cardiovascular infections

Question 1

which types of infections are viral?

Answer 1

• myocarditis

- pericarditis

Question 2

which types of infections are bacterial and fungal

Answer 2

endocarditis

pericarditis can be bacterial

Question 3

phlebitis

Answer 3

inflammation of the vein

Question 4

true or false? endocarditis can be caused by a virus

Answer 4

false. endocarditis is NEVER caused by a virus. only bacteria and fungi

Question 5

where do bacteria and fungi cause infection?

Answer 5

• inside heart chamber

- valves

Question 6

where do viruses cause infection?

Answer 6

• outside of the heart (pericardium)

- in the heart muscle (myocarditis)

Question 7

example of parasitic infection of the heart

Answer 7

american trypanosomiasis

Question 8

myocarditis: what infiltrates the cardiac m

Answer 8

t lymphocytes

Question 9

when should you use NSAIDS as a treatment?

a) myocarditis
b) pericarditis
c) endocarditis
d) both A and B

Answer 9

only b) pericarditis

*note: should not use NSAIDs for myocarditis

Question 10

what virus causes myocarditis

Answer 10

• MOSTLY enteroviruses (coxsackie B)
• adeno virus
• herpes
• parvovirus
• hiv
• flu
• also allergy, toxic, autoimmune

Question 11

enteroviruses are

Answer 11

• unenveloped
• get it from food
• worse in summer and fall

Question 12

what causes pericarditis

Answer 12

• enteroviruses (coxsackievirus, echovirus)
• hiv
• S. pneumonia, S. aureus
• tuberculosis
• rheumatic fever

Question 13

chest pain due to viral infection is caused by

Answer 13

virus => inflammation

Question 14

chest pain due to bacterial infection is caused by

Answer 14

bacteria => pus

Question 15

symptoms of pericarditis

Answer 15

• chest pain
• shortness of breath when reclining
• heart palpitations
• fever
• characteristic ECG changes

Question 16

treatment for pericarditis

Answer 16

• NSAIDS and steroids (viral)

- antibiotics and drainage of fluid (bacterial)

Question 17

which is more severe? bacterial or viral pericarditis

Answer 17

bacterial

Question 18

patient is at risk with arterial or ventricular septic defect?

Answer 18

ventricular

Question 19

predisposing factors for endocarditis

Answer 19

• prosthetic valves
• iv drug users
• iv catheters
• congenital heart disease
• rheumatic fever (after strep throat)

Question 20

acute ie

Answer 20

• sudden (2 weeks)
• life threatening in few days
• caused by S. aureus

Question 21

subacute ie

Answer 21

• gradual (months)
• subtle
• can be life threatening but outcome is better
• caused by a-streptococci and non-virulent bacteria

Question 22

most ie occurs on which side of heart

Answer 22

left

Question 23

IVDU occurs on which side of heart

Answer 23

right

Question 24

steps of ie

Answer 24

• turbulence in blood bc damaged valve
• non-bacterial thrombotic endo
• bacteremia
• vegetation

Question 25

infective endocarditis is the sum of

Answer 25

non-bacterial thrombotic endocarditis (NBTE) + bacteria

Question 26

signs of acute endo

Answer 26

- fever, chills - septic shock - peripheral manifestations and new/changing heart murmur

Question 27

types of peripheral manifestations for acute endo

Answer 27

- splinter hemorrhages | - embolic (janeway lesions, infarctions of toes and fingers)

Question 28

symptoms of subacute endo

Answer 28

- fatigue - fever, chills - weight loss - back pain - heart murmur - peripheral manifestations - SPLENOMEGALY (BIG SPLEEN) - ANEMIA (PALLOR)

Question 29

peripheral manifestations for subacute endo

Answer 29

- splinter hemorrhages - petechiae - Osler's nodes - Roth spots! (on retina)

Question 30

causes of endo

Answer 30

- viridans alpha streptococci - entercocci - S. aureus - coagulase-neg staph - HACEK group

Question 31

HACEK

Answer 31

``` Hemophilus Actinobacillus Cardiobacterium Eikenella Kingella ```

Question 32

complications of endo

Answer 32

- congestive heart failure (CHF) - perivalvular abscess - arrhythmias - heart block - myocardial infarction - tamponade - cardiac fistulas

Question 33

neurological consequences of endo

Answer 33

- new stroke with fever - mycotic aneurysms - meningitis - intracranial hemorrhage

Question 34

blood cultures for testing endo

Answer 34

- 3 sets | - streptococci, staphylococci, enterococci

Question 35

what are the two ways of diagnostic testing for IE

Answer 35

- blood culture | - echocardiography

Question 36

TTE (trans thoracic echo)

Answer 36

-low sensitivity

Question 37

TEE (trans esophageal echo)

Answer 37

high sensitivity

Question 38

which ones are specific for echo

Answer 38

- vegetations - abscess - new prosthetic valve dehiscence

Question 39

which ones are non- specific for echo

Answer 39

-new regurgitation or obstruction

Question 40

treatment for IE

Answer 40

- microbicidal | - surgery for specific situations

Question 41

when to use prophylaxis with dental procedure

Answer 41

- prosthetic cardiac valve - previous IE - CHD - cardiac transplant

Question 42

which types of procedure should you use prophylaxis

Answer 42

- MANIPULATION OF GINGIVAL TISSUE - THE PERIAPICAL REGION OF TEETH - PERFORATION OF ORAL MUCOSA

Question 43

main antimicrobial agent for dental procedure

Answer 43

amoxicillin

Question 44

symptoms of myocarditis

Answer 44

- various degrees of CHF - chest pain - arrhythmias - heart block - sudden death