Chest Pain and Fever II Flashcards

1
Q

fever of unknown origin

A

3 weeks or longer with 1 week of unknown workup

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2
Q

fever

A

PGE2

its release stimulated by IL1, IL6, and TNFalpha

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3
Q

causes of FUO

A

infection, cancer, autoimmune/CT disease

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4
Q

duke criteria

A

for endocaritis

two major
or one major and 3 minor
or 5 minor

major - two positive blood cultures, echo evidence, new regurg murmur

minor - predisposing condition, fever, vascular emboli (janeway/osler/roth), immuno with agglutinating bodies

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5
Q

common bug for endocarditis

A

bartonella hensalae or quintana

Tx - doxycycline and gentamicin

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6
Q

acute endocarditis

A

virulent organisms

valvulr regurg, high fever, early emboli

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7
Q

native valve endocarditis

A

brushing teeth, IV device

staph
or strep viridans
or HACEK

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8
Q

IV drug users

A

staph to tricuspid valve

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9
Q

early prostethic valve infection

A

within 2 months

-coagulase + and - staph

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10
Q

late prosthetic valve infection

A

strep or staph

coag - and +

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11
Q

Dx of endocarditis

A

3 cultures one hour apart

use dukes criteria
-2 positive cultures

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12
Q

HACEK

A

takes a long time to culture

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13
Q

negative culture in suspected endocarditis

A

could be HACEK group

-eikenella, kingella**

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14
Q

complications of endocarditis

A
heart block
CHF
emboli
mycotic aneurysms
myocardial abscess
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15
Q

prosthetic aortic valve infection

A

coxiella burnetii

if owned cat

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16
Q

Tx for coxiella infection

A

doxycycline if acute

doxycycline + rifampin if chronic

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17
Q

strep endocarditis Tx

A

PCN G

18
Q

enterococcal endocarditis Tx

A

PCN + gentamicin

19
Q

staphaylococcus endocarditis

A

nafcillin or vanco

20
Q

native valve treatment

A

vancomycin

21
Q

prosthetic valve

A

rifampin - kills staph adhered to foreign material**

22
Q

vancomycin

A

covers staph, strep, enterococcus

23
Q

PCN G

A

strep

24
Q

ampicillin and gentamicin

A

enterococcus

25
Q

penicillin sensitive staph

A

nafcillin

26
Q

nafcillin

A

for PCN sensitive staph

27
Q

vancomycin

A

for MRSA or coag negative staph

inhibits cell wall synthesis in gram positives

28
Q

gentamicin

A

30S ribosome

29
Q

rifampin

A

DNA dependent RNA polymerase

30
Q

poor dentition

A

strep mutans

31
Q

strep bovis

A

GI neoplasm

32
Q

enterococci

A

elderly with urinary problems

33
Q

HACEK

A

prolonged incubation

34
Q

late prosthetic valve

A

strep

35
Q

IV drug users

A

staph

36
Q

alcoholics and street people

A

bartonella

37
Q

no growth

A

tropheryma

38
Q

endocarditis prophylaxis

A

only high risk cardiac populations

-previous IE, prostethic valve, cyanotic heart disease

perforating procedures of teeth, lungs, skin

39
Q

dental antibiotics

A

amoxicillin 2 grams 1 hour before procedure

40
Q

syncope, diastolic rumble, weight loss, fever, sed rate elevation

A

atrial myxoma

41
Q

atrial myxoma

A

carney complex of pigmented skin

cAMP activated protein kinase A