Term
| what are the 5 steps in the inflammatory response |
|
Definition
1. damaged tissue release histamine
2. capillaries leak and release phospcytes and clotting factors
3. phagocytes engulf bacteria, dead cells, debris
4. platelets move out of capillaries to seal wound
5. serum proteins move in: complement, clotting, IL |
|
|
Term
| what 5 things does IL-1 do |
|
Definition
vasodilation
activate lymphocytes
destories tissue
Fecer
production of IL-6 |
|
|
Term
| what 3 things does TNFa cause |
|
Definition
increase permeability
shock
fever |
|
|
Term
| what 3 things does IL-6 cause |
|
Definition
lymphocyte activation
fever
increase acute phase protein production |
|
|
Term
|
Definition
| chemotactic factor for neutrophils, basophils, T cells |
|
|
Term
|
Definition
activate NK cells
differentiate T into Th1 |
|
|
Term
| explain how a fever forms |
|
Definition
| infection or toxin release of IL-1, tnf, IL-6 go to thermoregulatory receptors of hypothalamus and induce vasoconstriction and cause brain to have behavorial changes that increase temperature |
|
|
Term
| what are the two main events in the acute phase |
|
Definition
injury induces mast cells and IL which tell hypothalamus to cause fever and adrenal cortex to make cortisol which acts on liver to make proteins and complements to induce immune supression
injury signals for marrow to make PMN which use diapediases with ICAM to get to inflammatory site |
|
|
Term
| whatis the criteria for FUO |
|
Definition
| fever > 38.3(101F) for 3 weeks or more without diagnosis despite invesitigation |
|
|
Term
| what is the first step in FUO tx and two ways to accomplish it |
|
Definition
| improve diagnosis: serology and imaging |
|
|
Term
| what are the five general categories of cause for FUO |
|
Definition
cancer
connective tissue disorder
autoimmune
fastitious/munchausen
drugs
infection |
|
|
Term
| what are the 4 categories of infection that cause FUO |
|
Definition
bacterial
viral
parasite
fungal |
|
|
Term
| what are 5 cancers that cause FUO |
|
Definition
renal
liver
hodgkins lymphoma
non-hodgkins lymphomc
leukemia |
|
|
Term
| what is the difference between hodgkins and non-hodgkins lymphoma |
|
Definition
hodgkins: B cells, reed-sternberg cells
non: T or B cells, NK rarley |
|
|
Term
| what are two CT dissorders that cause FUO |
|
Definition
juvenile RA
stills disease |
|
|
Term
| what is the cause of Stills disease (4) |
|
Definition
| HLA B17, HLA B18, HLA B35, HLA DR2 |
|
|
Term
| why does stills disease cause feer (3) |
|
Definition
post infection with Y. enterocolitica, mycoplasm pneumo
reactive athritis |
|
|
Term
| what are the two main symptoms of stills disease |
|
Definition
|
|
Term
| what are 6 autoimmune conditions that cause fever |
|
Definition
giant cell arteritis
polymylagia rheumatic
polyarteritis nodosa
chrons
sarcoidosis
SLE |
|
|
Term
|
Definition
| pulmonary hilar lymphadenopathy, arteritis, granuloma |
|
|
Term
| what is giant cell arteritis |
|
Definition
| CMI causes inflammation causing cytokine damage of arterial vessel wall and multinucleated giant cells |
|
|
Term
| what causes giant cell arteritis (2) |
|
Definition
|
|
Term
| what are common manifestations of munchausen in FUO (4) |
|
Definition
by proxy (child abuse)
young adults with healthcare knowledge
manipulation of thermometer
injection of foreign material |
|
|
Term
| what are 7 categories of drugs that cause FUO |
|
Definition
antimicrobials
H1 and H1 antagonists
antieplieptic drugs
NSAIDS and slicylates
antiarthythmic
antithyroid
antihypertensive |
|
|
Term
| what are 15 bacterial causes of FUO |
|
Definition
TB
salmonalla typhi (enteric fever)
lyme disease
syphillis
relapsing fever
leptospirosis interrogans
rat bite fever - spirilum minus
brucellosis
chalmydophila psittaci
rickettsia anaplasmosis
erchichiosis anaplasmosis
Q fever - coxiella vurnetti
whipples disease - tropheryma wipplei
legionella
bartonella |
|
|
Term
| what are 10 viral causes of FUO |
|
Definition
mono
CMV
influenza
adenovirus
parvovirus
measles
mumps
HIV
hepatitis
hemorrhagic fever |
|
|
Term
| what are the three hemorrhagic fevers, why are they not commonly a FUO |
|
Definition
ebola, lassa, congo
onset is dramatic |
|
|
Term
| what are 4 parasites that cause FUO |
|
Definition
malaria: babesiosis
trypanosomiasis: T. brucei
ameobic abscess: E. histolytica (invasive diarrhea)
