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Host and Defense 2020 > 1/23/17 Intravascular infections Granger TEST #1 > Flashcards

1/23/17 Intravascular infections Granger TEST #1 Flashcards

1
Q

What is a bacteremia?

A

-Presence of bacteria in blood stream

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2
Q

What can bacteria in the blood lead to?

A

-Septic shock

shock = no blood pressure

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3
Q

What is metastatic infection?

A

-Bacteria in corners of the body (all locations/sites in the body)

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4
Q

What are two methods/ways of a bacteremia?

A
  • Transient

- Continuous

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5
Q

What makes a bacteremia transient?

A

-The clearance exceeds entry

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6
Q

What makes a bacteremia continuous?

A

-Seeding exceeds clearance capacity

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7
Q

What does continuous bacteremia lead to?

A

-Endovascular infections

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8
Q

Where do you find transient bacteremias?

A
  • Skin
  • lungs
  • joint
  • bone
  • abdomen
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9
Q

In a continuous bacteremia with septicemia what is a characteristic of the bacteria?

A

-They have high virulence

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10
Q

What type of infections can be caused by avirulent organisms?

A

-Endovascular infections

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11
Q

What is an example of endovascular infections?

A
  • Infective endocarditis
  • infected thrombus
  • mycotic aneurysm
  • infections of intravascular devices
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12
Q

When taking a blood culture how should the blood be removed?

A

-aseptically

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13
Q

What is the sensitivity of blood culture tests dependent on?

A

-Volume of the blood

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14
Q

Whenever you culture the blood infective endocarditis is it positive or negative?

A

-Positive

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15
Q

What are the (epidemiology) predisposition for endocarditis?

A
  • Congenital heart disease
  • Rheumatic heart disease
  • Intravenous drug abuse (IVDA)
  • Hospitalization
  • Dental, urological, gastrointestinal
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16
Q

What is the pathogenesis of endocarditis?

A
  • Turbulent blood flow
  • Endothelial cell activation
  • Fibrin and platelet deposition
  • Silent or clinical bacteremia seed sterile vegetations
  • Bacteria grow within fibrin vegetations
17
Q

Do the valves of the heart receive nourishment? If so from where?

A

-Blood stream

18
Q

What does the endocardium lack?

A

-Capillary circulations

19
Q

Why is capillary circulation important?

A

-It is required for neutrophil access to the site of infection

20
Q

Why is the infection of the valves of the heart dangerous?

A

-Because they don’t have capillary circulation allowing neutrophils to access the site of infection

21
Q

If you have endocarditis without antibiotics what happens with the bacteria?

A

-They are imbedded within vegetations and are impossible to entirely eradicate

22
Q

How do you diagnosis endocarditis?

A

-Look for the major and minor criteria?

23
Q

-What are the major criteria for diagnosing endocarditis?

A
  • Continuous bacteremia (found via blood culture)

- Target lesion on valve, supports, or endocardium (ECHO cardiography)

24
Q

What are some minor criteria for diagnosing endocarditis?

A
  • Fever
  • Predisposing heart condition
  • Injection druge user
  • Embolic phenomena
  • Immunological phenomena
25
Q

If a patient comes to your clinic and you take a blood culture do find continuous bacteremia, has a fever, is an injection drug user, and has a positive ECHO cardiography (target lesion on valve, supports or endocardium) test what would you diagnose them with?

A

-Endocarditis

26
Q

What causes Osler’s nodes?

A

-Embolic lesions

27
Q

What causes conjunctival petechia?

A

-Embolic lesions

28
Q

What causes the embolic lesions?

A

-Some of the vegetation breaking off of the valves in the heart caused from endocarditis

29
Q

When you take a microbiologic culture from the bacteria causing endocarditis what bacteria do you see?

A
  • Staphylococci
  • Streptococci
  • Enterococci
  • Gram - bacilli
  • Fungi
30
Q

If you have non-virulent strep species do you see them in endocarditis cultures?

A

-Yes

31
Q

What is the most common non-virulent strep species that you see in endocarditis cultures?

A

-Strep mutans

32
Q

Who is at high risk for adverse outcome from IE?

A
  • Prosthetic heart valves
  • Previous infect endocarditis
  • Congenital heart disease
  • Cardiac transplanted hearts
33
Q

What is a good way to prevent Infective endocarditis?

A

-Prophylactic antibiotics prior to procedures

34
Q

How do you treat someone with endocarditis?

A
  • Do Intravenous therapy

- Bactericidal regimen

35
Q

When diagnosing endocarditis what is something that you have to give special attention to?

A

-Blood cultruing

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