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Microbiology > CV infections > Flashcards

CV infections Flashcards

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Biology 101 flashcards
1
Q

Bacteremia

A

the presence of bacteria in the bloodstream; may or may not be clinically significant.

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2
Q

Transient Bacteremia

A

self-resolving in clients with no underlying illness, immune deficiency, or turbulent cardiac bloodflow.

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3
Q

Primary bacteremia

A

nosocomial infection, also associated with IV drug use. direct inoculation of bacteria into the bloodstream.

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4
Q

Secondary bacteremia

A

opportunistic infection. microorganisms causing infection at another site (eg. pneumonia) invade the bloodstream and disseminate via the circulation to other body areas (hematogenous spread)

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5
Q

Sepsis

A

life-threatening organ dysfunction caused by a dysregulated host response to infection.

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6
Q

Sepsis characteristics

A
  • infection (suspected or confirmed)

- acute, life threatening organ dysfunction as defined by a sepsis related organ dysfunction assessment (qSOFA) tool

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7
Q

qSOFA

A

quick sepsis-related organ failure assessment. measures respiratory, hepatic, CV, renal, CNS, and platelet aggregation.

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8
Q

Endocardium

A

thin lining inside the chambers of the heart

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9
Q

Myocardium

A

muscle tissue of the heart

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10
Q

Pericardium

A

thin, double layered sac that encloses the heart.

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11
Q

Rheumatic Fever

A

a rare complication of streptococcal pharyngitis (strep throat) infections. Caused by streptococcus pyogenes (GAS). most common in children ages 5-15 and adults in developing countries.

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12
Q

a rare complication of streptococcal pharyngitis (strep throat) infections. Caused by streptococcus pyogenes (GAS). most common in children ages 5-15 and adults in developing countries.

A

inflammation of the heart valves, no active infection

symptoms of rheumatic fever

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13
Q

Polyarthritis

A

large joints, lasting ~2-4 weeks

symptom of rheumatic fever

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14
Q

Erythema marginatum

A

Rash of Rheumatic fever

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15
Q

Chorea

A

abnormal involuntary movement disorder characteristic of rheumatic fever.

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16
Q

Rheumatic Fever Treatment

A

anti-inflammatories, diuretics, and bedrest. prevent further attacks with antibiotics.

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17
Q

Treatment for rheumatic fever with NO residual heart disease

A

Penicillin (IM) once monthly for a minimum of 10mo. or until 25 years old

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18
Q

Treatment for rheumatic fever WITH residual heart disease

A

Penicillin (IM) once monthly until 40-45 years old, but often continued for life.

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19
Q

Rheumatic heart disease

A

heart disease caused by rheumatic fever.

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20
Q

rheumatic heart valve

A

clients with one are at an increased risk of complications associated with bacteremia. this increased risk is associated with turbulent bloodflow at the site of the damaged heart valve.

21
Q

Non-Bacterial Thrombotic Endocarditis (NBTE)

A

minor fibrin and platelet deposition can occur on the low pressure side of the damaged valve

22
Q

Why is transient bacteremia problematic?

A

because it gives the microbe a place to adhere, increasing the risk of infective endocarditis

23
Q

Endocarditis

A

infection and inflammation of the endocardium; commonly affects the mitral and aortic heart valves.

24
Q

subacute endocarditis

A

symptoms develop slowly; fatigue, malaise, fever, chills, anorexia, weight loss, back pain.
signs include new or changing heart murmur, peripheral manifestations.
associated with relatively non-virulent bacteria (ie. viridans streptococci)

25
Q

acute endocarditis

A

symptoms develop quickly; intense fever, shaking, chills, exhaustion.
signs include new or changing heart murmur, peripheral manifestations, sepsis.
associated with highly virulent bacteria (ie. staphylococcus aureus)

26
Q

Peripheral manifestations of endocarditis

A

splinter hemorrhages, conjunctiva petichiae, osler’s nodes, roth’s spots, and janeway lesions

27
Q

Osler’s nodes

A

painful, raised, red lesions on hands and feet

28
Q

Roth’s Spots

A

red spots with white centres on the retina

29
Q

Janeway Lesions

A

non-tender, small, erythematous lesions on the palms or soles of feet.

