25. Cardio Path-3

Question 1

An 8 year old boy in Africa is brought to a field hospital by his family. He has been complaining of achy joints and has a noticeable rash. Blood test is done and shows elevated ASO and Anti-DNAse titers. What else would expect on the boys finding?

A. Absent Streptococci from lesions
B. Antibodies against Protein W  
C. Roth Spots
D. Depositions of calcium in the cusp of aortic valve 
E. Inflammation of the Myocardium alone

Answer 1

Ans. A - The patient is presenting symptoms of rheumatic fever. While it follows a strep infection it wouldn’t be expected to find Streopccoi in lessions

B. Antibodies against Protein W- should be Protein M yeah dumb distractor

C. Roth Spots- Endocarditis

D. Depositions of calcium is- calcific aortic stenosis happen is old patients

E. Rheumatic Fever causes pancarditis inflammation of all 3 layers of the heart.

Question 2

A 32 year old women ay manifest as fever, weight loss, night sweats. She is referred to a cardiologist who performs a cardiac biopsy which is notable for sterile vegetation on the cardiac valves. What else likely of the patient history given this information?

A. Prosthetic Valves 
B.  SLE 
C. Cancer 
D. IV Drug use
E. Recent Dental Surgery 

RFA

Answer 2

ANS. B SLE - the finding of sterile vegetation is point towards Libman-Sacks Endocarditis which is found in patients of SLE

A. Prosthetic Valves- would be prosthetic valve disease or IE via S. Epidermidis (friable and bulky vegetations, with inflammatory cells)

C Cancer- NBTE (Nonbacterial Thrombotic Endocarditis), noted by sterile thrombi and noninvasive and no destruction vegetations

D & E are both increase risk of IE D for S. Aureus infection and E S. Viridans. (friable and bulky vegetations, with inflammatory cells