Cardiac: Endocarditis Flashcards

1
Q

What is endocarditis? what usually causes it

A
  • inflammation of endocardium that lines the surface of cardiac valves
  • bacterial infection
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2
Q

What is the most common overall cause of endocarditis? and what does it infect

A

Streptococcus viridans : low-virulence organism that infects previously damaged valves

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3
Q

What diseases involve Streptococcus viridans

A
  • chronic rheumatic heart disease

- mitral valve prolapse

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4
Q

Streptococcus viridans results in what

A

subacute endocarditis: small vegetations do not destroy valve

  • damaged endocardial surface develops thrombotic vegetations
  • transient bactermia leads to trapping of bacteria in the vegatations
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5
Q

what can decrease the risk of endocarditis from streptococcus viridans

A

prophylactic antibiotics

- ex. dentist office

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6
Q

what bacteria is the most common cause of endocarditis in IV drug abuser

A

Staphylococcus aureus

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7
Q

endocarditis from staphylococcus aureus presents how? which valve does it usually attack

A
  • high virulence organism that infects normal valves
  • most common valve tricuspid
  • results in large vegetations that destroy the valve ( acute endocarditis)
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8
Q

Endocarditis of prosthetic valves is associated with what bacteria

A

Streptococcus epidermidis

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9
Q

What bacteria is associated with endocarditis in patients with underlying colorectal carcinoma

A

Streptococcus bovis

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10
Q

what bacteria is associated with endocarditis with negative blood culture

A

HACEK

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11
Q

what does HACEK organisms stand for

A
Haemophilus
Actinobacillus
Cardiobacterium 
Eikenella 
Kingella
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12
Q

What are 4 clinical features of bacterial endocarditis ? and why do we see them?

A
  1. fever - due to bacteremia
  2. murmur - due to vegetations on heart valve
  3. Janeway lesion, Osler nodes, splinter hemorrhages in nail bed, Roth spots - due to embolization of septic vegetations
  4. anemia of chronic disease - due to chronic inflammation
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13
Q

Janeway lesion?

A

erythematous nontender lesions on palms and soles

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14
Q

Osler nodes?

A

tender lesions on fingers and toes

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15
Q

What are laboratory findings of endocarditis

A
  1. positive blood cultures
  2. Anemia of chronic disease
  3. Transesophageal echocardiogram is useful for detecting lesions on valves
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16
Q

Nonbacterial thrombotic endocarditis is due to what

A

sterile vegetations that arise in association with a hypercoagulable state or underlying adenocarcinoma.

17
Q

where do vegetations aries from nonbacterial thrombotic endocarditis? what does this result in?

A

-mitral valve along lines of closure and result in mitral valve regurgitation

18
Q

What causes Libman-Sacks endocarditis

A

sterile vegetations that arise in associated with SLE

19
Q

Where does Libman-Sacks present

A

surface and undersurface of the mitral valve and result in mitral regurgitation