73. Endocarditis and rheumatic heart disease

Question 1

5 predisposing valve problems for endocarditis

Answer 1

o	Rheumatic
o	Congenital
o	Previous endocarditis
o	Mitral valve prolapse
o	Prosthetic valve
	Esp bad

Question 2

3 most common nosocomial casues of endocarditis

Answer 2

Pacers
IV devices
HD caths

Question 3

4 most common bacteria in endocarditis

Answer 3

1. Staph A
2. Viridans strep
3. Enterococci
4. Coad-neg staph

Question 4

3 RFs for fungal endocarditis

Answer 4

o IV caths
o Immunocompromise
o IVDU

Question 5

2 big complications of endocarditis

Answer 5

o CHF
o Neuro events
 Think of in stroke with a fever

Question 6

5 PHx findings of endocard

Answer 6

o	Murmur
o	Petechiae
o	Janeway lesions
o	Osler nodes
o	Roth spots

Question 7

number of criteria needed for DUKE

Answer 7

Definite
- 2 major
- 1 major, 3 minor
- 5 minor
Possible
- 1 Major and 1-2 minor
- 3 minor

Question 8

DUKE major crit

Answer 8

1. Positive blodd Cx of typical pathogens in 2 bottles

2. Echo findings

Question 9

DUKE minor criteria

Answer 9

1. Predisposing condition
2. Fever
3. Vascular phenomenon
4. Single positive blood Cx
5. Echo findings consitent but not meeting major criteria

Question 10

Abx for endocarditis

Answer 10

Cefti + vanco

Question 11

6 conditions requiring surgical intervention for endocarditis

Answer 11

1. Acute heart failure
2. Fungal
3. Periannular extension
4. Recurrent emboli
5. Large mobile vegs
6. Persistent bacteremia

Question 12

6 indications for prophylaxis in endocarditis

Answer 12

1. Prosthetic valve
2. Hx endocarditis
3. Unrepaired cyanotic lesions
4. Completely repaired lesion within 6 months
5. Repaired but residual defect
6. valvulopathy in transplant heart

Question 13

Jones requirements for rheumatic fever

Answer 13

Previous strep infection +

1. 2 major
2. 1 major + 2 minor

Question 14

5 major for JONES

Answer 14

1. Carditis
2. Polyarthritis
3. Chorea
4. Erythema marginatum
5. Subcutaenous nodules

Question 15

4 MINOR manifestations

Answer 15

1. Arthralgias
2. Fever
3. Increased ESR/CRP
4. long PR

Question 16

mgmt arthritis in RF

Answer 16

NSAIDS

Question 17

mgmt carditis in RF

Answer 17

steroids