toxoplasmosis gondii |
|
|
Term
| what are 5 fungal causes of FUO |
|
Definition
candidiasis albicans
cryptococcosis neoformans
aspergillus
systemic fungi: H. capsulatum, C. immitis |
|
|
Term
| what are 5 hidden infections that can present with FUO |
|
Definition
osteomyelitis
occult abscess
enerocarditis
pericarditis
myocarditis |
|
|
Term
| what is the most common cause of osteomyelitis in adults and kids |
|
Definition
S. aureus adults
influenza B in kids |
|
|
Term
| where do occult abscesses usually show up (4) |
|
Definition
intra abdominal
dental
liver
renal |
|
|
Term
| if someone is a veterinarian, what are you going to make sure to include in teir FUO work up (3) |
|
Definition
leprospirosis
brucellosis
Q fever |
|
|
Term
| if someone has traveled recently, what are you going to make sure to include in teir FUO work up (4) |
|
Definition
typhoid
RMSF
malaria
C. immitis |
|
|
Term
| what are three things you need to look at on a physical exam for FUO work up |
|
Definition
|
|
Term
| what are 4 important questions in a FUO history |
|
Definition
do you work with animals
have you treveled
have you had dental procedures
what meds are you on |
|
|
Term
| what are 3 criteria when taking a blood culture sample |
|
Definition
draw from three sites
at three different times
before antibiotic start |
|
|
Term
|
Definition
| infection or inflammation of chamber, septum, or valve lining |
|
|
Term
| who is the most common endocarditis patient and what part of the heart is affected |
|
Definition
| elderly men with mitral (2nd aortic) valve problem |
|
|
Term
| what is the number 1 cause of endocarditis and why |
|
Definition
| S. aureus because it can damage IN TACT valves due to ENZYMES and ANTI-PHAGOCYTIC properities |
|
|
Term
| what are some procedures or activities that can increase risk of endocarditis |
|
Definition
prostatic valves
central line placement
bite wounds
IV drug use
dental surgery
endoscopy/colonoscopy
trans-esophageal ECHO
gingivitis |
|
|
Term
| what are 4 heart defects that increase risk for endocarditis |
|
Definition
valve defect
aortic stenosis
tertaology of fallo
VSD |
|
|
Term
| what infection has a complication of endocarditis |
|
Definition
| strep - rheumatic fever/heart disease |
|
|
Term
| what are the two most common cause of endocarditis, why |
|
Definition
S. aureus
S. epidermiditis
normal skin flora |
|
|
Term
| what are 4 criteria for acute endocarditis |
|
Definition
days long
rapid destruction
sepsis
valve is in tact and not damaged |
|
|
Term
| what is the most common cause fo acute endocarditis, what are 3 other causes |
|
Definition
S. aureus
coag negative staph
oral strep
enterococcus |
|
|
Term
| what are 2 criteria for subacute endocarditis |
|
Definition
weeks to months
damaged valve |
|
|
Term
| what are two possible causes fo subacute endocarditis |
|
Definition
congenital disease
dental surgery / bad oral hygeine |
|
|
Term
| what are the two most common causes of subacute endocarditis. what are thre more |
|
Definition
HAECK, C. burnetti (animal profession)
S. viridans, enterococcus. coagn neg staph |
|
|
Term
| what is the most common cause of endocarditis in someone with a mechanical steel heart device for <60d(3) |
|
Definition
|
|
Term
| what is the most common cause of endocarditis in someone with a bioprosthetic heart device for >1y (3) |
|
Definition
|
|
Term
| what are the most common causes of endocarditis in a IV drug user |
|
Definition
| S. aureus, strep, pseudomonas, candidia, enterics from flora |
|
|
Term
| what is teh most common location for infection in an IV drug user |
|
Definition
| tricuspud (>mitral>aortic) |
|
|
Term
| what are the two most common nosocomial causes of endocarditis |
|
Definition
|
|
Term
| what are the three most common introduction methods for nosocomial endocarditis |
|
Definition
IV catheter
swan-ganz
hemodialysis |
|
|
Term
| why is staph and strep a common cause of endocarditis |
|
Definition
|
|
Term
| what non-HAECK GI and mouth flora are common causes of endocarditis (4) |
|
Definition
enterococcus
S. bovis/galloyticus
E. coli
P. aeruginosa |
|
|
Term
| what does HAECK stand for, what are the commonalities they share |
|
Definition
H. parainfluenza and arthrophilus
Actinobacillus actinomycetemcomitans
Cardiobacteroi, hominis
Ekienella corrodens
Kigella species
fastitious gram negative rod in mouth associated with bite wounds |
