Bacterial Endocarditis

Question 1

what is bacterial endocarditis?

Answer 1

bacterial infection of endocardium

Question 2

in which species does bacterial endocarditis impact the mitral or aortic valves most?

Answer 2

dog
cat
horse
swine

Question 3

what does the proposed pathogenesis of subacute bacterial endocarditis involve?

Answer 3

previously damaged cardiac valve
sterile platelet-rich-fibrin thrombus
bacteremia
high titer of agglutinating antibody against the organism

Question 4

what can bacteria being shed from the valve lead to?

Answer 4

pyelonephritis and UTI
meningitis
septic arthropathy
myocarditis

Question 5

what does infection of the valve lead to?

Answer 5

proliferation and fibrous valvular changes
vegetative lesions

Question 6

what are the four factors that go into subacute bacterial endocarditis?

Answer 6

previously damaged cardiac valve
sterile platelet-fibrin thrombus
bacteremia
high titer of agglutinating antibody against organism

Question 7

can bacterial endocarditis occur on normal valves?

Answer 7

yes: due to highly pathogenic bacteria

Question 8

what are the effects of bacterial endocarditis on the mitral valve?

Answer 8

mitral regurgitation
mitral stenosis
left-sided CHF

Question 9

what can immunologic reaction to chronic infection lead to?

Answer 9

immune-mediated polyarthropathy
glomerulonephritis
positive immunologic tests

Question 10

what are some historical predisposing factors to bacterial endocarditis?

Answer 10

recent bacteremia
cardiac disease
recent surgery, wounds, IV catheter
immunosuppression

Question 11

what are some radiographic findings with endocarditis?

Answer 11

cardiac chamber enlargement
evidence of CHF
evidence of pneumonia
pleural effusion
evidence of pulmonary thromboembolism

Question 12

what is diagnostic accuracy like with echocardiography with endocarditis?

Answer 12

80-90%

Question 13

what is a common clinical finding with the heart with bacterial endocarditis?

Answer 13

new or changing cardiac murmur

Question 14

which valve does Bartonella sp impact?

Answer 14

aortic

Question 15

what are the major criteria for bacterial endocarditis?

Answer 15

positive echocardiographic findings
positive blood cultures in absence of diskospondylitis or obvious sepsis
recent onset diastolic murmur or evidence of more than mild aortic regurgitation

Question 16

how can you treat bacterial endocarditis?

Answer 16

IV antibiotics 5-14 days
broad spectrum
oral antibiotics 4-8 weeks: culture and sensitivity
no corticosteroids

Question 17

which type of bacterial endocarditis is more common?

Answer 17

valvular endocarditis
mural less common

Question 18

what pathogens can adhere to cardiac valves?

Answer 18

Enterococci
Streptococci
Pseudomonas

Question 19

what pathogens can produce proteases and induce valve injury and facilitate colonization?

Answer 19

Staph
Strep

Question 20

what are some predisposing factors for bacterial endocarditis?

Answer 20

pre-existing valvular disease
immunosuppressive drugs
recent surgery
recent IV catheter placement
middle-ages, intact male large dogs
antimicrobial use
allergic factor

Question 21

what are the cardiac effects of bacterial endocarditis of the pulmonic and tricuspid valve?

Answer 21

stenosis or insufficiency of either valve
right CHF
pulmonary thromboembolism

Question 22

what are the clinical scenarioss of bacterial endocarditis?

Answer 22

congestive heart failure
fever of unknown origin
multisystemic signs suggestive of infection or immune mediated disease
organ embolism

Question 23

what types of murmurs in dogs and cats are often associated with endocarditis?

Answer 23

diastolic descrendo murmurs

Question 24

is PT or PTT usually prolonged in bacterial endocarditis?

Answer 24

PTT

Question 25

what arrhythmias can be seen with endocarditis?

Answer 25

ventricular arrhythmias most common
atrial arrhythmias
AV block
ST segment depression

Question 26

what is transesophageal echocardiography useful for?

Answer 26

better definition of structures at heart base
improves diagnostic accuracy

Question 27

what can you culture for bacterial endocarditis?

Answer 27

joint
urine
blood

Question 28

what are the minor criteria for bacterial endocarditis?

Answer 28

fever
large breed dog
new or worsening systolic murmur

Question 29

what are some broad spectrum antibiotics used in bacterial endocarditis?

Answer 29

beta-lactams/cephalosporins
with aminoglycoside/fluoroquinolone

Question 30

what is the overall median survival time of bacterial endocarditis?

Answer 30

72 days