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DIT cardiac path 1

murmurs, inflammation,shock,vasculitis, end quiz

crescendo-decrescendo systolic murmur best heard in the 2nd/3rd right interspace close to the sternum aortic stenosis
Early diastolic decrescendo murmur heard best along the left side of the sternum pulmonary regurg
late diastolic decrescendo murmur heard best along the lest side of the sternum tricuspid stenosis
pansystolic/holosystolic/unifrom murmur best heard at the apex and often radiates to the left axilla mitral regurg
late systolic murmur preceded by a mid systolic click mitral prolapse
crescendo-decrescendo systolic murmur best heard in the 2nd-3rd left interspace close to the sternum pulmonary stenosis
pansystolic/holosystolic/uniform murmur best heard along the left lower sternal border and generally radiating to the right lower sternal border VSD or tricuspid regurg
rumbling late diastolic murmur with an opening snap mitral stenosis
pansystolic/holosystolic/uniform murmur best heard at the 4th to 6th left intercostal spaces tricuspid regurg
continuous machine-like murmur (in systole and diastole) PDA
high pitched diastolic murmur a/w a widened pulse pressure aortic regurg
What are the most common causes of aortic stenosis? congenital bicuspid valve, senile/degenerative calcification, chronic rheumatic valve disease, congenital unicuspid aortic valve
What heart sounds are benign when there is no evidence of disease? spilit S1, split S2 on inspiration, S3 in pts <40, early quiet systolic murmum
murmurs best heard in left lateral decubitus position mitral regurg, mitral stenosis, left sided S3/S4 sounds
80 yo with a systolic crescendo decrescendo murmur aortic stenosis
signs of right sided HF peripheral edema, JVD, hepatosplenomegaly
signs of left sided HF pulmonary edema, orthopnea, DOE
meds for chronic heart failure diuretics, digoxin, ace/arb, beta blockers
meds for acute HF (LMNOP)Loops, Morphine, Nitrates, O2, Positioning/Pressors
signs of embolism from endocarditis brain infarct = focal neuro defects, renal infart = hematuria, splenic infarct = abdominal and shoulder pain
most common valve in endocarditis mitral valve
common valve in IVDA with endocarditis tricuspid valve = septic pulmonary infarcts
new regurgitation heart murmur or heart failure endocarditis
SVR, CO and tx of hypovolemic shock increased SVR, decreased CO, fluids and blood
SVR, CO and tx of heart failure increased SVR, decreased CO, LMNOP
SVR, CO and tx of septic/anaphylactic shock decreased SVR, increased CO (tachycardia), Abx, IV fluids, NE
SVR, CO, and tx of neurgenic shock decreased SVR, decreased CO, IV fluids, steroids
What are the diagnostic (jones) criteria for rheumatic fever? (JONES) 2 or mor + evidence of GAS. Joints, Pancarditis, Nodules, Erythema marginatum, Syndeham's chorea
JVD with inspiration due to decreased capacity of RV Kussmaul's sign
constrictive pericarditis>>tamponade Kussmaul's sign
decreased SBP by more than 10mmHG with inspiration because of a decreased capacity of LV Pulsus paradoxus
cardiac tamponade>>pericarditis Pulsus paradoxus
IVDA with chest pain, dyspnea, tachycardia, and tachypnea tricuspid endocarditis with a bacterial embolism
MVA presents with chest pain, dyspnea, tachycardia, and tachypnea Tension pneumothorax
post op with chest pain, dyspnea, tachycardia, and tachypnea pulmonary embolism
young girl with congenital valve disease is given penicillin prophylactically. She's go bacterial endocarditis, what's the next step? IV Vancomycin until culture comes back
In what circumstances might you see pulsus paradoxus? cardiac tamponade, asthma, OSA, croup, severe COPD
diffuse myocardial inflammation with necrosis and mononuclear cells myocarditis
focal myocardial inflammation with multinucleate giant cells aschoff body (RF)
fever + IVDA + new heart murmur tricuspid endocarditis
chest pain and course rubbing heart sounds in pt with Cr of 5.0 pericarditis (Uremic)
tree-barking of the aorta tertiary syphillis
child with fever, joint pain, cutaneous nodules 4 weeks after a throat infection Rheumatic HD
ST elevations in all EKG leads pericarditis
Disordered growth of myocytes hypertrophic cardiomyopathy
EKG shows electrical alternans cardiac tamponade
weak pulses in upper extremities Takayasu
necrotizing granulomas of lung and necrotizing glomerulonephritis Wegeners
Necrotizing immune complex inflammation of visceral/renal vessels Polyarteritis Nodosa
Young male smokers Bergers
Young Asian women Takayasu
Young asthmatics Churg-strauss
INfants and young children; involves coronary aa Kawasaki's
most common vasculitis henoch schloen
a/w hep B polyarteritis nodosa
occlusion of ophthalmic a can lead to blindness temporal arteritis
perforation of nasal septum wegeners
unilateral HA, jaw claudication temporal arteritis
Benign raised red lesion about the size of a mole in older patients cherry hemangioma
raised, red area present at birth, increases in size initially then regresses over months to years strawberry angioma
lesion caused by lymphoangiogenic growth factors in an infected HIV pt kaposi sarcoma
polypoid red lesion found in pregnancy or after trauma pyogenic granuloma
benign painful red blue tumor under fingernails glomus tumor
cavernous lymphangioma a/w Turner's syndrome cystic hygroma
skin papule in AIDS pt caused by bartonella bacillary angiomatosis
classic presentation of pt with temporal arteritis jaw claudication, unilateral HA, blindness
What lab finding helps diagnose temporal arteritis? elevated ESR
staph aureus, large vegetations, rapid growth acute bacterial endocarditis
viridans strep, small, previously diseased valves, slow growth subacute bacterial endocarditis
Why do the kidneys retian fluid in CHF pts decreased CO --> JGA --> renin --> ang II --> aldosterone
common causes of restrictive cardiomyopathy sarcoidosis, amyloidosis, hemochromatosis, loeffler's eosinophilia, post radiation fibrosis
post-MI a/i fibrinous pericarditis with an elevated ESR dressler's syndrome
2 most common complications after MI arrhythmia, LV insufficiency (= Pulm Edema)
4-24 hrs post MI contraction bands and enzyme spillage
2-4 days post MI NPs, red hepatization
5-10 days post MI MP, yellow stuff
2 weeks post MI scarring
most common locations for atherosclerosis abdominal aorta, coronary a, popliteal a, carotid a
adult with history of hypertension has sudden sharp tearing pain radiating to the back. What do you see on CXR? widening of the medistinum
pansystolic murmur at the apex with radiation to axilla mitral regurg
25 yo pregger in 3rd tri has nL BP standing and sitting, but it drops to 90/50 when supine. Compression of the IVC
onion skin periosteal reaction ewings sarcoma
pseudopalisading tumor cell arrangement glioblastoma multiforme
elevated serum uric acid Gout, Lesch Nyhan, tumor lysis, loop and thiazide diuretics
Created by: kayjames