IE Causes
Contrast the organisms seen in the Early vs Late phase
Early: Staphylcoccus, Gram negative, Diptheroids, Candida
Late: Streptococci
Name the four groups of microorganisms that can cause Pericarditis (hint one is Bacteria)
Then, name as many species within each group that you can.
What are:
Bacteria: Lyme Disease, Pneumococcus, Staphylococcus
Viral: Coxackievirus, HIV, CMV, HBV
Mycobacterial: Tuberculosis, MAC (mycobacterium avian complex)
Fungi: histoplasmosis
Name the combinations of major and minor criteria to give a diagnosis of IE.
What is the Duke criteria?
What is:
2 Major (Kawhi Leonard wears #2)
1 Major , 3 Minor (PG-13)
5 minor (Baron Davis wears #5)
These are used to treat those that are Symptomatic for Pericarditis (first line of tx's)
What are: NSAIDs and narcotic analgesics?
Name all the signs and Symptoms of Infective Endocarditis (OFF JAR MOP)
What are:
Organ enlargements, Fever, Fatiguability, Janeway Lesions, Anorexia, Roth's Spots, Musculoskeletal Pain, Osler's nodes, Petechiae
COntrast the acute vs Subacute organisms
Acute: Staphylococcus
Subacute: Streptococci and Enterococci
These are the two specific metabolic disorders that lead to Pericarditis.
What are HYPOthyroidism and Uremia?
Describe the Major Criteria for Diagnosis of IE
What are:
Positive for 2 blood samples of an organism associated with IE
TEE positive for Intracardiac Mass
Abscess
These are the second line of Tx's for Pericarditis if the pt has not responded well to the first lines of defense.
What are: Corticosteroids and non-steroidal immunosuppressants
These are the two types of Pericarditis
These are the causes of each
What are acute and constrictive pericarditis
Acute: Increased fluid accumulation or effusion in teh pericardial cavity
Constrictive: Chronic persistent inflammation leading to fibrosis, calcification and adhesion of the pericardium.
These are the 3 main species involved in Culture Negative Endocarditis
Describe why else a person may appear to be Culture Negative
What are: Coxiecella, Bartonella, and Chlamydia (Coxieciella Bartonella got Chlamydia at Coachella)
-They were taking Antibiotics
Name the specific subtypes within "Drug related" and "Trauma" that lead to Pericarditis (such as stab wound for trauma (still more in this category)).
What are: isonazids (for TB), and CYCLOsporine
Trauma: CPR or general blunt trauma.
Describe the Minor Criteria for the DUKE criteria
What are:
Fever Fatiguability, Janeway Lesions, Osler's nodes, Roth spots, mycotic aneurysms, serological evidence of active evidence of microbial infection
These are the 2 invasive treatements for Pericarditis
What are: Pericardiocentesis and Pericardiectomy.
These are the normal functions of a healthy Pericardium
What are:
Protective barrier against infectious agents or spread of inflammation from adjacent structures
To maintain the heart volume, affecting tthe filling pressure in the cardiac chambers.
Name all the Predisposing Causes of Infective Endocarditis (hint MR CHIP)
What are:
Mitral Valve Prolapse,
Rheumatic Heart Disease,
Congenital Heart Defects,
Healthcare Associated Infections,
Injection Drug Use,
Prosthetic Heart Valves.
This is both a Tx and a cause of Pericarditis. Describe it as a cause here.
What is Post Pericardiotomy Syndrome?
Describe the AB Prophylaxis Regimen for IE.
Hints (ITHRO=500mg)
Cefa =1g
Cepha=2 (think 2 letters to make the same f sound)
What is:
Amoxicillin 2g or children 50mg/kg up to 2g.
Allergic to Penicillin:
-Clindamycin (600mg), Azithromycin 500mg, Clarithromycin 500mg, Cephalexin 2g
Non oral
Ampicillin 2g IV
Allergies:
Clindamycin 600mg, Cefazolin 1g, Cefriaxone 1g.
THis is the sound of the Pericardial Friction Rubs
WHat is having the patient lean forward or get on hands and knees.
What is walking on crunchy snow?
Describe the pain experienced in Pericarditis.
What is a sharp stabbing pain that may radiate to the left trapezial ridge and to the left arm?
The cause of Non-bacterial Endocarditis
THis is the most common organism associated with Dental Procedures
What is a Hypercoagulable State?
What is Streptococcal species?
This type of congenital disorder can lead to Pericarditis
What are the connective tissue diseases such as Rheumatic Heart Disease, Rheumatoid Arthritis, Systemic Lupus
Describe the groups of ppl that should receive AB Prophylaxis
What are:
Prosthetic Valve pts,
Previous History of IE,
Cardiac transplant pts who develop Valvulopathy
CHD pts:
-Untreated CHD,
-Treated within the last 6 months,
-Treated but with defects
Describe why anatomically that Pericarditis manifests as Right sided heart failure and doesnt affect the left side as much
What is bc the Caval Vessels are those vessels mainly inside the Pericardium and much of the Left Atrium are extraperitioneal.
Describe the physical findings of Pericarditis (mef2ca, there are 2 a's)
What are: Modest Leukocytosis, ECG changes (showing ischemia), Fever, Cardiac enzymes elevated, Abnormal chest X-ray , Abnormal Echocardiogram