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Block 12 Module 3 > carditis > Flashcards

carditis Flashcards

1
Q

inflammation of the heart muscle

A

myocarditis

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2
Q

most commonly affected in IE

A

heart valves

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3
Q

how does IE occur

A

when bacteria and occasionally fungi and other
microbes enter the bloodstream & attack the lining of
the heart or the heart valves

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4
Q

how does IE cause a leaky valve

A

there are vegetations or holes on valves or scarring of the valve tissue that may result in a leaky valve

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5
Q

Intracardiac effects include severe valvular

insufficiency, which may lead to:

A
  • intractable congestive heart failure

- myocardial abscesses (foci of infection

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6
Q

prototypic lesion of IE

A

vegetation

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7
Q

what are vegetations

A

mass of platelets, fibrin, microcolonies of mcg and scant InFtory cells

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8
Q

Febrile illness that rapidly damages cardiac

structures

A

acute endocarditis

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9
Q

what is mycotic aneurism

A

ballooning of blood vessel due to bacteria

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10
Q

bacteria that cause acute endocarditis

A

S aureus

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11
Q

bacteria that cause subacute endocarditis

A

S. viridans

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12
Q

this usually occurs w/o ill effects but usually leads to IE in patients w/
an underlying CV lesion or w/ a suppressed immune
system

A

transient bacteremia

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13
Q

HACEK

A 
Haemophilus
Actinobacillus
Cardiobacteria
Eikenella
Kingella
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14
Q

this causes Q fever

A

Coxiella burnetti

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15
Q

most common cause of early prosthetic valve infections

A

Staphylococci

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16
Q

how does NBTE develop?

A

Endothelial cells that line the inside of the heart and the
heart valve can become damaged leading to the
accumulation of platelets or uninfected platelet-fibrin
thrombus producing a condition called non-bacterial
thrombotic endocarditis (NBTE)

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17
Q

conditions which lead to endothelial cell damage

A 
RHD
CHD
MVP
Degenerative HD
Prosthetic valve replacement
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18
Q

where does bacteria and platelets accumulate to produce NBTE

A

downstream or low-pressure side of valvular lesion

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19
Q

this help bacteria colonize NBTE

A

Surface adherence factors

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20
Q

this binds to platelet receptors

A

Strep sanguis

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21
Q

this binds to fibronectin

A

S aureus

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22
Q

where does S sanguis bind

A

platelet receptors

23
Q

where does S aureus bind

A

fibronectin

24
Q

four outcomes in the formation of vegetations

A
  1. damage to intracardiac structures
  2. embolization of vegetation fragments
  3. Hematogenous infection of sites during bacteremia
  4. Tissue injury due to the deposition of circulating
    immune complexes or immune responses to
    deposited bacterial antigens
25
Q

the symptoms of acute IE is similar to the presence of what

A

abscess

26
Q

which has a rapid onset of symptoms (acute or subacute)

A

acute

27
Q

most common symptom of subacute IE

A

low grade fever

28
Q

manifestations seen in both types of endocarditis

A 
murmurs
roth spots
petechial hemorrhages
janeway lesions
osler nodes
29
Q

changing murmur occurs when

A

valve leaflet is destroyed or chordae tendinae ruptures

30
Q

murmurs are less common in ____

A

R-sided endocarditis

31
Q

these are retinal hemorrhages with pale centers

A

roth spots or flame shaped hemorrhages

32
Q

Painless hemorrhagic plaques on the palms and

soles

A

janeway lesions

33
Q

Small, pea-sized subcutaneous, painful
erythematous nodules that occur in the pads of the
fingers and toes and the thenar eminence

A

osler nodes

34
Q

In IE lab results, peripheral leukocyte count is not normal in what conditions

A

myocardial abscess formation
extravascular site infection
acute endocarditis

35
Q

test for the confirmation of IE

A

2D echo

36
Q

what are the findings in the chest x-ray in IE

A

distinct round cannonball like pulmo emboli in R-sided endocarditis

37
Q

1 do you need to do an hourly blood culture at different sites of the body

A

to rule out transient bacteremia which lasts abt 30 min

38
Q

doppler color flow allows assessment of

A

valve function
myocardial contractility
chamber volume

39
Q

Definite endocarditis accdg to duke criteria

A

2 major
1 maj 3 min
5 min

40
Q

possible endocarditis accdg to duke criteria

A

1 maj 1 min

3 min

41
Q

therapy for IE must be

A

bactericidal and given for long periods

42
Q

High risk cardiac lesions for which endocarditis prophylaxis is advised before dental procedure

A 
prosthetic HV
prior endocarditis
unrepaired cyanotic CHD
completely repaired CHD
valvulopathy after cardiac transplant
43
Q

most important infectious agent for myocarditis

A

viruses

44
Q

single most important group of viruses for myocarditis

A

enteroviruses

45
Q

bacterial causes of myocarditis

A

legionella chlamydia
borrelia
burgdorferi

46
Q

fungal causes of myocarditis

A

aspergillus
caandida
cryptococcus

47
Q

parasitic causes of myocarditis

A

trypanosoma cruzi

trichinella spiralis

48
Q

before the heart effects are seen in myocarditis what is usually the manifestation

A

skin infection

49
Q

if the pericardium is involved this sign may be present

A

friction rub

50
Q

ekg in myocarditis may present

A

ST and T wave changes, vent or atrial arrhythmias

conduction defects

51
Q

why echo is used in the diagnosis fo myocarditis

A

assess cardiac contractility,

chamber size, valve function and wall thickness

52
Q

why contrast enhanced MRI is used in the diagnosis fo myocarditi

A

detect the extent and degree of IFN

determine parameters that correlate with LV function

53
Q

contraindicated in the treatment of myocarditis

A

Glucocorticosteroids and immunosuppresive drugs

54
Q

treatment for fulminant disease

A

cardiac transplant

Block 12 Module 3 (4 decks)

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