CV Infectious Disease--Diebel

Question 1

3 layer of the heart: 3 inflammatory diseases of layers of the heart

+ causative organisms

Answer 1

endocarditis: Staph and Strep

myocarditis: Coxsackie B, adenovirus

pericarditis: Coxsackie A and B, echovirus, influenza

Question 2

When are coxsackie virus infections most common?

Answer 2

summer

Question 3

When is one most likely to have pericarditis (time of year)?

Answer 3

summer

coxsackie most prevelent in summer months

(all enteroviruses)

fecal-oral transmission

Question 4

IV drug users are most likely to have this causative organism causing endocarditis

Answer 4

S. aureus

Question 5

Two major categories of infectious endocarditis

Answer 5

acute

subacute

Question 6

Acute infectious endocarditis Sx

Answer 6

hectically febrile

rapidly damages cardiac structures

seeds distally via sepsis

death in weeks w/o Tx

Question 7

Subacute infectious endocarditis Sx

Answer 7

low infectious course

slow damage

rarely seeds via sepsis

gradually progressive

Question 8

IV drugs can cause infectious endocarditis in this location that is unusual

Answer 8

tricuspid valve

Question 9

Two most common points of infection for infectious endocarditis

Answer 9

mitral and aortic valves

Question 10

protein A

S. aureus

Answer 10

binds Fc region of IgG

Question 11

coagulase

S. aureus

Answer 11

forms fibrin clot around organism

Question 12

hemolysins and leukocidins

S. aureus

Answer 12

destroy RBC and WBC

Question 13

hyaluronidase

S. aureus

Answer 13

breaks down CT, deep tissue invasion

Question 14

staphylokinase

Answer 14

lyses formed clots

Question 15

lipase

S. aureus

Answer 15

breaks down fat

Question 16

S. aureus virulence factors

Answer 16

biofilm formation

capsule

adhesins

pathogenicity islands

Question 17

Strepococcal viridans species are a common cause of infectious endocarditis, especially in what situation?

Answer 17

post-dental procedures

common oral flora

Question 18

Common Strep viridans species

Answer 18

S. mutans

Question 19

S. mutans classification

Answer 19

bacteria

Gram +

Cocci

Catalase -

alpha-hemolytic

bacitracin-resistant

S. mutans

Question 20

Enterococcus species

cause endocarditis in which populations

Answer 20

young women after OB procedures

older men after genitourinary procedures

Question 21

Enterococcus species virulence factors

Answer 21

pili

surface proteins

extracellular enzymes

hyaluronidases

Question 22

Complications of what infection leads to rheumatic fever?

Answer 22

S. pyogenes pharyngitis

Question 23

S. pyogenes

classification

Answer 23

Bacteria

Gram +

Cocci

Coagulase -

Beta-hemolytic

bacitracin-sensitive

S. pyogenes

Question 24

Major unforgettable S. pyogenes virulence factor

Answer 24

M-protein

normally resists phagocytosis

antibodies to M-protein cross-react with mycardial meromyosin in some individuals and causes rheumatic heart disease

Question 25

M-protein in *S. pyogenes* normally...

Answer 25

resists phaogcytosis

Question 26

Sx of rheumatic fever

Answer 26

2-4 week post-strep pain/swelling of large joints fever weakness muscle aches SOB chest pain N/V hacking cough circular rash lumps under skin

Question 27

Rheumatic fever can cause what kind of damage to the mitral valve

Answer 27

stenosis inability to open all the way

Question 28

Antibodies and rheumatic fever

Answer 28

formed against M-protein in *S. pyogenes* but cross-react with meromyosin in heart

Question 29

Age group of rheumatic fever

Answer 29

5-15 y/o

Question 30

Myocarditis organisms

Answer 30

coxsackie B adenovirus

Question 31

Pericarditis organsisms

Answer 31

coxsackie A and B echovirus influenza

Question 32

coxsackie classification

Answer 32

virus ssRNA(+), Group IV nonsegmented icosohedral nucleocapsid non-enveloped picornavirus enterovirus coxsackie A and B

Question 33

Rocky mountain spotted fever organism

Answer 33

*R. rickettsii*

Question 34

Rocky mountain spotted fever Tx

Answer 34

doxycycline

Question 35

Specialness of rocky mountain spotted fever, pathogenicity

Answer 35

obligate intracellular organism requires host ATP

Question 36

Rash in rocky mountain spotted fever

Answer 36

on palms and soles, spreading centrally

Question 37

FnbpA (elastin, collagen, fibronectin) binding proteins - function - organism

Answer 37

adhesion/biofilm formation ## Footnote *S. aureus*

Question 38

Coagulase -organism

Answer 38

*S. aureus*

Question 39

Leukocidin -organism

Answer 39

*S. aureus*

Question 40

Capsule -organism

Answer 40

*S. aureus*

Question 41

SdrG (SD-repeat containing protein G) - function - organism

Answer 41

- adhesion - *S. epidermidis*

Question 42

CAR binding proteins - function - organism

Answer 42

coxsackie-adenovirus cellular receptor - adhesion - coxsackie A and B, adenovirus

Question 43

OmpA and OmpB - function - organism

Answer 43

- adhesion - *R. rickettsia*

Question 44

Type 4 secretion system (T4SS) - function - organism

Answer 44

- host cell entry - *R. rickettsia*