Flashcards on Myocarditis: Inflammation of the Heart
Myocarditis: Inflammation of the Heart - A Student's Guide
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Parasitic Infections
23 cards
Card 1
Question: What are the typical clinical manifestations of the acute phase of Chagas disease, and how often are they recognized?
Answer: The acute phase with parasitemia is usually unrecognized; in <5% of cases, it manifests with several weeks of nonspecific symptoms or, rarely, acute m
Card 2
Question: How does untreated (without antiparasitic therapy) Chagas disease progress in the medium to long term?
Answer: The silent phase slowly progresses over >10–30 years in nearly half of patients to chronic manifestations in the cardiac and GI systems.
Card 3
Question: What are the typical cardiac abnormalities in chronic Chagas disease?
Answer: Conduction system disorders (sinus and AV node), right bundle branch block, atrial fibrillation, ventricular tachyarrhythmias, small apical ventricula
Card 4
Question: Why are dilated ventricles in Chagas disease thrombogenic, and what complications does this cause?
Answer: Dilated ventricles, especially with apical aneurysms, are thrombogenic and lead to pulmonary and systemic emboli.
Card 5
Question: What diagnostic tests are used for Chagas disease, and what are their limitations?
Answer: Xenodiagnosis is rare; serological tests for specific IgG have insufficient specificity and sensitivity, thus two different positive serological tests
Card 6
Question: What does treatment for advanced stages of Chagas disease focus on?
Answer: Treatment focuses on clinical manifestations: medications for heart failure, implantation of pacemakers/defibrillators, and anticoagulation.
Card 7
Question: Which antiparasitic drugs are most commonly used for Chagas disease, and in whom are they effective?
Answer: Benznidazole and nifurtimox; effective in children with chronic Trypanosoma cruzi infection.
Card 8
Question: What are the side effects of benznidazole and nifurtimox?
Answer: Both drugs are associated with severe reactions: dermatitis, gastrointestinal distress, and neuropathy.
Card 9
Question: What was the outcome of a large study on antimicrobial therapy in adults with Chagas cardiomyopathy?
Answer: Benznidazole in adults with established Chagas cardiomyopathy did not prevent disease progression, leaving the role of antiparasitic therapy unclear.
Card 10
Question: What is the prognosis for patients with manifest heart failure in Chagas disease?
Answer: Survival is <30% after 5 years from the onset of overt clinical heart failure.