What is the cause of cardiac dilation in congestive heart failure?
Increased ventricular end-diastolic volume
Increased venous return in the supine position causes what common symptom of congestive heart failure?
Orthopnea, in which patients have difficult breathing when not upright
How does the blood pressure on the right side of the heart affect portal venous blood flow?
As the pressure in the right heart (and, therefore, the central venous system) increases, portal flow decreases
Increased right-sided heart pressure can lead to what finding on abdominal physical exam?
Hepatomegaly (nutmeg liver on pathology) and rarely cardiac cirrhosis
Does left ventricular failure increase or decrease pulmonary venous pressure?
What are heart failure cells?
Hemosiderin-laden macrophages in the lungs due to microhemorrhages caused by increased pulmonary capillary pressure
What is congestive heart failure?
Congestive heart failure is the constellation of signs and symptoms that occur as a result of poor cardiac function; its severity can be defined symptomatically and with imaging
What are physical signs of right-sided heart failure?
Ankle edema, jugular venous distention, and hepatomegaly
What is the most common cause of right-sided heart failure?
Left-sided heart failure
What is the most common cause of right-sided heart failure in the absence of left-sided heart failure?
Cor pulmonale, in which the right ventricle fails because of increased pulmonary arterial pressure
How does the body compensate for the decreased left ventricular contractility (and therefore decreased cardiac output) that occurs with left-sided heart failure?
The kidneys increase the activity of the renin-angiotensin-aldosterone system, and sympathetic tone is increased, both of which ultimately increase preload and cardiac output
Tender, red, raised lesions on the finger or toe pads in the setting of endocarditis are known as what?
A round white spot on the retina that is surrounded by hemorrhage in the setting of endocarditis is known as what?
A small, painless erythematous lesion on the palm or sole in a patient with endocarditis is called what?
In a case of acute bacterial endocarditis, which organism is most likely responsible?
Is Staphylococcus aureus bacterial endocarditis rapid or insidious in onset?
Rapid; it has a high virulence and results in large vegetations on previously normal valves
Is Streptococcus viridans bacterial endocarditis rapid or insidious in onset?
Insidious; smaller vegetations appear on congenitally abnormal or diseased valves
Which type of endocarditis is associated with dental procedures: acute or subacute bacterial endocarditis?
Subacute; smaller vegetations appear on congenitally abnormal or diseased valves, with insidious onset
Nonbacterial endocarditis can be the result of which two causes?
Malignancy or hypercoagulable state (marantic/thrombotic endocarditis)
Which valve is most likely to be involved in bacterial endocarditis?
The mitral valve
In a patient with tricuspid valve involvement as a part of bacterial endocarditis, what is the suspected source of the infection?
Intravenous drug abuse (remember: dont tri drugs)
What symptoms and signs do the letters in the mnemonic FROM JANE represent in bacterial endocarditis?
Fever, Roth spots, Oslers nodes, Murmur, Janeway lesions, Anemia, Nail-bed hemorrhages, and Emboli
What is the classic renal complication that can occur after a case of bacterial endocarditis?
What is the name for the group of bacteria that cause endocarditis but will not grow in standard culture medium?
Which pathogen is often responsible for bacterial endocarditis on prosthetic heart valves?
Other than Staphylococcus aureus, which organisms are known to cause endocarditis in intravenous drug users?
Pseudomonas and Candida
What type of endocarditis is seen in patients with lupus?
Libman-Sacks endocarditis (remember: SLE causes LSE)
How do the vegetations in Libman-Sacks endocarditis differ from those in bacterial endocarditis?
Sterile, verrucous, and occur on both sides of the valve
In Libman-Sacks endocarditis, which valve is commonly affected?
The mitral valve
Which murmurs are associated with Libman-Sacks endocarditis?
Mitral regurgitation, and less commonly mitral stenosis