Acquired Heart Disease

Question 1

Duke Criteria Criteria mnemonic

Answer 1

BE TIMER

Blood culture positive > 2 times 12 hours apart with typical microorganisms

Echocardiographic evidence of vegetation, abscess or new partial dehiscence of prosthetic valve

Temperature > 38
Immune phenomena (Janeway, Osler, Roth spots)
Micro evidence not meeting major Criteria
Embolic phenomena
Risk factors

Question 2

Paediatric risk factors for IE

Answer 2

Rheumatic carditis, congenital heart disease (VSD PDA ToF) and cardiac surgery (shunts , valves, stents, patches)

Question 3

Microbiology in kids for IE

Answer 3

Viridian strep (Mitis, Mutant, Bovis, Sanguis), S aureus, CONS, Enterococci, HACEK, Fungi, Aspergillus

Question 4

Which group is at risk of viridian strep IE

Answer 4

Rheumatic carditis, late post op endocarditis

Question 5

Groups at risk of S Aureus endocarditis

Answer 5

Acute IE, long term CVL, neonate, IVDU

Question 6

Group at risk of CONS endocarditis

Answer 6

Early post op endocarditis, nosocomial infection of prosthetic valve

Question 7

HACEK organisms

Answer 7

Haemophillus parainfluenzae, Actinobacillus actinimycetumcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae, Q Fever (Coxiella Burnetti)

Question 8

How many of Duke Criteria needed for diagnosis

Answer 8

2 major or 1 major plus 3 minor or 5 minor

Question 9

High risk predisposing factors

Answer 9

Previous endocarditis, Aortic Valve Disease, Rheumatic Heart Disease, Prosthetic Valve. Coarctation, Complex congenital disease

Question 10

Moderate risk predisposing factors

Answer 10

MV prolapse, mitral stenosis, tricuspid disease, pulmonary stenosis, cardiomyopathy

Question 11

Low risk

Answer 11

ASD, IHD, MV prolapse without regurgitation

Question 12

Dental and ENT procedures for which prophylaxis is recommended for

Answer 12

• Manipulation of gingivitis tissue or perforation of oral mucosa
• Adenotonsillectomy

Question 13

Conditions for which prophylaxis recommended for

Answer 13

Previous endocarditis, Rheumatic Heart Disease, Prosthetic Heart Valve, Unrepaired cyanotic congenital heart disease (including palliative shunts/conduits), within 6 months of surgical or catheter repair of congenital heart disease

Question 14

Antibiotic recommended for prophylaxis

Answer 14

Amoxicillin 50mg/kg (max 1g) one dose prior to procedure. OR Clarithromycin OR Clindamycin 15mg/kg one dose