30
Q

bacteremia risk factors

A

associated with injection drug users and people with central IVs in people with both normal and abnormal valves

31
Q

subacute infective endocarditis risk factors

A

people with abnormal heart valves, prosthetic valves, rheumatic valves, mitral valve prolapses, and congenitally abnormal valves

32
Q

Turbulent bloodflow

A

causes roughening of the endocardium that allows bacteria to adhere to the endocardium

33
Q

Complications of endocarditis

A
  • persistent bacteremia and risk of seeding distant sites (risk of secondary infection, sepsis)
  • Tissue destruction (damage to heart valve, heart failure)
  • Fragmentation of Vegetation (CNS emboli, MI, stroke, vascular insufficiency, and necrosis)
  • Stimulation of antibodies (combine with bacterial antigens and form circulating immune complexes that deposit in kidneys or skin)
  • Recurrent infection (once you’ve had endocarditis, you’re at a higher risk for getting in again d/t damaged heart valve)
34
Q

Duke Criteria

A

for endocarditis (need 2 major, 1 major + 3 minor, or 5 minor)
MAJOR:
1. 2 positive blood cx with staph aureus, viridans strep, strep bovis/epidermidis, enterococci, GNRs, Candida (HACEK orgs are generally cx negative!)
2. abnormal echo (mass/vegetation, abscess, new partial detachment of prosthetic valve)
MINOR:
1. fever >38 degrees
2. risk factors (IV drug use, structural heart disease, prosthetic valve, dental procedures involving bleeding, h/o endocarditis)
3. vascular findings (janeway lesions, septic pulmonary infarcts, arterial emboli, mycotic aneurysm, conjunctival hemorrhage)
4. immunologic findings (roth spots, osler’s nodes, Glomerulonephritis)
5. micro findings (positive blood culture that doesn’t meet major criteria)

35
Q

treatment of endocarditis

A

appropriate antimicrobial therapy (bactericidal) administered parenterally (long duration 4-6 weeks), valve replacement surgery in cases of severe AROs, severe valve dysfunction, recurrent embolism, or in cases of fungal endocarditis

36
Q

Prevention of endocarditis

A

Prophylactic antibiotic therapy in advance of surgical and dental procedures (ie. procedures associated with transient bacteremia)

37
Q

Myocarditis

A

inflammatory cardiomyopathy most often associated with a viral infection of the myocardium and infiltration of cardiac muscle by t-lymphocytes.

38
Q

Myocarditis causative pathogens

A

enteroviruses (coxsackie B), adenovirus, HSV, influenza, HIV.

39
Q

Myocarditis symptoms

A

Hx of recent flulike syndrome of fever, malaise, pharyngitis, tonsilitis, or upper respiratory tract infection.
Sx of mild heart failure (fatigue, weakness, SOB, edema, palpitations, arrhythmias)
Pain reported in those with concomitant pericarditis

40
Q

pediatric myocarditis

A

acute symptoms; cardiogenic shock and acute heart failure, sudden death

41
Q

adult myocarditis

A

progresses slowly- progressive heart failure and dilated cardiomyopathy

42
Q

coxsackie-adenovirus receptor (CAR)

A

a receptor in the heart myocytes that welcomes viral pathogens into the heart. the virus then attacks the heart, T-lymphocytes enter that are also filled with virus. the heart then makes more of these receptors, and the client becomes more ill.
higher concentration in children than adults.

43
Q

Myocarditis treatment

A

same as for heart failure; ACE inhibitors, diuretics, beta-blockers. avoid NSAIDs (increased risk of mortality), induce fluid retention (d/t vasoconstriction of blood vessels in the kidneys), immunosuppressive therapy

44
Q

early resolution of myocarditis

A

complete recovery

45
Q

prolonged symptoms of myocarditis

A

permanent dilated cardiomyopathy, increased risk of heart attack and stroke, worsening heart failure, death, or need for cardiac transplantation.

46
Q

Pericarditis

A

inflammation of the pericardium. may coexist with myocarditis.
viruses are the most causative pathogens (eg. entoviruses; coxsackie virus, echovirus)
appears 2-3 weeks after “flu-like” symptoms

47
Q

Pericarditis symptoms

A

sharp, stabbing chest pain caused by rubbing of 2 layers of the pericardium. pain worsens when laying down, with deep breaths, swallowing, and coughing. pain improves with sitting upright or forward.

48
Q

Pericarditis diagnostic findings

A

abnormal heart sounds (pericardial rub), abnormal ECG, echocardiogram (appearance of fluid surrounding the heart)

49
Q

pericarditis treatment

A
  • analgesics and anti-inflammatory drugs (NSAIDs or steroids)
  • antibiotics for bacterial causes
  • pericardial tamponade (tachycardia, SOB, increased RR and prominent neck veins): pericardiocentesis (drainage of pericardial fluid)
  • constructive paricarditis: pericardectomy (surgical removal of pericardium)

Microbiology (7 decks)

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