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Pathoma LAH > Cardiology: 8.5: Endocarditis > Flashcards

Cardiology: 8.5: Endocarditis Flashcards

1
Q

What is endocarditis?

A

inflammation of the endocardium, esp. that which lines the surface of the cardiac valves

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2
Q

What is nonbacterial thrombotic endocarditis?

A

sterile valve vegetations

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3
Q

What is the hemolysis pattern of Strep. viridans?

A

alpha

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4
Q

Strep. viridans can only infect which heart valves?

A

previously damaged valves

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5
Q

Dx?

  • sterile valve vegetations from SLE
A
  • Libman-Sacks endocarditis
  • “LSE in SLE”
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6
Q

What lab findings are seen in endocarditis?

A
  • positive blood cultures
  • anemia of chronic disease (low MCV, low hemoglobin)
  • high ferritin = TIPC low = serum Fe decreased
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7
Q

What valves does Staph. aureus infect?

A

normal valves, esp the tricuspid

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8
Q

What is the gram stain and morphology of Staph. epidermidis?

A

gram positive cocci in clusters

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9
Q

Is Strep. viridans catalase positive or negative?

A

negative

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10
Q

What is the hemolysis pattern of Strep. bovis?

A

gamma (no hemolysis)

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11
Q

What kind of endocarditis do the HACEK organisms cause? Why?

A
  • endocarditis w/ negative blood cultures
  • they’re hard to grow
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12
Q

What detects lesions on heart valves?

A

trans-esophageal echo (TEE)

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13
Q

What is the endocarditis called when caused by Staph. aureus?

A

acute endocarditis

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14
Q

You discover that your pt has endocarditis from Strep. bovis. What do you do next?

A

check for colorectal carcinoma

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15
Q

What are Janeway lesions?

A
  • erythematous, nontender lesions on the palms and soles
  • assoc with endocarditis
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16
Q

Why can Strep. viridans attach to damaged heart valves?

A
  • the thrombotic vegetations that form trap these bacteria
  • bc the bugs make dextrans
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17
Q

What are the HACEK organisms?

A
  • Hemophilus
  • Actinobacillus
  • Cardiobacterium
  • Eikenella
  • Kingella
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18
Q

What are painful lesions on the fingers and toes assoc. with endocarditis called?

A

Osler nodes

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19
Q

Where does nonbacterial thrombotic endocarditis arise? What does this cause?

A
  • on the mitral valve along the lines of closure
  • regurg
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20
Q

What is Libman-Sacks endocarditis?

A
  • sterile valve vegetations from SLE
  • “LSE in SLE”
21
Q

What heart findings are associated with SLE?

A
  • Libman-Sacks endocarditis:
    • vegetations on the surface and undersurface (both sides) of the mitral valve
    • mitral regurg
    • *** “LSE in SLE”
22
Q

Which bug commonly infects prosthetic heart valves?

A

Staph. epidermidis

23
Q

What is the endocarditis caused by Strep. viridans called?

A

subacute endocarditis

24
Q

What is the most common cause of endocarditis in IV drug abusers?

A

Staph. aureus

25
Q

Where is Strep. viridans a normal flora of the body?

A

in the mouth/oropharynx

26
Q

Dx?

  • vegetations on the surface and undersurface (both sides) of the mitral valve with mitral regurg
A

Libman-Sacks endocarditis

27
Q

Name a common way Strep. viridians enters the bloodstream.

A

dental work

28
Q

What is the gram stain and morphology of Strep. bovis?

A

gram positive cocci in chains

29
Q

How can Strep. bovis be differentiated from Group D strep/enterococci?

A

does not grow in 6.5% NaCl

30
Q

Is Viridans strep optochin sensitive or resisitant?

A

sensitive

31
Q

What are the s/s of endocarditis?

A
  • fever
  • murmur (bc of vegetations on the valves) –> :
    • Janeway lesions (erythematous, nontender lesions on the palms and soles)
    • Osler nodes (painful lesions on the fingers and toes)
    • splinter hemorrhages in the nailbeds
  • anemia of chronic disease
32
Q

What do thrombotic vegetations consist of? What do they attach to?

A
  • platelets + fibrin
  • subendothelial collagen and tissue factor
33
Q

Where does Libman-Sacks endocarditis occur? What does this cause?

A
  • on the surface and undersurface (both sides) of the mitral valve
  • mitral regurg
34
Q

Dx?

  • vegetations on the mitral valve along the lines of closure with mitral regurg
A

nonbacterial thrombotic endocarditis

35
Q

Is Staph. epidermidis catalase positive or negative?

A

positive

36
Q

What is the morphology of Strep. viridans?

A

gram positive cocci in chains

37
Q

What does Staph. aureus do to heart valves?

A

large vegetations destroy the valve –> acute endocarditis

38
Q

Is Staph. epidermidis novobiocin sensitive or resistant?

A

sensitive

39
Q

What are Osler nodes?

A

painful lesions on the fingers and toes assoc. with endocarditis “Ouch Ouch Osler”

40
Q

What happens in endocarditis caused by Strep. viridans?

A

small vegetations form which do not destroy the valve

41
Q

What is a consequence of valve vegetations?

A

they can embolize (septic embolization)

42
Q

What is the most common overall causative organism of endocarditis?

A

Strep. viridans

43
Q

What causes nonbacterial thrombotic endocarditis?

A
  • a hypercoagulable state
  • underlying adenocarcinoma
44
Q

Which bug commonly infects pts with underlying colorectal carcinoma?

A

Strep. bovis

45
Q

Is Staph. epidermidis coag positive or negative?

A

negative

46
Q

What usually causes endocarditis?

A

bacterial infection

47
Q

How can Strep. viridans be distinguished from S. pneumo?

A

Viridans is not encapsulated

48
Q

What are erythematous, nontender lesions on the palms and soles assoc. with endocarditis called?

A

Janeway lesions

Pathoma LAH (77 decks)

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