pericarditis

Question 1

what is the pericardium

Answer 1

protective covering for the heart

Question 2

what does pericardium consist of

Answer 2

• outer fibrous pericardial sac

- inner serous pericardium

Question 3

what does the outer pericardium line

Answer 3

the fibrous sac

Question 4

what is normal amount of pericardial fluid

Answer 4

20-49mL

Question 5

what does the pericardial fluid do

Answer 5

lubricate the surface of the heart

Question 6

what is pericarditis

Answer 6

inflammation of the pericardium

Question 7

what are most cases caused by

Answer 7

unknown

Question 8

causes

Answer 8

• infection e.g. TB, strep, staph, H.influenza
• tumours
• autoimmune
• post-surgical
• post-radiation
• familial

Question 9

what is most common viral cause

Answer 9

Coxsackie B virus

echovirus

Question 10

how long does viral pericarditis last

Answer 10

short time

Question 11

what is an implication

Answer 11

HIV

Question 12

what can bacterial pericarditis occur with

Answer 12

• septicaemia

- pneumonia

Question 13

what is a frequent cause of bacterial pericarditis in HIV patients

Answer 13

staph aureus

Question 14

what does TB pericarditis present with

Answer 14

• low grade fever in evening
• SOB
• malaise
• night sweats
• weight loss

Question 15

what is required for diagnosis of TB pericarditis

Answer 15

pericardial aspiration

Question 16

what is an outcome of TB pericarditis

Answer 16

constrictive pericarditis

Question 17

what is treatment for TB pericarditis

Answer 17

as for pulmonary tuberculosis plus prednisolone daily for 2-3 weeks

Question 18

what is a frequent complication of endemic fungal infections

Answer 18

pericarditis

Question 19

when can pericarditis occur after MI

Answer 19

first few days following MI

Question 20

what type of MI is post-MI pericarditis common with

Answer 20

• anterior MI
• STEMI
  with high serum cardiac enzymes

Question 21

what is post-MI pericarditis usually a feature of

Answer 21

Dressler syndrome

Question 22

what are differential diagnosis of post-MI pericarditis

Answer 22

• new MI

- unstable angina

Question 23

what are common causes of malignant pericarditis

Answer 23

• carcinoma of bronchus
• carcinoma of breast
• Hodgkins lymphoma

Question 24

what is uraemic pericarditis due to

Answer 24

irritation of the pericardium by accumulating toxins

Question 25

how can uraemic pericarditis occur

Answer 25

in patients with advanced kidney disease if dialysis is delayed

Question 26

symptoms

Answer 26

- sharp central chest pain that is exacerbated by movement - pain relieved by sitting forward - pain may radiate to neck or shoulder - pericardial friction rub - fever - SOB

Question 27

differential diagnosis

Answer 27

- angina | - pleurisy

Question 28

what is diagnostic

Answer 28

ECG

Question 29

what is seen on ECG

Answer 29

- saddle shaped ST elevation - ST depression in reciprocal leads - sinus tachycardia

Question 30

what else is done for investigations

Answer 30

- cardiac enzymes elevate = myocarditis ? | - CXR = cardiomegaly ?

Question 31

treatment

Answer 31

bed rest and NSAIDs

Question 32

examples of NSAIDs

Answer 32

- aspirin | - ibuprofen

Question 33

what is drug of choice in patient with recent MI

Answer 33

aspirin