CV 6 Infective Endocarditis

Question 1

microbial (bac/virus) infection of the endothelial surface of the heart

Answer 1

endocarditis

Question 2

non-bacterial endocarditis may be seen with –

Answer 2

hypercoagulable state

Question 3

acute: associated with marked toxicity and progresses over days to several weeks to –

Answer 3

valvular destruction

Question 4

caused by Staph aureus

Answer 4

acute endocarditis

Question 5

subacute evolves over weeks to months with modest toxicity rarely causing metastatic infection; caused by –

Answer 5

viridans streptococci, and enterococci

Question 6

female rheumatic heart disease

Answer 6

mitral valve

Question 7

male rheumatic heart disease

Answer 7

aortic valve

Question 8

injection drug use (mainly Staph, gram -, and fungi) mostly affects – valve

Answer 8

tricuspid

Question 9

organisms involved from dental manipulation

Answer 9

strep

Question 10

organisms involved with early prosthetic heart valves

Answer 10

Staph, candida, gram - bacilli, diphtheroids

Question 11

organisms involved with late prosthetic heart valves

Answer 11

strep

Question 12

culture negative bacteria

Answer 12

coxciella (Q fever) - sheep; airborn
bartonella - cats
chlamydia - STD

Question 13

Janeway lesions are – phenomenon

Answer 13

embolic (bigger clots in hands and feet)

Question 14

Olser’s nodes are – phenomenon

Answer 14

immune

Question 15

Roth’s spots are – phenomenon

Answer 15

immune

Question 16

petechiae are – phenomenon

Answer 16

vascular/embolic

Question 17

musculoskeletal pain esp –

Answer 17

low back pain

Question 18

enlarged – common in subacute infective endocariditis

Answer 18

spleen

Question 19

small, reddish, bluish discoloration of skin and conjunctiva (may be in oropharynx)

Answer 19

petechiae

Question 20

small, slightly nodular, non-painful, red, small areas on palms and soles

Answer 20

janeway lesions

Question 21

splinter hemorrhages (vascular phenomenon)

Answer 21

subungual hemorrhage

Question 22

tender, purple, subcutaneous nodules that dev in pulp of fingers and disappear within several days

Answer 22

Olser’s nodes

Question 23

oval areas of hemorrhage with pale centers and exudates in the retina

Answer 23

Roth’s spots

Question 24

more sensitive Echocardiogram

Answer 24

trans-esophageal (vs trans-thoracic)

Question 25

Does a negative echocardiogram rule out endocarditis?

Answer 25

no

Question 26

How can you distinguish between transient bacteremia and true endothelial infection?

Answer 26

Duke criteria

Question 27

critical criteria

Answer 27

2 major
1 major 3 minor
5 minor

Question 28

how do you use antibiotics for treatment?

Answer 28

prolonged administration (usually IV)