejection fraction?

A

less than/equal to 40%

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13
Q

causative organism of rheumatic fever

A

Group A beta haemolytic streptococci

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14
Q

list minor criteria for rheumatic fever (5)

A
  • fever
  • raised CRP/ESR
  • arthralgia
  • prolonger PR interval
  • previous rheumatic fever
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15
Q

list major criteria for rheumatic fever (5)

A
  • Carditis
  • Arthritis
  • Subcutaneous nodules
  • Erythema marginatum
  • Sydenham’s syndrome
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16
Q

fever & new murmur is ___ until proven otherwise

A

infective endocarditis

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17
Q

what is infective endocarditis

A

infection involving the endocardial surfaces of the heart, involving valvular structures, chordae tendinae, sites of septal defects or mural endocardium

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18
Q

what are vegetations along edge of valve in infective endocarditis (3)

A
  • fibrin
  • platelets
  • infective organism
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19
Q

risk factors for IE (5)

A
  • prosthetic valve
  • previous episodes
  • congenital heart defects
  • IVDU
  • HOCM
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20
Q

most common causative organism of IE

A
  • staphylococcus aureus
21
Q

most common causative organism of IE in patients following prostethic valve surgery

A
  • staphylococcus epidermis
22
Q

IE organism associated with colorectal cancer

A

streptococcus bovis

23
Q

iE organisms found in the mouth assoc with poor dental hygiene or following a dental procedure

A
  • strep mitis

- strep sanguinis

24
Q

blood cultures needed in IE

A

3 sets taken within 24 hours

25
Q

IE echo findings

A
  • vegetations if > 2 mm
  • underlying valvular disease
  • valvular regurgitation
  • abscess
26
Q

Dukes major criteria (2)

A

1) Positive blood cultures

2) Endocardium involved

27
Q

Dukes minor criteria (5)

A

1) Predisposition (e.g. cardiac lesion, IVDU)
2) Fever (> 38.0 deg)
3) Vascular/immunological signs
4) Positive blood cultures that do not meet major criteria
5) positive echo that does not meet major criteria

28
Q

minor dukes criteria vascular phenomena

A

Vascular phenomena such as;

  • major arterial emboli
  • septic pulmonary infarcts
  • mycotic aneurysm
  • intracranial haemorrhage
  • conjunctival haemorrhage
  • janeway lesions
29
Q

minor dukes immunological phenomena

A

Immunological phenomena

  • osler nodes
  • glomerulonephritis
  • roth spots
  • rheumatoid factor
30
Q

Treatment of infective endocarditis

A

Ceftriaxone
or
Cef & gent

31
Q

Viral causes of acute pericarditis (4)

A
  • Coxsackie
  • EBV
  • Mumps
  • Varicella
  • HIV
32
Q

management of acute pericarditis

A

Analgesia - e.g. Ibuprofen

consider colchicine

33
Q

Accumulation of pericardial fluid raised intrapericardial pressure –> poor ventricular filling + fall in cardiac output

A

Cardiac tamponade

34
Q

3 causes of cardiac tamponade

A
  • acute pericarditis
  • aortic dissection
  • haemodialysis
35
Q

Becks triad - diagnosis of cardiac tamponade (3)

A
  • muffled heart sounds
  • falling BP
  • rising JVP
36
Q

2 commonest causes of HF

A
  • acute coronary disease

- HTN

37
Q

structural & congenital causes of HF

A

structural: valvular pathologies
congenital: ASD, VSD, inherited cardiomyopathies

38
Q

rate related causes of HF

A
  • AF uncontrolled
  • thyrotoxicosis
  • anaemia
  • heart block
39
Q

pulmonary causes of HF

A
  • COPD
  • pulmonary fibrosis
  • recurrent PE
  • primary pulmonary HTN
40
Q

autoimmune disease causes of HF

A
  • amyloidosis

- sarcoidosis

41
Q

when should digoxin therapy be considered

A

non paroxysmal AF & they are sedentry

42
Q

4 causes of mitral regurg

A

1) rheumatic heart disease
2) ischaemic heart disease - papillary muscle rupture
3) valvular vegetations - patients with endocarditis
4) physiological mitral valve regurg due to dilated left atrium

43
Q

what maintains the long plateau in an action potential

A

calcium influx through L-type channel

44
Q

electrolyte involved in depolarisation

A

sodium influx

45
Q

electrolyte in repolarisation

A

potassium

46
Q

effect of adrenaline on frank starling graph

A

push to the left

47
Q

what should be performed prior to cardioverion in patient with AF & why?

A
  • echocardiogram

- identify thromboembolism

48
Q

Rivaroxiban mechanism

A

Factor Xa inhibitor

49
Q

drug used to reduce anxiety & dyspnoea in HF exacerbation

A

morphine

CARDIOLOGY - RIA (8 decks)

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