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Test-4-Clinical Med

Pericardial Disease / Pulmonary Heart Disease

What is referred to as "ABNORMAL" increase in the amount of pericardial fluid? Pericardial Effusion
What is the M/C cause of pericarditis? Viral Pericarditis
Patient presents to your office with sudden onset of chest pain, worse at night when the patient is in the SUPINE position, but if the patient SITS up to get water the pain is better. Auscultation reveals FRICTION rub, ECG - Pan ST-elevation. Dx? Acute Pericarditis -Friction Rub is not always present.
Name 3 lab orders for a patient with Acute pericardITIS? Tell me why these labs are ordered. (Hint: only order test to confirm Dx not to find Dx). ESR, C-RP, WBC. (All these test are order to confirm ITIS-inflammatory condition "pericardITIS").// -CPK-MB + Troponin is ordered and may be mildly elevated.
What medication is used to Tx your inflammed heart sac after being kicked in the chest/heart by Mike's big toe? Colchicine - CRASY your big toe's medication (M/C area for gout-meds) is what now helps your HEART too. Tx for Pericarditis
Acute pericarditis is dynamic in that you have to treat and manage two difference problems, what are they? -Tx the CAUSE with COLCHICINE (med) or drain effusion if suggestion of tamponade by echo.// -MANAGE: PAIN with anti-ITIS (inflam) MEDS NSAID or Steroid
My pet boa constrictor, CARl BECK is a TrAMP! He focuses on the weak side of people's heart (RA&RV) and once he gains all their Love (L and Right heart) its a VICIOUS CYCLE of SQUEEZING life out of them(compressing heart). Dx? Pericardial Tamponade = Cardiac Tamponade. Pericardial effusion causes increase pericardial pressure that impairs cardiac function.
If CARl squeezes/smothers persons heart to fast, their love (heart OUTPUT) maybe be so low they don't want to stroke/pet him anymore(dec. stroke volume.) I keep telling him to slow down to have a longer relationship, allow for change. Fast is bad. Amount of fluid necessary to cause Tamponade depends on Rate of accumulation.// Pressure causes decrease in SV and CO
If you Dx a patient with "CARl TrAMP= Cardiac Tamponade what will affect their symptoms for better and for worse? Intravascular Volume.// -Decrease Preload allows for CARl to constrict.// -Increase Preload attenuates CARl from constricting
CARl's last name is BECK why? Beck's Triad (periCARdial Tamponade) - Hypotension/JVD/Muffled (absent) Heart sounds..///// -Can not here the heart b/c CARl is wrapped around it.
How can you explain the difference b/t Constrictive Pericarditis and Tamponade? Con. Pericarditis: Fibrous pericardium (sarah says - Filling a cup that will not expand, easy at first, hard in the end)./// Tamponade: Fluid, hard all through diastole -impaired ventricular filling (gravity pulls fluid down around Vent pushing closed)
What is two signs/symptoms of Constrictive Pericarditis? Weight gain/loss, Dyspnea, fatigue, HEPATIC DISTENSION.///heart constriction causes fluid retention edema, Liver first than lower extremity.
You KUSS, just before you get MAULed by a tiger, and take a deep breath to run, but b/c your feet are ENCASED IN STONE (heart encase in stone Const. Pericard) JUGs you stay in the SAME spot. Constrictive Pericarditis - KUSS-MUAL sign- JUGular pressure stays the same with increased breath but normal would decrease b/c inspiration allows blood to flow into heart and out of jugular veins.
What is the Tx for Constrictive Pericarditis? Decrease Volume b/c heart can only fill a certain amount due to Stone Casing of Pericardium. Reduce Salt, Diuretics. Or Stripping the Watermelon rind around heart.
Describe Restrictive Cardiomyopathy. Hardening of the heart muscle. Myocardial tissue can only stretch so much. Think about if you had to were a cast, it would restrict movement of muscle and cause loss of flexibility.
CARl BECK is a boa CONSTRICTOR not a restrictor, so would you feel a prominent Apical PMI in Restrictive or constrictive problem? Restrictive you would feel Apical PMI. CARl BECK is wrapped around heart muffling Apical PMI and sounds of the heart in Constrictive
What mmHg Classify Pulmonary Hypertension into mild, moderate and severe? Mild=>20mmHg /// Moderate=>30mmHg /// Severe=>45mmHg of MAP mean arterial pressure in Pulmonary Artery
Dx of Idiopathic Pulmonary Hypertension will KILL you with in how many years? DEATH 2-8 yrs
Idiopathic Pulmonary Hypertension would show what on an Echo? HUGE Right Atrium
We know why men would take Viagra at night buy what would cause a women to need Viagra and Oxygen at night? B/c Idiopathic Pulmonary Hypertension./// O2, Viagra, Diuretics and a Lung Transplant are the Tx for Idiopathic Hypertension.
COPD (M/C chronic cause), PE (m/c acute cause), PneumoCOniosis (COal minor lung), and Pickwickians syndrom all affect the Lungs which result with Right Heart stress causing what. Cor Pulmonale - Think anything that affects lungs or arteries to the lungs (Idiopathic Pulmonary Hypertension) will result in Right heart problems.
Cor pulmonale is a right heart condition, but remember its cause is due to pulmonary problems so what would labs show? Pulmonary problem = bad breathing = Hypoxia (O2 SATuration less than 85% = Increase RBC = POLYCYTHEMIA
Created by: cmuox2000