|
|
Term
| how can S pyogens and P aeurgnosa be identified |
|
Definition
|
|
Term
| how can S. aureus be identified |
|
Definition
|
|
Term
| how can enterococcus be identified |
|
Definition
| non hemolytic or slightly B hemolytic |
|
|
Term
| how can s. vididans be identified |
|
Definition
|
|
Term
|
Definition
SOB
fever, chills
fatigue
murmur
swelling
weight loss
night sweats
cough
chest pain
splinter hemorrhage: nail beds
osler's nodes: finger tip tender
janeway spots: palms and soles, painless
roth spots: retinal hemorrhages (immune complexes) |
|
|
Term
| what is the mortality rate of endocarditis |
|
Definition
|
|
Term
| what are 6 complications of endocarditis |
|
Definition
venturi effect
bacteremmia/fungemia
pneumonia
pyelonephritis
immune system caused damage
CHF |
|
|
Term
| what is the venturi effect |
|
Definition
| turbulence or trauma causes embolism on low pressure side of valve |
|
|
Term
| what valves get less damage with venturi effect, why |
|
Definition
| tricuspid and pulmonary because they are low pressure |
|
|
Term
| what are the 4 parts to endocarditis tx |
|
Definition
oxygen
hemodialys
antifungal/antibiotics - long term to removal biofilms
valve removal or replacement |
|
|
Term
|
Definition
| infection or inflammation of cardiac muscle (myocytes, vascular tissue, autonomic nerves, interstitum) |
|
|
Term
| what are 6 signs of myocarditis |
|
Definition
heart failure
chest pain
arrhythmia
flu like
pulmonary congestion or hypertension |
|
|
Term
| what are the non-infectious causes of myocarditis (9) |
|
Definition
collagen diseases: SLE, RA, JRA
thyotoxicosis
drugs: cocaine, OH, heavy metals
hypersensitivity
automimmune disease |
|
|
Term
| what are the 7 viral causes of myocarditis |
|
Definition
enterovirus: cosackie A/B
influenza
edenovirus
MMR
CMV
EMB |
|
|
Term
| what are the 7 bacterial causes of myocarditis |
|
Definition
B. burdorgeri
C. dyptheria
GPC
rickettsia
salmonella
mycoplasma
spirochetes |
|
|
Term
| what are 7 parasitic causes of myocarditis |
|
Definition
t. crysi
T. bruci
plasmodia
trichinella
toxoplasmosis
ascarias
filariasis |
|
|
Term
| T. crusi: disease, transmission |
|
Definition
|
|
Term
| T. bruci: disease, transmission |
|
Definition
|
|
Term
| three fungal causes of myocarditis |
|
Definition
candidia
aspergillus
systemic: coccidioides immitis |
|
|
Term
|
Definition
| infection or inflammation of pericardium |
|
|
Term
| 8 non-infectious causes of pericarditis |
|
Definition
collagen diseases: RA, SLE
reactive arthritis
heart attack
renal disease
malignancy
drug
idiopathic |
|
|
Term
| signs of acute pericarditis 8 |
|
Definition
chest pain
fever
dyspenia
weakness
edema
dry cough
friction rub
tamponade |
|
|
Term
| what are the three parts to tamponade |
|
Definition
increased jugular pressure
hypotension
pulsus paradoxus: decrease systemic GP in inspiration |
|
|
Term
| what are 4 signs of chronic pericarditis |
|
Definition
ankle swelling
abdominal swelling
SOB
heart failure |
|
|
Term
| what are the causes of infective pericarditis |
|
Definition
| same as endocarditis and myocarditis |
|
|
Term
| what labs are done in suspicion of pericarditis |
|
Definition
CRP, ESR, CBC, chem
cardiac enzymes, isoenzymes, troponin (exclude MI)
serology for vuruses, SLE, rA
ECG, sonogram |
|
|
Term
| define suppurative thrombophlebitis |
|
Definition
| jugular, pelvic, intra-abdominal, or cranial infection |
|
|
Term
| what are 8 causes of suppurative thrombophlebitis |
|
Definition
IV, drug use, dialysis
infection
embolism
septic artheitis
osteomyelitis
skin and oral flora |
|
|
Term
|
Definition
| septic jugular vein thrombophlebitis |
|
|
Term
| what are the 10 causes of leimerres disease |
|
Definition
vincents anginia
pharyngitis
tonsilitis
dental infection
anaerobic pharyngitis
embolism
abscess
septic arthritis
osteomyelitis
liver abscess |
|
|
Term
| what is anaerobic pharyngitis caysed by |
|
Definition
| fusobacterium necrophorum/ gram negative anerobic rod |
|
|
Term
| how does strep cause endocarditis |
|
Definition
| post strep infection causes typ II hypersensitivty and complexes build on heart tissue |
|
|
Term
| how does C. perfringens and C. diptheriae cause myocarditis |
|
Definition
| exotoxins cause gangrene due to sugar metabolism in muscle |
|
|
Term
| how does S. aureus cause endocarditis |
|
Definition
|
|
